The Effects of Vitamin D Supplementation on Musculoskeletal Health: The VITAL and DO-Health Trials

Author:

LeBoff Meryl S12,Bischoff-Ferrari Heike A3ORCID

Affiliation:

1. Calcium and Bone Section, Skeletal Health and Osteoporosis Center and Bone Density Unit, Harvard Medical School , Boston, Massachusetts , USA

2. Endocrinology, Diabetes and Hypertension Division, Brigham and Women’s Hospital , Boston, Massachusetts , USA

3. Department of Geriatrics and Aging Research, University of Zurich and University Hospital of Zurich , Zurich , Switzerland

Abstract

Abstract Previous clinical trials and systematic reviews on the effects of supplemental vitamin D on musculoskeletal outcomes are conflicting. In this paper, we review the literature and summarize the effects of a high daily dose of 2 000 IU vitamin D on musculoskeletal outcomes in generally healthy adults, in men (≥50 years) and women (≥55 years) in the 5.3-year US VITamin D and OmegA-3 TriaL (VITAL) trial (n = 25 871) and women and men (≥70 years) in the 3-year European DO-HEALTH trial (n = 2 157). These studies found no benefit of 2 000 IU/d of supplemental vitamin D on nonvertebral fractures, falls, functional decline, or frailty. In VITAL, supplementation with 2 000 IU/d of vitamin D did not reduce the risk of total or hip fractures. In a subcohort of VITAL, supplemental vitamin D did not improve bone density or structure (n = 771) or physical performance measures (n = 1 054). In DO-HEALTH, which investigated additive benefits of vitamin D with omega-3 and a simple home exercise program, the 3 treatments combined showed a significant 39% decreased odds of becoming prefrail compared to the control. The mean baseline 25(OH)D levels were 30.7 ± 10 ng/mL in VITAL and 22.4 ± 8.0 ng/mL in DO-HEALTH and increased to 41.2 ng/mL and 37.6 ng/mL in the vitamin D treatment groups, respectively. In generally healthy and vitamin D-replete older adults not preselected for vitamin D deficiency or low bone mass or osteoporosis, 2 000 IU/d of vitamin D had no musculoskeletal health benefits. These findings may not apply to individuals with very low 25(OH)D levels, gastrointestinal disorders causing malabsorption, or those with osteoporosis.

Funder

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Cancer Institute

National Heart, Lung, and Blood Institute

Office of Dietary Supplements

National Institute of Neurological Disorders and Stroke

National Center for Complementary and Integrative Health

Seventh framework program of the European Commission

University of Zurich

DNP

Roche

NESTEC

Pfizer

Streuli

National Institute on Aging

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging

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