Serum 25-Hydroxyvitamin D Levels and Stress Fractures in Military Personnel: A Systematic Review and Meta-analysis.
Am J Sports Med. 2014 Nov 4. pii: 0363546514555971. [Epub ahead of print]
Dao D 1, Sodhi S 1, Tabasinejad R 2, Peterson D 3, Ayeni OR 3, Bhandari M 4, Farrokhyar F 5.
1Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
2School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
3Department of Surgery, McMaster University, Hamilton, Ontario, Canada Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
4Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Surgery, McMaster University, Hamilton, Ontario, Canada Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
5Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Surgery, McMaster University, Hamilton, Ontario, Canada Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
BACKGROUND: Low serum 25-hydroxyvitamin D (25(OH)D) levels have been associated with stress fractures in various physically active populations such as the military.
PURPOSE: To examine the association between serum 25(OH)D levels and stress fractures in the military.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: Relevant studies were identified through searching multiple databases and manually screening reference lists. Two reviewers independently selected the included studies by applying the eligibility criteria to the title, abstract, and/or full text of the articles yielded in the search. Two reviewers also independently conducted the methodological quality assessment and data extraction. A random-effects model was used to calculate the mean difference (MD) with 95% CI in serum 25(OH)D levels between stress fracture cases and controls.
RESULTS: Nine observational studies on lower extremity stress fractures were eligible, and 1 was excluded due to inadequate data. A total of 2634 military personnel (age, 18-30 years; 44% male) with 761 cases (16% male) and 1873 controls (61% male) from 8 studies were included in the analysis. Three of the 8 studies measured serum 25(OH)D levels at the time of stress fracture diagnosis, and the 5 remaining studies measured serum 25(OH)D levels at the time of entry into basic training. The mean serum 25(OH)D level was lower in stress fracture cases than in controls at the
- time of entry into basic training (MD, -2.63 ng/mL; 95% CI, -5.80 to 0.54; P = .10; I2 = 65%) and at the
- time of stress fracture diagnosis (MD, -2.26 ng/mL; 95% CI, -3.89 to -0.63; P = .007; I2 = 42%).
Despite the inherent limitations of the included studies, the study results suggest some association between low serum 25(OH)D levels and lower extremity stress fractures in military personnel. Given the rigorous training of military personnel, implementing strategies to ensure sufficient 25(OH)D levels may be beneficial for reducing the risk of stress fractures.
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- Army Training trying performance readiness bars with 1400 IU of Vitamin D (Dr. Matthews) – Sept 2018
- Vitamin D prescriptions in US Military increased 5X in 5 years – July 2015
- Review of Vitamin D and Physical Performance – May 2013
- Sports benefits from up to 50 ng of Vitamin – meta-analysis - Nov 2012 has the following chart
Items in both categories Bone and Sports:
- Stress fractures take longer to heal if low vitamin D – Aug 2020
- Stress Fractures and Vitamin D – narrative review March 2021
- Many Foot and ankle problems are treated by Vitamin D – review of 35 studies – Sept 2019
- 4X fewer stress fractures in college athletes if more than 40 ng of vitamin D – Feb 2016
- Metatarsal Stress Fracture 5X more likely if low vitamin D – Nov 2015
- Stress fractures – 83 percent had less than 40 ng of vitamin D – Sept 2015
- Stress fractures in basic training associated with 2.5 ng less vitamin D – meta-analysis Nov 2014
- People with old burns improved muscle strength with 2200 IU average vitamin D – RCT Sept 2014
- Strong bones need both physical activity and vitamin D – Jan 2013
- Female Athlete health problems may be due to lack of vitamin D and Iron – July 2012
- Half as many fractures for girls with high vitamin D intake – March 2012
- Perhaps Stress fractures 2X less frequent if 4000 IU of vitamin D – June 2011
- Shin splints decrease with vitamin D
- Many abstracts on fewer stress and bone fractures with vitamin D
- Sports Nutrition Conference on Bone health Calcium and vitamin D – Sept 2010
- Vitamin D at Experimental Biology meeting April 2010