Fraser Health in Canada will be giving 20000 IU vitamin D weekly to reduce falls – Nov 2011

News Release

Optional for all Fraser Health 7,500 senior residents in Western Canada
Cost per year to Fraser Health of providing the vitamin D is estimated to about that of the cost of a single hip fracture , $20,000
Before vitamin D they had 1,000 to 1,500 falls per year
They hope to prevent 10% to 25% of the falls per year
Thus they hope to prevent 100 to about 300 falls per year
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Notes from phone conversation with Michael McBryde at Fraser Health Nov 23, 2011

Vitamin D has a problem of following other “wonder drugs” which proved to be not so beneficial – but this time is different. A problem of “cry wolf”.
Great resistance by many doctors to try vitamin D until after extensive and solid evidence.
Their program is somewhat funded by the Canadian govt (after 18 months of effort).
Fraser has issued quarterly reports – such as hip fractures as required in Canada
They should have a large enough dataset – with 7,000 residents – to easily detect the reduction in fractures etc. as a result of adding vitamin D
They will not have vitamin D tests before and during the protocol – too expensive.
All prescriptions are given by nurses to the senior home residents, approximately 85% of whom are demented.
Prescription of 20,000 IU tablet once per week.
  Had considered once per month, but was concerned that the resident might be absent on the day of the month that it was given.
He expects a very high participation rate – as the doctors must give a reason why their patients should not participate. - This might be called an opt-out situation.
A very small percentage of the residents will not participate – probably due being on dialysis or having high levels of Calcium

Future expansion of the program:

– Add co-factors of Vitamin K2 and Magnesium (the residents already get enough Calcium) to improve the effectiveness of the vitamin D on the bones
– Add more vitamin D for those at high risk (dark skin, obese, etc)
– Others in Fraser Health will probably elect in the future to extend vitamin D to some of the 99.9% of Fraser Health who are not in senior facilities

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See VitaminDWiki

• Overview Falling, Fractures and Vitamin D
  It appears that at least 2,000 IU of vitamin D and 500 mg of Calcium are needed to substantially reduce falling
• Overview Bone fractures and vitamin D
  Build bone by having enough vitamin D (>1,000 IU) when also having cofactors
    >4,000 IU for a wide variety of reasons
  Reduce falls by having enough vitamin D to maintain youthful nerve and muscle response time - again with co-factors
• HMOs will save millions of dollars with vitamin D
• All items in category Cost Savings 145 items
• Overview of Vitamin D Wiki made for Fraser Health
• Forum at this site on HMOs includes some items on Fraser

Possible problems if Fraser Health does not reduce Calcium when increasing Vitamin D

Previously the nutritionists made sure that seniors got > 1 gram of Calcium daily
The literature shows problems with > 750 mg of Calcium when the person has 'enough' vitamin D
IoM again fails to look at interactions - Nov 2010 has the following chart

• CLICK HERE for all items in Calcium category 98 items as of July 2012
• Must balance co-factors when increasing vitamin D
• Is excess calcium harmful to health - 2010 many papers
• More than 800 mg of Calcium increases Cardiovascular events by 85 percent– Nov 2011
• Controversy: Too much Calcium if increase Vitamin D
• Vitamin D Omega 3 and Exercise are being used in controlled trial to support healthy ageing – Feb 2012

Update July 2012

Dr. Michael McBryde retired Jan 2012
The project in now supported by Dr. Larry Gustafson
It will actually start in the fall of 2012

Update fall 2014

They ran the study and published the results Contact = tim.green at ubc.ca
Read the study ($6) - I was amazed that:

• They failed to compute mortality vs vitamin D levels
• They failed to compute falls/fracture vs vitamin D levels - as was initially intended
• They did not record if the vitamin D was actually taken - just prescribed
• They stated that there was no benefit, but the PDF failed to show ANY computation of benefit
• Smokers had HIGHER vitamin D levels than non-smokers
  They thought the higher levels might be due to the requirement that smoking must be done outdoors