Vitamin D and fracture reduction: an evaluation of the existing research.
This article re-evaluates the literature on vitamin D and fracture reduction, highlighting the relevance of new understandings for fracture prevention. A new set of science-based research guidelines for clinical trials on vitamin D and fracture is proposed. The existing clinical trials on vitamin D and fracture are analyzed, focusing on studies that most closely meet the proposed guidelines. An estimation of the true fracture-reduction potential of therapeutic-level vitamin D supplementation is offered. The analysis outlined in this article leads to a series of striking conclusions. First, most of the available clinical trials and meta-analyses of vitamin D and fracture underestimate the true fracture reduction potential of vitamin D. Second, achievement of vitamin D serum sufficiency levels (now set in the United States, Europe, and many other places at a minimum of 32 ng per mL) could provide for a 50- to 60-percent fracture reduction. And third, providing for vitamin D sufficiency is the simplest, most life-supporting, and most cost effective means of significantly reducing the incidence of osteoporotic fractures worldwide. Given the urgent need, the Osteoporosis Education Project (OEP) has initiated a call for universal vitamin D repletion as the primary basis for osteoporotic fracture prevention worldwide.
Brown
Susan E
SE
Osteoporosis Education Project and Nutrition Education and Consulting Service, Syracuse, NY, USA. drsbrown@earthlink.net
D002986:Clinical Trials as Topic; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D017408:Guidelines as Topic; D006801:Humans; D010024:Osteoporosis / Q000150:complications / Q000517:prevention & control*; D012106:Research / Q000592:standards; D013472:Sunlight; D014807:Vitamin D / Q000008:administration & dosage / Q000502:physiology*; D014808:Vitamin D Deficiency / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage
D014815:Vitamins; D014807:Vitamin D