Physical Performance and Vitamin D in Elderly Black Women – The PODA Randomized Clinical Trial
The Journal of Clinical Endocrinology & Metabolism, https://doi.org/10.1210/jc.2018-01418
John Aloia, MD Mageda Mikhail, MD Melissa Fazzari, PhD Shahidul Islam, MPH, PStat® Lou Ragolia, PhD Jack Guralnik, MD, PhD
Note: This study increased the vitamin D levels by about 10 ng
- Frailty risk increases 12 percent for every 10 ng less vitamin D – meta-analysis Sept 2018
- Speed of getting up from chair is proportional to Vitamin D levels (above 30 ng) Jan 2018
- 30 ng, which was the goal of the study on this page, was not enough
- Elderly should not have more than 40 ng of vitamin D (if infrequent dosing or fail to adjust cofactors) Aug 2017
- Is 50 ng of vitamin D too high, just right, or not enough
- Many organizations believe that >40 ng is needed
10 reasons why seniors need more vitamin D has the following
- Senior skin produces 3X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptors as they age
- Seniors are indoors more than than when they were younger
- not as agile, weaker muscles; frail, no longer enjoy hot temperatures
- (if outside, stay in the shade), however, seniors might start outdoor activities like gardening, biking, etc.
- Seniors wear more clothing outdoors than when younger
- Seniors also are told to fear skin cancer/wrinkles
- Seniors often take various drugs which reduce vitamin D
- Some reductions would not show up on vitamin D test
- statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
- Seniors often have one or more diseases which consume vitamin D
- osteoporosis, diabetes, MS, ...
- Seniors generally put on weight at they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Reduced stomach acid ==>less Magnesium needed to utilize vitamin D
(would not show up on vitamin D test)
- Seniors with poorly functioning kidneys do not process vitamin D as well
(would not show up on vitamin D test) 2009 full text online Also PDF 2009
- Vitamin D is not as bioavailable in senior digestive systems (Stomach acid or intestines?)
- Category Seniors and Vitamin D
Context: There is limited information on the influence of vitamin D on physical performance in black Americans.
Objective: To determine if maintenance of serum 25(OH)D above 75 nmol/L prevents the decline in physical performance.
Design: The PODA trial had a prospective, randomized, placebo controlled, double-dummy design with two arms: one with placebo vitamin D3 adjusted to maintain serum 25(OH)D above 75 nmol/L.
Patients: The target population was healthy elderly black women with serum 25(OH)D between 20 and 65 nmol/L. The trial was 3 years in duration with measurement of physical performance every 6-months:
- Grip strength,
- Short Physical Performance Battery (SPPB),
- 10 chair rises and 6-minute walk distance.
260 women entered the study and 184 completed 3 years. Mean age was 68.2 years.
Baseline 25(OH)D was 53 nmol/L and total SPPB was 11 (10-12).
Setting: Research Center in an Academic Health Center.
Main Outcomes Measure: Prevention of decline in physical performance measures.
Intervention: Participants were randomly assigned to placebo or active vitamin D. Vitamin D3 dose was adjusted to maintain serum 25(OH)D above 75 nmol/l.
Results: There was a decline with time in grip strength and the 6-minute walk. The SPBB increased with time. There were no significant differences between the placebo and active vitamin D3 groups with respect to the temporal patterns observed for any of the performance measures.
Conclusions: There is no benefit of maintaining serum 25(OH)D above 75 nmol/L in preventing the decline in physical performance in healthy black American women.Physical performance of black senior women not improved with 30 ng of Vitamin D – RCT Nov 2018
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