Supplementation Needed for Elderly to Get Enough Vitamin D

Vitamin D deficiency is now considered to be “a major public health concern in elderly populations”. Vitamin D deficiency carries a large number health risks that include possible pregnancy problems (1), being a risk factor for stroke (2) and cardiovascular disease (3), and may even contribute to chronic pain (4). Vitamin D deficiency has even been found to increase overall mortality in women (5).

Although vitamin D deficiency is common in U.S. children (6), it is just as much of a problem in the elderly. While there is no consensus on optimal vitamin D blood levels for the elderly, the suggested minimum blood level is 75 nanomoles/Liter. This blood level has been associated with optimal bone density, reduced fracture risk, and lower extremity muscle strength (7). Now a new study (8) has found that supplementation may be the best way to achieve this suggested minimum level.

The study involved 404 healthy men and women aged 69 to 83 years participating in the NuAge longitudinal study in Québec, Canada (9). They provided information on their diet to assess vitamin D intake and blood samples to measure vitamin D blood levels. Methods to obtain the dietary information had been used in previous research (10).

The researchers found that 7% of the patients had vitamin D blood levels below 37.5 nmol/L, 48% had levels between 37.5 and 74.9 nmol/L, and 45% had levels greater than 75 nmol/L. When they looked at vitamin D supplement intake from supplements across the three groups, those in the first group (below 37.5 nmol/L) had an average intake of 0.5 micrograms per day (20 IU/day), those in the second group (37.5-74.9 nmol/L) had 4.1 micrgrams/day (164 IU/day), and those in the highest group (greater than74.5 nmol/L) had 8.9 micrograms/day (356 IU/day).

When the researchers added food intake to the supplement intake, vitamin D intake increased to 4.6 (184 IU), 8.7 (348 IU), and 14.1 (564 IU) micrograms per day, respectively. When looking at the group able to achieve greater than 75 nmol/L, vitamin D supplements accounted for 56% of total vitamin D intake, causing the researchers to cite vitamin D supplementation as “an important contributor to achieve a minimal target of 25(OH)D concentration of at least 75 nmol/Liter.”

Previous research has shown 15–25 micrograms per day (600 – 1000 IU) to reach vitamin D levels of 75–112 nmol/L (11, 12, 13). For the researchers, ”Supplement use is an important contributor to achieve a minimal target of 25(OH)D concentration of at least 75 nmol/L.”

Greg Arnold is a Chiropractic Physician practicing in Danville, CA.

Reference:

1. Bodnar LM. Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy. J. Nutr. 2009 139: 1157-1161. First published online June 1, 2009; doi:10.3945/jn.108.103168
2. Poole KE. Reduced vitamin D in acute stroke. Stroke. 2006 Jan;37(1):243-5
3. Lee JH. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008 Dec 9;52(24):1949-56.
4. Hooten WM. Prevalence and Clinical Correlates of Vitamin D Inadequancy among Patients with Chronic Pain. Abstracft A1380. Presented October 15, 2007
5. Semba RD. Low serum 25-hydroxyvitamin D concentrations are associated with greater all-cause mortality in older community-dwelling women. Nutrition Research 2009; 29(8): 525-530
6. Mansbach JM. Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D? Pediatrics 2009;124;1404-1410
7. Bischoff-Ferrari HA. The 25-hydroxyvitamin D threshold for better health. J Steroid Biochem Mol Biol. 2007;103:614–9
8. Roula Baraké. Vitamin D Supplement Consumption Is Required to Achieve a Minimal Target 25-Hydroxyvitamin D Concentration of 75 nmol/L in Older People. J. Nutr. 2010 140: 551-556. First published online March 1, 2010; doi:10.3945/jn.109.115626
9. NuAge Study details available at www.rqrv.com/en/init_NuAge.php
10. Payette H, Gray-Donald K. Dietary intake and biochemical indices of nutritional status in an elderly population, with estimates of the precision of the 7-d food record. Am J Clin Nutr. 1991;54:478–88
11. Vieth R. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J. 2004;3:8
12. Chapuy MC. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992;327:1637–42
13. Dawson-Hughes B. Serum 25-hydroxyvitamin D and functional outcomes in the elderly. Am J Clin Nutr. 2008;88:S537–40