Low serum 25-hydroxyvitamin D is associated with increased risk of stress fracture during Royal Marine recruit training.
Osteoporos Int. 2016 Jan;27(1):171-9. doi: 10.1007/s00198-015-3228-5. Epub 2015 Jul 10.
Davey T1, Lanham-New SA2, Shaw AM3, Hale B4, Cobley R3, Berry JL5, Roch M6, Allsopp AJ3, Fallowfield JL3.
- Stress fractures in 1 in 5 women during Army basic training – April 2018
- Army Training trying performance readiness bars with 1400 IU of Vitamin D (Dr. Matthews) – Sept 2018
- Increased Bone strength during military training – with just 800 IU of vitamin D and Calcium – RCT April 2014
- Stress fractures in basic training associated with 2.5 ng less vitamin D – meta-analysis Nov 2014
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Metatarsal Stress Fracture 5X more likely if low vitamin D – Nov 2015
- Need for Routine Vitamin D Screening in Military Personnel – Sept 2016
- Perhaps Stress fractures 2X less frequent if 4000 IU of vitamin D – June 2011
- Huge increase in Vitamin D supplementation in the US military (2005-13) – Oct 2016 - they are learning of the benefits of Vitamin D
See also web
- Femoral and tibial stress fractures associated with vitamin D insufficiency J R Army Med Corps, March 2014
1Environmental Medicine and Science, Institute of Naval Medicine, Cresent Road, Alverstoke, Gosport, PO12 2DL, UK. trish at trishdavey.co.uk.
2Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
3Environmental Medicine and Science, Institute of Naval Medicine, Cresent Road, Alverstoke, Gosport, PO12 2DL, UK.
4University of Chichester, College Lane, Chichester, West Sussex, PO19 6PE, UK.
5Specialist Assay Laboratory, Clinical Biomechemistry, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
6Clinical Laboratory Services, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, B15 2WB, UK.
The aim of this study was to investigate vitamin D status and stress fracture risk during Royal Marine military training. Poor vitamin D status was associated with an increased risk of stress fracture. Vitamin D supplementation may help to reduce stress fracture risk in male military recruits with low vitamin D status.
Stress fracture is a common overuse injury in military recruits, including Royal Marine (RM) training in the UK. RM training is recognised as one of the most arduous basic training programmes in the world. Associations have been reported between serum 25-hydroxyvitamin D (25(OH)D) and risk of stress fracture, but the threshold of 25(OH)D for this effect remains unclear. We aimed to determine if serum 25(OH)D concentrations were associated with stress fracture risk during RM training.
We prospectively followed 1082 RM recruits (males aged 16-32 years) through the 32-week RM training programme. Troops started training between September and July. Height, body weight and aerobic fitness were assessed at week 1. Venous blood samples were drawn at weeks 1, 15 and 32. Serum samples were analysed for 25(OH)D and parathyroid hormone (PTH).
Seventy-eight recruits (7.2 %) suffered a total of 92 stress fractures. Recruits with a baseline serum 25(OH)D concentration below 50 nmol L(-1) had a higher incidence of stress fracture than recruits with 25(OH)D concentration above this threshold ( (2) (1) = 3.564, p = 0.042; odds ratio 1.6 (95 % confidence interval (CI) 1.0-2.6)). Baseline serum 25(OH)D varied from 47.0 ± 23.7 nmol L(-1) in February, to 97.3 ± 24.6 nmol L(-1) in July (overall mean 69.2 ± 29.2 nmol L(-1), n = 1016). There were weak inverse correlations between serum 25(OH)D and PTH concentrations at week 15 (r = -0.209, p < 0.001) and week 32 (r = -0.214, p < 0.001), but not at baseline.
Baseline serum 25(OH)D concentration below 50 nmol L(-1) was associated with an increased risk of stress fracture. Further studies into the effects of vitamin D supplementation on stress fracture risk are certainly warranted.
PMID: 26159112 DOI: 10.1007/s00198-015-3228-5