09 October 2010

Why vitamin D is vital in the elderly

What's the latest on vitamin D and the elderly? Most don't get enough, says Jeri Nieves, Ph.D., who addresed us on the topic today at the American College of Nutrition conference in New York City.

There has been a "burst" of new studies on vitamin D, so she will only covef a few.

The prevalence of vitamin D deficiency in older adults puts them at higher risk of several poor health outcomes such as osteoporosis, cardiovascular disease, and cancer.

We know that vitamin D is necessary with calcium to prevent bone loss and fracture risk. Plus, several studies she goes into show that vitamin D status is directly correlated with hip fracture.

One study showed 36 percent reduction of hip fractures in people with high vitamin D status. The higher the dose, the stronger the reduction.

What if we give vitamin D to people in the hospital who have already had hip fractures? At 2000IU daily, there was no significant difference in rate of falls, but reduced repeat hospital admissions.

Why does vitamin D protect against falls? It is related to muscle. Vitamin D deficiency causes muscle weakness. High vitamin D levels are associated with greater leg strength (Stockton, Osteop Int 2010).

NHANES research shows that vitamin D deficiency is associated with increased risk of frailty.

What about infectious disease? Elderly with higher serum 25-D levels don't get sick as often (Chesney, J Peds, 2010), so maybe vitamin D should accompany vaccinations.

She's now talking about how low vitamin D levels is associated with multiple sclerosis later in life, as well as rheumatoid arthritis and depression. In fact, vitamin D deficiency is associated with worse outcomes.

Lower vitamin D is also associated with higher risk of gum disease. Those with higher levels have less tooth loss.

What about cancer? Higher levels of vitamin D is related to a 50 percent reduction of breast cancer, reduced risk of colorectal cancer, and prostate cancer.

However, as a cautionary note, vitamin D in levels above 40ng is associated with higher risk of pancreatic cancer.

What about CVD? Living at higher latitudes increases risk of hypertension and cardiovascular disease. Vitamin D deficiency increases cardiovascular events by 62 percent.

Just this week, a study shoerd that patients with heart failure and low levels of vitamin D had a higher risk of all-cause mortality.

In general, low serum 25-D levels is associated wit increased risk of death, higher mortality rates, according to several studies and meta-analyses.

In summary, vitamin D is associated with several major chronic, age-related diseases and the elderly should consider supplementation. She recommends an intake of 1,000 IU a day with assessment of 25-D serum levels.

She also briefly talks about D3 versus D2 and why it should not matter which is used, since they both work (Holick JCEM 2008).

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