title: Exogenous calciferol (vitamin D) and vitamin D endocrine status among elderly nursing home residents in the New York City area.
abstract: OBJECTIVE
  To determine the role and relative importance of sources of exogenous calciferol (vitamin D) in maintaining vitamin D endocrine status in the mid-winter and early spring in a representative sample of institutionalized elderly persons in the New York City area.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A privately-run urban nursing home and the long-term care unit of a suburban public hospital.
  
  
  METHODS
  Residents aged 60 years and older scheduled for a routine annual physical examination and an additional group of individuals ascertained by random sampling. Those with a history of anti-convulsant or glucocorticoid use, liver disease, chronic renal disease (or serum creatinine > 1.5 mg/dL), parathyroid disease, Paget's disease, gastric surgery, or pharmacological vitamin D use were excluded. Of 301 sampled individuals, 221 were found eligible to participate, and 109 were successfully enrolled.
  
  
  RESULTS
  The average vitamin D intake was 379 IU/day (range 55-1006 IU/day) and total vitamin D intake was below the Recommended Dietary Allowance in 16% of subjects. Fifty percent of total vitamin D intake came from fortified milk, and 26% came from vitamin supplements. Vitamin supplement use was not associated with low dietary intake. Among subjects taking a supplement containing 400 IU/day, none had serum calcidiol levels below 15 ng/mL, while among subjects with vitamin D intake between 200 and 400 IU/day, 46% had serum calcidiol levels below 15 ng/mL and 14% had calcidiol levels below 10 ng/mL. Vitamin D intake from non-supplement sources (but not from supplements) appeared to have a negative association with serum calcitriol levels.
  
  
  CONCLUSIONS
  Many nursing home residents may require vitamin supplements in order to achieve optimal levels of calciferol replacement. The choice of a vehicle for calciferol replacement may affect calcitriol levels.
authors: Division of Epidemiology, Columbia University School of Public Health, New York, New York.
authors: K J
authors: KJ
authors: O'Dowd
authors: T L
authors: TL
authors: Clemens
authors: J L
authors: JL
authors: Kelsey
authors: R
authors: R
authors: Lindsay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002112:Calcifediol / Q000097:blood; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004872:Ergocalciferols / Q000008:administration & dosage*; D015444:Exercise; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009735:Nursing Homes; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D010758:Phosphorus / Q000097:blood; D012621:Seasons; D012709:Serum Albumin / Q000032:analysis; D014808:Vitamin D Deficiency / Q000097:blood / Q000178:diet therapy / Q000453:epidemiology*
chemical_list: D004872:Ergocalciferols; D012709:Serum Albumin; D010758:Phosphorus; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase; D002117:Calcitriol; D002112:Calcifediol; D002118:Calcium