Knee osteoarthritis more painful if low vitamin D, especially among obese – Jan 2015

A Cross-Sectional Examination of Vitamin D, Obesity, and Measures of Pain and Function in Middle-Aged and Older Adults with Knee Osteoarthritis.

Clin J Pain. 2015 Jan 7. [Epub ahead of print]
Glover TL1, Goodin BR, King CD, Sibille KT, Herbert MS, Sotolongo AS, Cruz-Almeida Y, Bartley EJ, Bulls HW, Horgas AL, Redden DT, Riley JL 3rd, Staud R, Fessler BJ, Bradley LA, Fillingim RB.
1*University of Florida, College of Nursing, Adult and Elderly Nursing, Gainesville FL †University of Alabama at Birmingham, Departments of Psychology and Anesthesiology, Birmingham, AL ‡University of Florida, College of Dentistry, Department of Community Dentistry and Behavioral Science, Gainesville, FL ∥University of Alabama at Birmingham, Department of Psychology, Birmingham, AL ¶University of Alabama at Birmingham, Department of Medicine, Division of Clinical Immunology and Rheumatology, Birmingham, AL §University of Florida, Institute on Aging, Department of Aging and Geriatric Research, Gainesville, FL #University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL **University of Florida, Department of Medicine, Gainesville, FL ††University of Alabama at Birmingham School of Medicine, Department of Clinical Immunology and Rheumatology, Birmingham, AL

OBJECTIVES::
The prevalence of knee osteoarthritis is increasing with the aging population and is exacerbated by the growing numbers of obese older adults. Low levels of vitamin D, measured by serum 25-hydroxyvitamin D (25(OH)D), in older adults and obese individuals are correlated with several negative health conditions, including chronic pain. This cross-sectional study sought to examine the interactive influence of 25(OH)D levels and obesity on knee osteoarthritis pain and functional performance measures.

METHODS::
The sample consisted of 256 (63% female) racially-diverse (55% Black/African Americans) middle-aged and older adults (mean age 56.8 y). Blood was collected for analysis of 25(OH)D by high performance liquid chromatography. Participants provided self-report regarding knee osteoarthritis pain and underwent a lower extremity functional performance test.

RESULTS::
Results demonstrated that obesity was associated with lower levels of 25(OH)D. Participants with adequate 25(OH)D levels reported significantly less knee osteoarthritis pain compared to participants with deficient or insufficient levels, regardless of obesity status. Furthermore, there was a significant interaction between obesity and 25(OH)D levels for lower extremity functional performance, such that obese individuals with adequate 25(OH)D levels demonstrated better performance than those obese participants with deficient or insufficient 25(OH)D levels.

DISCUSSION::
The mechanisms by which adequate 25(OH)D levels are associated with pain severity and improved function have not been completely elucidated. It may be that the pleiotropic role of biologically active 25(OH)D influences pain and pain processing via peripheral and central mechanisms. Alternatively, higher levels of pain may lead to reduced outdoor activity, which may contribute to both obesity and decreased vitamin D. Thus, investigating vitamin D status in obese and non-obese individuals with knee osteoarthritis warrants further study.

PMID: 25569220

Study was reported in ScienceDaily

. . obese individuals who suffer from osteoarthritis and have adequate vitamin D levels could walk, balance and rise from sitting to standing better than obese participants with insufficient vitamin D levels.”

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See also VitaminDWiki

• Blacks had lower vitamin D and more quantifiable pain than whites with knee osteoarthritis – Nov 2012
• Good evidence for knee osteoarthritis and vitamin D, unsure of other OA – Review March 2013
• Knee osteoarthritis 2.3 X more likely to get worse if low level of vitamin D – Dec 2014
• Search VitaminDWiki for "Knee Osteoarthritis" 55 items as of Feb 2015

Overview Obesity and Vitamin D contains the following summary

• FACT: People who are obese have less vitamin D in their blood
• FACT: Obese need a higher dose of vitamin D to get to the same level of vit D
• FACT: When obese people lose weight the vitamin D level in their blood increases
• FACT: Adding Calcium, perhaps in the form of fortified milk, often reduces weight
• FACT: 168 trials for vitamin D intervention of obesity as of Dec 2021
• FACT: Less weight gain by senior women with > 30 ng of vitamin D
• FACT: Dieters lost additional 5 lbs if vitamin D supplementation got them above 32 ng - RCT
• FACT: Obese lost 3X more weight by adding $10 of Vitamin D
• FACT: Those with darker skins were more likely to be obese Sept 2014
• OBSERVATION: Low Vitamin D while pregnancy ==> more obese child and adult
• OBSERVATION: Many mammals had evolved to add fat and vitamin D in the autumn
  • and lose both in the Spring - unfortunately humans have forgotten to lose the fat in the Spring
• SPECULATION: Low vitamin D might be one of the causes of obesity – several studies
• SUGGESTION: Probably need more than 4,000 IU to lose weight if very low on vitamin D due to
    risk factors such as overweight, age, dark skin, live far from equator,shut-in, etc.
• Obesity category has 442 items

See also: Weight loss and Vitamin D - many studies   Child Obesity and Vitamin D - many studies   Obesity, Virus, and Vitamin D - many studies
Obese need more Vitamin D

• Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study