VITAMIN D SUPPLEMENTATION
No question, calcium provides a benefit to preventing fractures. But just how much Vitamin D should African American women be taking?
It is estimated that as many as 30% to 40% of older adults with hip fractures are Vitamin D insufficient. So, it’s possible older adults may benefit from supplemental Vitamin D, which helps get calcium into bones to make them strong.
“I’m not the kind of person who takes supplements. I thought what I was eating was enough,” says Beverley Riley.
Dr. John Aloia of Winthrop University Hospital says, “There’s a lot of evidence that current recommended amounts of vitamin D are not adequate for everyone. African American women have lower Vitamin D levels than white women because increased skin pigmentation is associated with decreased production of Vitamin D in the skin. We are looking to lower osteoporosis by providing greater amounts of Vitamin D than is currently recommended,” says Dr Aloia.
Vitamin D is crucial in ensuring the proper absorption of calcium from the gut. And while many would argue that taking in more Vitamin D is important to maintain levels of either is decreased production of Vitamin D in the skin because of calcium in the blood, there was no evidence to show that this actually slows bone loss.
Researchers at Winthrop University Hospital, led by Dr. Aloia, studied two groups of African American women; one got calcium supplements and extra Vitamin D, above the typically recommended 400 international units daily.
The other group got the calcium and a dummy placebo pill, and no extra Vitamin D.
Beverly was in the study. “When they did the first bone density test it showed that there was a decreased bone mass on my left side. By the end of the three years they showed there was a great increase.”
So was Beverly getting the vitamin D? “I thought I was taking Vitamin D only to find out at the end of the study I was taking placebo,” Beverly says.
So, what Dr. Aloia’s team found, was that the Vitamin D didn’t make a bit of difference. Bone density went up, in Beverly’s case, but only because of the calcium supplements.
And over time, the bones still lost density, even with as much as five times the typical Vitamin D dose.
“My bias going into this study was that we were going to see a benefit associated with Vitamin D. When the results came out it was clear this was not the case. In white women, most people believe that it will be beneficial, but we won’t know if it is beneficial until the study is done,” states Dr. Aloia
For now, the answer to bone density is calcium, exercise, and medicines--with Vitamin D perhaps on the outside looking in.
The optimal Vitamin D dose is in fact really a big question mark--so much so, that major advisory groups say there’s not enough evidence to create an RDA, or a recommended daily allowance.
The question now is, are those higher doses at all providing any benefit to other ethnic groups aside from African Americans, because it’s clear, above 400 IU’s, they don’t help that population at all.
Related Stories Links:
|