Cochraine, like many other meta-groups, ignores dose size, so the majority of studies which use 400 IU cancel out the benefits from studies using 10X as much
They also ignore the importance of Magnesium, Boron, and Silicone in building strong bones.
They probably also (wrongly) assume that the increase Bone Mineral Density (BMD) results in increase in Bone Strength.
Vitamin D and related vitamin D compounds for preventing fractures resulting from osteoporosis in older people Updated
Avenell A, Mak JCS, O'Connell D
Published Online: 14 April 2014
Why do older people suffer bone fractures?
Hip fractures and several other types of fractures are very common in post-menopausal women and older men due to age-related weakening of their bones (osteoporosis).
What is the impact of bone fractures in older people?
Fractures due to osteoporosis often occur in the hip, wrist or spine and can lead to considerable disability or even death. Those who survive often have reduced mobility and may require greater social and nursing care.
Why might vitamin D help?
Vitamin D is necessary for building strong bone. Older people often have low vitamin D levels because of lack of exposure to sunlight and low consumption of vitamin D in their diet. Therefore, it has been suggested that taking additional vitamin D in the form of supplements may help to reduce the risk of fractures of the hip and other bones.
Purpose of this review
To investigate the effects of vitamin D or vitamin D-related supplements, taken with or without calcium supplements, for preventing fractures in post-menopausal women and older men.
Conduct of this review
The review authors searched the medical literature up to December 2012, and identified 53 relevant medical trials, with a total of 91,791 people taking part. The trials reported fracture outcomes in postmenopausal women or men aged over 65 years from community, hospital and nursing-home settings. These trials compared vitamin D or related supplements with – or without - calcium supplements, against fake supplements (placebo), no supplement or calcium supplements alone.
Findings of this review
The review found reliable evidence that taking vitamin D only, in the forms tested in the trials, is unlikely to prevent fractures. However, reliable evidence showed that vitamin D taken with additional calcium supplements slightly reduces the likelihood of hip fractures and other types of fracture. The review found that there was no increased risk of death from taking vitamin D and calcium.
Although the risk of harmful effects (such as gastrointestinal (stomach) symptoms and kidney disease) from taking vitamin D and calcium is small, some people, particularly with kidney stones, kidney disease, high blood calcium levels, gastrointestinal disease or who are at risk of heart disease should seek medical advice before taking these supplements.
Abstract
Background: Vitamin D and related compounds have been used to prevent osteoporotic fractures in older people. This is the third update of a Cochrane review first published in 1996.
Objectives: To determine the effects of vitamin D or related compounds, with or without calcium, for preventing fractures in post-menopausal women and older men.
Search strategy:
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (to December 2012), the Cochrane Central Register of Controlled Trials (2012, Issue 12), MEDLINE (1966 to November Week 3 2012), EMBASE (1980 to 2012 Week 50), CINAHL (1982 to December 2012), BIOSIS (1985 to 3 January 2013), Current Controlled Trials (December 2012) and reference lists of articles.
Selection criteria:
Randomised or quasi-randomised trials that compared vitamin D or related compounds, alone or with calcium, against placebo, no intervention or calcium alone, and that reported fracture outcomes in older people. The primary outcome was hip fracture.
Data collection and analysis:
Two authors independently assessed trial risk of selection bias and aspects of methodological quality, and extracted data. Data were pooled, where possible, using the fixed-effect model, or the random-effects model when heterogeneity between studies appeared substantial.
Main results:
We included 53 trials with a total of 91,791 participants. Thirty-one trials, with sample sizes ranging from 70 to 36,282 participants, examined vitamin D (including 25-hydroxy vitamin D) with or without calcium in the prevention of fractures in community, nursing home or hospital inpatient populations. Twelve of these 31 trials had participants with a mean or median age of 80 years or over.
Another group of 22 smaller trials examined calcitriol or alfacalcidol (1-alphahydroxyvitamin D3), mostly with participants who had established osteoporosis. These trials were carried out in the setting of institutional referral clinics or hospitals.
In the assessment of risk of bias for random sequence generation, 21 trials (40%) were deemed to be at low risk, 28 trials (53%) at unclear risk and four trials at high risk (8%). For allocation concealment, 22 trials were at low risk (42%), 29 trials were at unclear risk (55%) and two trials were at high risk (4%).
There is high quality evidence that vitamin D alone, in the formats and doses tested, is unlikely to be effective in preventing hip fracture (11 trials, 27,693 participants; risk ratio (RR) 1.12, 95% confidence intervals (CI) 0.98 to 1.29) or any new fracture (15 trials, 28,271 participants; RR 1.03, 95% CI 0.96 to 1.11).
There is high quality evidence that vitamin D plus calcium results in a small reduction in hip fracture risk (nine trials, 49,853 participants; RR 0.84, 95% confidence interval (CI) 0.74 to 0.96; P value 0.01). In low-risk populations (residents in the community: with an estimated eight hip fractures per 1000 per year), this equates to one fewer hip fracture per 1000 older adults per year (95% CI 0 to 2). In high risk populations (residents in institutions: with an estimated 54 hip fractures per 1000 per year), this equates to nine fewer hip fractures per 1000 older adults per year (95% CI 2 to 14).
There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures. However, there is only moderate quality evidence of an absence of a statistically significant preventive effect on clinical vertebral fractures. There is high quality evidence that vitamin D plus calcium reduces the risk of any type of fracture (10 trials, 49,976 participants; RR 0.95, 95% CI 0.90 to 0.99).
In terms of the results for adverse effects: mortality was not adversely affected by either vitamin D or vitamin D plus calcium supplementation (29 trials, 71,032 participants, RR 0.97, 95% CI 0.93 to 1.01). Hypercalcaemia, which was usually mild (2.6 to 2.8 mmol/L), was more common in people receiving vitamin D or an analogue, with or without calcium (21 trials, 17,124 participants, RR 2.28, 95% CI 1.57 to 3.31), especially for calcitriol (four trials, 988 participants, RR 4.41, 95% CI 2.14 to 9.09), than in people receiving placebo or control. There was also a small increased risk of gastrointestinal symptoms (15 trials, 47,761 participants, RR 1.04, 95% CI 1.00 to 1.08), especially for calcium plus vitamin D (four trials, 40,524 participants, RR 1.05, 95% CI 1.01 to 1.09), and a significant increase in renal disease (11 trials, 46,548 participants, RR 1.16, 95% CI 1.02 to 1.33). Other systematic reviews have found an increased association of myocardial infarction with supplemental calcium; and evidence of increased myocardial infarction and stroke, but decreased cancer, with supplemental calcium plus vitamin D, without an overall effect on mortality.
Authors' conclusions:
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people. Supplements of vitamin D and calcium may prevent hip or any type of fracture. There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium. This review found that there was no increased risk of death from taking calcium and vitamin D.
See also VitaminDWiki
- Anti-depression medication about as good as big increase in vitamin D – meta-analysis of flawless data April 2014
a good example of a meta-analysis which ignored studies using worthless amount of vitamin D - Overview Fractures and vitamin D
- 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013
- Yet again, 800 IU of vitamin D was found to be barely enough to help bones – Lancet Oct 2013
- Both Vitamin D and Calcium are needed to reduce bone loss – RCT Sept 2013
- 22 percent more bone cracking found with low vitamin D – July 2013
- Osteoporosis spot therapies: vitamin D with Calcium was the most popular – Feb 2013
- Osteoporsis doctors need to prescribe 800 IU of vitamin D - study proposed of how to tell them – May 2012
Overview Osteoporosis and vitamin D contains the following summary
- FACT: Bones need Calcium (this has been known for a very long time)
- FACT: Vitamin D improves Calcium bioavailability (3X ?)
- FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
- FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
- FACT: Vitamin D supplements are very low cost
- FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
- FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
- FACT: Co-factors help build bones.
- FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
- It appears that to TREAT Osteoporosis:
- Calcium OR vitamin D is ok
- Calcium + vitamin D is good
- Calcium + vitamin D + other co-factors is great
- Low-cost Vitamin D Receptor activators sometimes may be helpful
- CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
- Category Osteoporosis has
221 items - Category Bone Health has
314 items Note: Osteoporosis causes bones to become fragile and prone to fracture
Osteoarthritis is a disease where damage occurs to the joints at the end of the bones
VitaminDWiki pages in BOTH Osteoporosis and Meta-analysis- Osteoporosis synergistically treated by bisphosphonates and Vitamin D - meta-analysis Nov 2024
- Vitamin D during pregnancy increased child’s bone mineral density – meta-analysis April 2023
- Osteoporosis Risk varies with Vitamin D Receptor – three meta-analyses in 2020
- Osteoporosis 15 percent more likely if poor Vitamin D receptor – meta-analysis Dec 2018
- Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014
- Vitamin D Receptor genes bb and BB and Osteoporosis, esp. for blacks – meta-analysis Nov 2012
- Hip fractures reduced 30 percent with 800 IU of vitamin D – meta-analysis July 2012
- Vitamin D for elderly 800 to 2000 IU - Osteoporosis Canada - Sept 2010
- Hip fractures in India - editorial with recommendation - Sept 2010
- Cochrane review finds that Vitamin D and Calcium treat osteoporosis – Feb 2010
VitaminDWiki pages in BOTH Fractures/Falls and Meta-analysis
- No increase in falls, fractures or all-cause mortality when Vitamin D is given monthly or less often– meta-analysis April 2024
- 100,000 IU of Vitamin D monthly (27 ng) is not enough to reduce fractures and falls – meta-analysis April 2024
- Increased risk of fracture if high level of Vitamin D (if continue to take Calcium) – umbrella analysis of meta-analyses Nov 2020
- Hip fractures not prevented by Vitamin D (800 IU daily or large quarterly or annual doses) – meta-analysis – Dec 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Vitamin D not help fractures and falls if not vitamin D deficient – meta-analysis Oct 2018
- Fractures not reduced by small amounts of vitamin D - meta-analysis Dec 2017
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk reduced somewhat by 800 IU of vitamin D and Calcium – meta-analysis Oct 2015
- Acute fracture patients – 70 percent were vitamin D deficient – meta-analysis Sept 2015
- Falls not prevented by vitamin D given every 3 months or less often – meta-analysis Jan 2015
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Bone fractures reduced by a minimum of 800 IU vitamin D and Calcium – meta-meta-analysis March 2014
- Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014
- Fallers often had less than 20 ng of vitamin D – meta-analysis April 2014
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Vitamin D may prevent falls and fractures without Calcium – an overview of 9 meta-analysis – Oct 2012
- Hip fractures reduced 30 percent with 800 IU of vitamin D – meta-analysis July 2012
- Vitamin D reduces falls – meta-analysis Oct 2011
- Active form of vitamin D (calcitriol) cut in half the fractures following organ transplant – meta-analysis Aug 2011
- 1000 IU minimum to decrease falls and fractures Swiss - 2009
- Meta-analysis of falls and 800+ IU of vitamin D found good results – June 2010
- 800 IU vitamin D reduces falls - Dec 2009
Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014(Cached) Printer Friendly Follow this page for updates12086 visitors, last modified 12 Feb, 2018, This page is in the following categories (# of items in each category) - Category Bone Health has