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(Reuters Health) – A new analysis suggests that vitamin D supplementation may not improve bone density or prevent fractures and falls in adults.
After combining data from 81 randomized controlled trials, the researchers found that vitamin supplementation was of no benefit to the bones, according to the report published in The Lancet Diabetes & Endocrinology.
"Our results show that adults have little reason to take vitamin D supplements to protect themselves from fractures, except in high-risk groups, such as those who are not exposed to the sun for prolonged periods," the report said. co-author of the study, Dr. Alison Avenell of the University of Aberdeen in the United Kingdom. "For example, the elderly in institutions that never go out."
Vitamin D supplements have long been recommended for the elderly to treat and prevent osteoporosis, a disease that causes bone loss. Avenell and his colleagues would like to see changes in guidelines that keep people away from supplements.
For the new study, Avenell and his colleagues have searched the medical literature for studies on the impact of vitamin D supplementation on bone health. In the end, they concluded 81 trials with a total of 53,537 participants. The duration of the participants' study varied considerably, ranging from four weeks to five years. More than three quarters of the trials included women over 65 years of age.
Although most trials lasted one year or less, "25 trials were tracked for more than a year," said Avenell in an email. "There were eight trials with over 33,000 participants who followed people for three to five years. Most of the data come from large-scale and long-term trials. "
The researchers did not calculate average or median age for study participants, but most were 65 or older, noted Avenell.
Most trials did not include participants with bone problems. But, said Avenell, "one trial recruited people with low bone density, one suffering from osteoporosis, six with previous fractures – one of the largest having more than 5,000 participants – 17 more being seniors from falls clinics, retirement homes or hospitals where an increased risk of fracture was likely. Very few trials have been conducted with young and healthy populations. "
When the researchers pooled the data from the 81 trials, they found that vitamin D supplementation had no effect on the number of fractures and falls. The dosage of vitamin D does not seem to make any difference either. Supplements do not seem to increase bone density either.
According to Avenell, one of the major problems with studying vitamin D is that there is no consensus as to the healthy content of nutrients.
"There is a lot of disagreement between different organizations that produce guidelines around the world," she added. "Our work suggests it's a lot less than what people thought."
New discoveries may be true for an average person, but they may also be false for people whose bones have already been thinned, said Dr. Ethel Siris, director of the Toni Stabile Osteoporosis Center in New York-Presbyterian / Irving Medical Center from Columbia University and professor of medicine at Columbia University.
"The main reason that older women start losing bone mass and fracturing is the loss of estrogen at menopause," said Siris. "A low risk factor in terms of worsening is the low level of calcium or vitamin D. You have to know how much it takes, but if there is already a bone problem, you want to make sure that you are adequately covered with regard to calcium and vitamins. RE."
The risks associated with vitamin D are minimal, Siris said. "And while we prefer people to eat vitamin D through their diet, we will add a pill if needed. My patients can not afford to have vitamin D deficiency. "
Siris said that the substance of the new study "does not change my point of view regarding the types of people I occupy?"
Siris said she feared news from the new research would convince already frail people to stop taking vitamin D supplements. "People read (news) about these things and assume that 'they read yesterday is the truth,' she added.
SOURCE: bit.ly/2LArJXX The Lancet Diabetes & Endocrinology, online 4 October 2018.
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