Effect of supplementation with cholecalciferol and calcium on 2-y bone mass accrual in HIV-infected children and adolescents: a randomized clinical trial. Bone mass and density response to a 12-month trial of calcium and vitamin D supplement in preadolescent girls. A combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents. The effect of high-dose vitamin D3 supplementation on bone mineral density in subjects with prediabetes Does vitamin D supplementation of healthy Danish Caucasian girls affect bone turnover and bone mineralization? Vitamin K Supplement Along with Vitamin D and Calcium Reduced Serum Concentration of Undercarboxylated Osteocalcin While Increasing Bone Mineral Density in Korean Postmenopausal Women over Sixty-Years-Old Effects of Vitamin D Supplementation on Bone Mineral Density and Bone Markers in HIV-Infected Youth Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Vitamin K, bone turnover, and bone mass in girls. Effect of a Nutritional Supplementation on Bone Health in Chilean Elderly Subjects with Femoral Osteoporosis The effects of whole-body vibration training and vitamin D supplementation on muscle strength, muscle mass, and bone density in institutionalized elderly women: a 6-month randomized, controlled trial. The effect of various vitamin D supplementation regimens in breast cancer patients Vitamin D treatment in primary hyperparathyroidism: a randomized placebo controlled trial. Vitamin K, circulating cytokines, and bone mineral density in older men and women. Vitamin D supplementation in breastfed infants from Montréal, Canada: 25-hydroxyvitamin D and bone health effects from a follow-up study at 3 years of age Effect of Vitamin D3 Supplementation in Black and in White Children: A Randomized, Placebo-Controlled Trial. Prediction of bone mass density variation by bone remodeling markers in postmenopausal women with vitamin D insufficiency treated with calcium and vitamin D supplementation. Vitamin K supplementation does not significantly impact bone mineral density and biochemical markers of bone in pre- and perimenopausal women. Vitamin D supplementation after parathyroidectomy: effect on bone mineral density-a randomized double-blind study. Three doses of vitamin D, bone mineral density, and geometry in older women during modest weight control in a 1-year randomized controlled trial Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease.
BACKGROUND Skeletal abnormalities have been reported in HIV-infected children and adolescents . Although the etiology is not well understood , vitamin D deficiency may be involved . OBJECTIVE The study objective was to evaluate the effect of vitamin D and calcium supplementation on bone mass accrual in HIV-infected youth . DESIGN Perinatally HIV-infected children were r and omly assigned to receive vitamin D ( 100,000 IU cholecalciferol given every 2 mo ) and calcium ( 1 g/d ) ( supplemented group ) or double placebo ( placebo group ) for 2 y. The total-body bone mineral content ( TB BMC ) , total-body bone mineral density ( TBBMD ) , spine bone mineral content ( S BMC ) , and spine bone mineral density ( SBMD ) were assessed by using dual-energy X-ray absorptiometry at baseline and at 2 annual follow-up visits . RESULTS Fifty-nine participants , aged 6 - 16 y , were r and omly assigned to either the supplemented ( n = 30 ) or the placebo ( n = 29 ) group . At enrollment , supplemented and placebo groups did not differ with respect to age , sex , dietary intakes of vitamin D and calcium , mean baseline serum 25-hydroxyvitamin D [ 25(OH)D ] concentration , TB BMC , TBBMD , S BMC , or SBMD . Significant increases in serum 25(OH)D were observed in the supplemented group but not in the placebo group . TB BMC , TBBMD , S BMC , and SBMD increased significantly at 1 and 2 y in both groups . No between-group differences were observed at any time before or after adjustment for stage of sexual maturation by mixed linear model analysis . CONCLUSION One gram of calcium per day and oral cholecalciferol at a dosage of 100,000 IU every 2 mo administered to HIV-infected children and adolescents did not affect bone mass accrual despite significant increases in serum 25(OH)D concentrations . This trial was registered at clinical trials.gov as NCT00724178 BACKGROUND Maximal bone acquisition in adolescent girls through dietary and lifestyle practice s is advocated to prevent or minimize the development of osteoporosis and its associated complications in later life . Longitudinal investigations of bone acquisition in children and adolescents have utilized areal bone mineral density ( BMD , mg/cm(2 ) ) as a measure of bone mass and strength . Peripheral quantitative computed tomography ( pQCT ) , which provides a three-dimensional display of data , separate analyses of bone compartments , and bone mass in terms of volumetric BMD ( vBMD , mg/cm(3 ) ) , has recently been introduced for clinical use . OBJECTIVE To assess the impact of a 12-month daily calcium supplement on total and trabecular bone acquisition as measured by pQCT in preadolescent girls . DESIGN Early adolescent Caucasian girls ( aged 12 years , Tanner Stage 2 ) were enrolled in a r and omized trial of daily calcium supplement ( TX , 800 mg calcium carbonate and 400 IU vitamin D ) or placebo ( C ) . Body weight , height , and distal tibia measurements by pQCT were obtained at enrollment , 6 and 12 months . Pubertal status and physical activity records were assessed at baseline and 12 months . Three-day food intake records were completed every three months . RESULTS Seventy-one girls completed the 12-month trial ( TX=35 , C=36 ) . No differences were found for age , weight , height , body mass index , pubertal maturation , or reported physical activity at enrollment or during the study . Average intakes during the study were 1524 mg calcium and 496 IU vitamin D ( TX ) versus 865 mg calcium and 160 IU vitamin D ( C ) per day . Baseline total bone values were similar , however , trabecular values were greater in TX girls despite r and omization . Percent changes were calculated to adjust for baseline differences . Because of the small cortical thickness at the 10 % site ( mean values < 1.6 mm ) , cortical mass and density were not analyzed . The percent changes for trabecular bone mineral content ( BMC , mg ) and vBMD were significantly greater in TX girls ( + 4.1 % BMC and + 1.0 % vBMD TX versus -1.6 % BMC and -2.0 % vBMD C , p<0.006 ; ANCOVA ) after 12 months of supplement . Trabecular bone area ( BA , cm(2 ) ) and total bone change , however , did not differ between groups . CONCLUSIONS Daily calcium and vitamin D supplementation promotes greater trabecular BMC and vBMD acquisition in preadolescent girls . The single site selected for pQCT evaluation in this study did not allow evaluation of the cortical bone compartment . Future studies that utilize the pQCT technique need to incorporate multiple measurement sites to better assess total , cortical , and trabecular bone BACKGROUND Short-term studies in adolescents have generally shown an enhancement of calcium absorption by inulin-type fructans ( prebiotics ) . Results have been inconsistent ; however , and no studies have been conducted to determine whether this effect persists with long-term use . OBJECTIVE The objective was to assess the effects on calcium absorption and bone mineral accretion after 8 wk and 1 y of supplementation with an inulin-type fructan . DESIGN Pubertal adolescents were r and omly assigned to receive 8 g/d of a mixed short and long degree of polymerization inulin-type fructan product ( fructan group ) or maltodextrin placebo ( control group ) .  Bone mineral content and bone mineral density were measured before r and omization and after 1 y. Calcium absorption was measured with the use of stable isotopes at baseline and 8 wk and 1 y after supplementation . Polymorphisms of the Fok1 vitamin D receptor gene were determined . RESULTS Calcium absorption was significantly greater in the fructan group than in the control group at 8 wk ( difference : 8.5 + /- 1.6 % ; P < 0.001 ) and at 1 y ( difference : 5.9 + /- 2.8 % ; P = 0.04 ) . An interaction with Fok1 genotype was present such that subjects with an ff genotype had the least initial response to fructan . After 1 y , the fructan group had a greater increment in both whole-body bone mineral content ( difference : 35 + /- 16 g ; P = 0.03 ) and whole-body bone mineral density ( difference : 0.015 + /- 0.004 g/cm(2 ) ; P = 0.01 ) than did the control group . CONCLUSION Daily consumption of a combination of prebiotic short- and long-chain inulin-type fructans significantly increases calcium absorption and enhances bone mineralization during pubertal growth . Effects of dietary factors on calcium absorption may be modulated by genetic factors , including specific vitamin D receptor gene polymorphisms Summary The rationale of this study was to determine the effect of high-dose vitamin D3 supplementation on bone mineral density ( BMD ) .  Prediabetic males given vitamin D had significantly less reduction in BMD at the femoral neck compared to the controls . The clinical implication s of our findings require further investigation . Introduction Type 2 diabetes mellitus is associated with increased fracture risk , and recent studies show crosstalk between bone and glucose metabolism . Few studies have investigated the effect of vitamin D supplementation on the bone without additional calcium . In the present study , we aim ed to determine whether a high dose of vitamin D3 could improve bone mass density ( BMD ) in prediabetic subjects . Methods The current study was conducted as a secondary research on a previously performed trial , in which 511 subjects with prediabetes were r and omized to vitamin D3 ( 20,000 IU per week ) versus placebo for 5 years  . BMD was measured using dual-energy X-ray absorptiometry ( DEXA ) . Results Two hundred and fifty-six subjects were r and omized to vitamin D and 255 to placebo . Mean baseline serum 25-hydroxyvitamin D ( 25(OH)D ) level was 60 nmol/L. Two hundred and two and 214 in the vitamin D and placebo groups , respectively , completed BMD measurements , whereas one in each group was excluded due to use of bisphosphonates . Males given vitamin D had significantly less reduction in BMD at the femoral neck measurement site compared to the controls ( 0.000 versus − 0.010 g/cm2 , p = 0.008 ) . No significant differences between intervention groups were seen at the total hip measurement site , regarding both males and females . Conclusions Vitamin D3 supplementation alone may be beneficial in males with prediabetes , but confirmatory studies are needed INTRODUCTION A high peak bone mass may be essential for reducing the risk of osteoporosis later in life and a sufficient vitamin D level during puberty may be necessary for optimal bone accretion and obtaining a high peak bone mass . Dietary intake and synthesis during winter of vitamin D might be limited but the effect of vitamin D supplementation in adolescence on bone mass is not well established . OBJECTIVE To investigate the effect of supplementation with 5 and 10 microg/day vitamin D(3 ) for 12 months in 11- to 12-year-old girls on  bone mass and bone turnover as well as the possible influence of VDR and ER genotype on the effect of the supplementation . METHODS The girls ( n=221 ) were r and omized to receive either 5 microg or 10 microg vitamin D(3 ) supplementation per day or placebo for 12 months . Whole body and lumbar spine bone mass measured by DXA and pubertal status were determined at baseline and after 12 months whereas physical activity and dietary intake of calcium and vitamin D were assessed at baseline . Serum ( S ) 25-hydroxyvitamin D ( 25OHD ) , S-osteocalcin , S-parathyroid hormone , S-calcium , S-inorganic phosphate , urinary ( U ) pyridinoline ( Pyr ) and deoxpyridinoline ( Dpyr ) were measured at baseline and after 6 and 12 months . RESULTS The S-25OHD concentration increased ( p<0.001 ) relative to the baseline values in the groups receiving either 5 microg/day ( mean+/-SD ; 11.0+/-10.3 nmol/l , baseline 41.9+/-17.6 nmol/l ) or 10 microg/day ( 13.3+/-11.8 nmol/l , baseline 44.4+/-16.6 nmol/l ) vitamin D(3 ) for 12 months compared to placebo ( -3.1+/-9.8 nmol/l , baseline 43.4+/-17.1 nmol/l ) . There was no effect of vitamin D-supplementation on biomarkers for bone turnover or on whole body or spine bone mineral augmentation . However , vitamin D supplementation increased whole body bone mineral density ( BMD ) ( p=0.007 ) and bone mineral content ( BMC ) ( p=0.048 ) in the FF VDR genotype but not in the Ff or ff VDR genotypes . CONCLUSION Supplementation with vitamin D ( 5 or 10 microg/day ) over 12 months increased the S-25OHD concentration but there was no effect on indices of bone health in the entire group of girls . However , there was an effect on BMD for a subgroup with the FF VDR genotype indicating an influence of genotype There are inconsistent findings on the effects of vitamin K on bone mineral density ( BMD ) and undercarboxylated osteocalcin ( UcOC ) . The present intervention study evaluated the effect in subjects over 60-yr-old . The vitamin K group ( vitamin K + vitamin D + calcium supplement ; 15 mg of vitamin K2 [ menatetrenone ] three times daily , 400 IU of vitamin D once a day , and 315 mg of calcium twice daily ) and the control group ( vitamin D + calcium supplement ) were r and omly assigned . During the six months of treatment , seventy eight women participated ( 38 in the vitamin K group and 40 in the control group ) and 45 women completed the study . The baseline characteristics of study participants did not differ between the vitamin K and the control groups . In a per protocol analysis after 6 months , L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group ( 0.01 ± 0.03 g/cm2 vs -0.008 ± 0.04 g/cm2 , P = 0.049 ) . UcOC concentration was also significantly decreased in the vitamin K group ( -1.6 ± 1.6 ng/dL vs -0.4 ± 1.1 ng/dL , P = 0.008 ) . In conclusion , addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration Background : Low bone mineral density ( BMD ) is a significant comorbidity in HIV . However , studies evaluating vitamin D supplementation on bone health in this population are limited . This study investigates changes in bone health parameters after 12 months of supplementation in HIV-infected youth with vitamin D insufficiency . Methods : This is a r and omized , active-control , double-blind trial investigating changes in bone parameters with 3 different vitamin D3 doses [ 18,000 ( st and ard/control dose ) , 60,000 ( moderate dose ) , and 120,000 IU/monthly ( high dose ) ] in HIV-infected youth 8–25 years old with baseline serum 25-hydroxyvitamin D ( 25(OH)D ) concentrations < 30 ng/mL.  BMD and bone turnover markers were measured at baseline and 12 months . Results : One hundred two subjects enrolled . Over 12 months , serum 25(OH)D concentrations increased with all doses , but the high dose ( ie , 120,000 IU/monthly ) maintained serum 25(OH)D concentrations in an optimal range ( ≥30 or ≥20 ng/mL ) throughout the study period for more subjects ( 85 % and 93 % , respectively ) compared with either the moderate ( 54 % and 88 % , respectively ) or st and ard dose ( 63 % and 80 % , respectively ) . All dosing groups showed some improvement in BMD ; however , only the high-dose arm showed significant decreases in bone turnover markers for both procollagen type 1 aminoterminal propeptide ( −3.7 ng/mL ; P = 0.001 ) and & Bgr;-CrossLaps ( −0.13 ng/mL ; P = 0.0005 ) . Conclusions : High-dose vitamin D supplementation ( 120,000 IU/mo ) given over 12 months decreases bone turnover markers in HIV-infected youth with vitamin D insufficiency , which may represent an early , beneficial effect on bone health . High vitamin D doses are needed to maintain optimal serum 25(OH)D concentrations BACKGROUND Little is known about the effect of vitamin D status on bone gain in adolescents . OBJECTIVE The objective was to examine whether vitamin D status is associated with accrual of bone mineral density ( BMD ) and bone mineral apparent density ( BMAD ) . DESIGN This 3-y prospect i ve study examined the association between changes in BMD or BMAD and serum 25-hydroxyvitamin D [ 25(OH)D ] in 171 healthy Finnish girls aged 9 - 15 y.  Lumbar spine and femoral neck BMDs were measured by dual-energy X-ray absorptiometry . RESULTS Baseline 25(OH)D correlated significantly with the unadjusted 3-y change in BMD at the lumbar spine ( r = 0.35 , P < 0.001 ) and femoral neck ( r = 0.32 , P < 0.001 ) in all participants . The difference from baseline in adjusted 3-y BMD accumulation between those with severe hypovitaminosis D [ 25(OH)D < 20 nmol/L ] and those with a normal vitamin D status [ 25(OH)D > or = 37.5 nmol/L ] was 4 % ( 12.7 % , 13.1 % , and 16.7 % for the lowest , middle , and highest tertiles of 25(OH)D , respectively ; P for trend = 0.01 ) at the lumbar spine in the girls with advanced sexual maturation at baseline ( n = 129 ) . Moreover , the adjusted change in lumbar spine BMD was 27 % greater in the highest vitamin D intake tertile than in the lowest tertile in the same girls ( P for trend = 0.016 ) . CONCLUSIONS Pubertal girls with hypovitaminosis D seem to be at risk of not reaching maximum peak bone mass , particularly at the lumbar spine . Dietary enrichment or supplementation with vitamin D should be considered to ensure an adequate vitamin D status BACKGROUND survivors of hip fracture are at 5- to 10-fold risk of a second hip fracture . There is little consensus about secondary prevention . Many are given calcium and vitamin D , but the evidence supporting this is circumstantial . OBJECTIVE to compare the effects of different calcium and vitamin D supplementation regimens on bone biochemical markers , bone mineral density and rate of falls in elderly women post-hip fracture . DESIGN r and omised controlled trial . SETTING orthogeriatric rehabilitation ward . METHODS 150 previously independent elderly women , recruited following surgery for hip fracture , were assigned to receive a single injection of 300,000 units of vitamin D(2 ) , injected vitamin D(2 ) plus 1 g/day oral calcium , 800 units/day oral vitamin D(3 ) plus 1 g/day calcium , or no treatment . Follow-up was one year , with measurement of 25-hydroxyvitamin D , parathyroid hormone , bone mineral density , and falls . RESULTS mean 25-hydroxyvitamin D increased and mean parathyroid hormone was suppressed in all the actively treated groups , more so in the group receiving combined oral vitamin D and calcium . Twenty per cent of participants injected with vitamin D were deficient in 25-hydroxyvitamin D a year later . Bone mineral density showed small but statistically significant differences of up to 4.6 % between actively treated groups and placebo . Relative risk of falling in the groups supplemented with vitamin D was 0.48 ( 95 % CI 0.26 - 0.90 ) compared with controls . CONCLUSION Vitamin D supplementation , either orally or with injected vitamin D , suppresses parathyroid hormone , increases bone mineral density and reduces falls . Effects may be more marked with calcium co-supplementation . The 300,000 units of injected vitamin D may not last a whole year BACKGROUND Supplementation with calcium and vitamin D reduces bone loss and prevents fractures in elderly people , but it is not known whether any lasting benefit remains if the supplements are discontinued . OBJECTIVE The objective was to determine whether gains in bone mineral density ( BMD ) induced by calcium and vitamin D supplementation persist after supplement withdrawal . DESIGN Two-hundred ninety-five healthy , elderly men and women ( aged > /=68 y ) who had completed a 3-y r and omized , placebo-controlled trial of calcium and vitamin D supplementation were followed for an additional 2 y during which no study supplements were given .  BMD was measured by dual-energy X-ray absorptiometry , and biochemical variables related to calcium metabolism and bone turnover were measured . RESULTS In the 128 men , supplement-induced increases in spinal and femoral neck BMD were lost within 2 y of supplement discontinuation , but small benefits in total-body BMD remained . In the 167 women , there were no lasting benefits in total-body BMD or at any bone site . Consistent with the observations on BMD , the bone turnover rates in both men and women ( as measured by serum osteocalcin concentrations ) returned to their original higher concentrations within the same 2-y period . CONCLUSION Discontinued calcium and vitamin D supplementation has limited cumulative effect on bone mass in men and women aged > /=68 BACKGROUND Vitamin K has been suggested to have a role in bone metabolism , and low vitamin K intake has been related to low bone density and increased risk of osteoporotic fracture . OBJECTIVE The objective of this study was to determine whether phylloquinone ( vitamin K(1 ) ) intake and biochemical indicators of vitamin K status are related to bone mineral content ( BMC ) and markers of bone formation and bone resorption in girls . DESIGN Vitamin K status [ plasma phylloquinone concentration and percentage of undercarboxylated osteocalcin ( % ucOC ) ] was measured at baseline in a study of 245 healthy girls aged 3 - 16 y. Cross-linked N-telopeptide of type 1 collagen ( NTx ) breakdown , osteocalcin , and bone-specific alkaline phosphatase were measured to reflect bone resorption and formation . BMC of the total body , lumbar spine , and hip and dietary phylloquinone intake were measured annually for 4 y. RESULTS Phylloquinone intake ( median : 45 microg/d ) was not consistently associated with bone turnover markers or BMC . Better vitamin K status ( high plasma phylloquinone and low % ucOC ) was associated with lower bone resorption and formation . Plasma phylloquinone was inversely associated with NTx and osteocalcin concentrations ( P < 0.05 ) , and % ucOC was positively associated with NTx and bone-specific alkaline phosphatase concentrations ( P < 0.05 ) . Indicators of vitamin K status were not consistently associated with current BMC or gain in BMC over the 4-y study period . CONCLUSIONS Better vitamin K status was associated with decreased bone turnover in healthy girls consuming a typical US diet . R and omized phylloquinone supplementation trials are needed to further underst and the potential benefits of phylloquinone on bone acquisition in growing children Objective : To study the effects of a special nutritional supplement on bone mineral density and bone turnover markers in Chilean elderly subjects with femoral osteoporosis . Setting : Public primary health care clinics in Chile . Subjects : Free living elderly subjects with femoral osteoporosis . Interventions : Subjects were r and omized to receive the usual nutritional supplement provided by the Chilean Ministry of Health or a special nutritional supplement providing , among other nutrients , 90 mg isoflavones , 800 mg calcium , 400 IU vitamin D , 60 ug vitamin K and 31 g proteins per day . Measures of Outcome : At baseline , and after six and twelve months of supplementation , body composition , bone mineral density , serum 25 OH vitamin D , intact parathyroid hormone ( iPTH ) , osteocalcin , decarboxylated osteocalcin , urinary aminoterminal telopeptide of type I collagen ( NTX ) , deoxypyridoline cross links ( Dpd ) and equol were measured . Every month , urinary daidzein was measured in a morning urine sample . Results : No differences between treatment groups were observed in body composition or bone mineral density changes . The group receiving the special supplement had a significant increase in serum 25 OH vitamin D and a significant decrease in serum iPTH and decarboxylated osteocalcin . No association between daidzein or equol excretion and changes in bone mineralization was observed . Conclusions : A special supplement delivered to elderly subjects with osteoporosis improved serum vitamin D and reduced serum iPTH and undercarboxylated osteocalcin levels but did not affect BMD Sarcopenia and osteoporosis represent a growing public health problem . We studied the potential benefit of whole-body vibration ( WBV ) training given a conventional or a high dose of daily vitamin D supplementation in improving strength , muscle mass , and bone density in postmenopausal women . In a 2 × 2 factorial- design trial , 113 institutionalized elderly females aged over 70 years ( mean age 79.6 years ) were r and omly assigned either to a WBV or a no-training group , receiving either a conventional dose ( 880 IU/day ) or a high dose ( 1600 IU/day ) of vitamin D(3 ) . The primary aim was to determine the effects of 6 months of WBV and /or vitamin D supplementation on isometric and dynamic strength , leg muscle mass , and hip bone mineral density ( BMD ) . Additionally , the increase in 25-hydroxyvitamin D [ 25(OH)D ] levels between conventional and high-dose supplementation was compared . After 6 months of treatment , dynamic muscle strength , hip BMD , and vitamin D serum levels improved significantly in all groups , whereas isometric strength and muscle mass did not change . When compared with no training , the WBV program did not result in additional improvements . When compared with 880 IU , a high dose of 1600 IU of vitamin D did result in higher serum vitamin D levels but did not result in additional improvements . In institutionalized women older than 70 years , the WBV training protocol tested is not more efficient in enhancing muscle mass , strength , and hip BMD compared with vitamin D supplementation . A higher dose of 1600 IU of vitamin D does not provide additional musculoskeletal benefit in this population compared with conventional doses Vitamin D deficiency in the patients treated for breast cancer is associated with numerous adverse effects ( bone loss , arthralgia , and falls ) . The first aim of this study was to assess vitamin D status , determined by 25-OH vitamin D levels , among women diagnosed with breast cancer according to demographic/ clinical variables and bone mineral density ( BMD ) . The second aim of this study was to evaluate the effect of daily low-dose and weekly high-dose vitamin D supplementation on 25-OH vitamin D levels . This retrospective study included 224 women diagnosed with stage 0–III breast cancer who received treatment at the James P. Wilmot Cancer Center at the University of Rochester Medical Center . Total 25-OH vitamin D levels ( D2 + D3 ) were determined at baseline for all participants . Vitamin D deficiency was defined as a 25-OH vitamin D level < 20 ng/ml , insufficiency as 20–31 ng/ml , and sufficiency as ≥32 ng/ml . BMD was assessed during the period between 3 months before and 6 months following the baseline vitamin D assessment . Based on the participants ’ baseline levels , they received either no supplementation , low-dose supplementation ( 1,000 IU/day ) , or high-dose supplementation ( ≥50,000 IU/week ) , and 25-OH vitamin D was reassessed in the following 8–16 weeks . Approximately 66.5 % had deficient/insufficient vitamin D levels at baseline . Deficiency/insufficiency was more common among non-Caucasians , women with later-stage disease , and those who had previously received radiation therapy ( P < 0.05 ) . Breast cancer patients with deficient/insufficient 25-OH vitamin D levels had significantly lower lumbar BMD ( P = 0.03 ) . Compared to the no-supplementation group , weekly high-dose supplementation significantly increased 25-OH vitamin D levels , while daily low-dose supplementation did not significantly increase levels . Vitamin D deficiency and insufficiency were common among women with breast cancer and associated with reduced BMD in the spine . Clinicians should carefully consider vitamin D supplementation regimens when treating vitamin D deficiency/insufficiency in breast cancer patients CONTEXT Low 25-hydroxyvitamin D levels are common in patients with primary hyperparathyroidism ( PHPT ) and associated with higher PTH levels and hungry bone syndrome after parathyroidectomy ( PTX ) . However , concerns have been raised about the safety of vitamin D supplementation in PHPT . OBJECTIVE We aim ed to assess safety and effects on calcium homeostasis and bone metabolism of supplementation with high doses of vitamin D in PHPT patients . DESIGN , SETTING This was an investigator-initiated double-blind , r and omized , placebo-controlled , parallel-group trial from a single center . PATIENTS Forty-six PHPT patients were recruited , with a mean age of 58 ( range 29 - 77 ) years , and 35 ( 76 % ) were women . INTERVENTIONS Intervention included daily supplementation with 70 μg ( 2800 IU ) cholecalciferol or identical placebo for 52 weeks . Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX . MAIN OUTCOME MEASURES PTH , calcium homeostasis , and bone metabolism were evaluated . RESULTS Preoperatively , 25-hydroxyvitamin D increased from 50 to 94 nmol/L in the treatment group and decreased from 57 to 52 nmol/L in the placebo group ( P < .001 ) . Compared with placebo , vitamin D  decreased PTH significantly by 17 % before PTX ( P = .01 ) , increased lumbar spine bone mineral density by 2.5 % ( P = .01 ) , and decreased C-terminal β-CrossLaps by 22 % ( P < .005 ) . The trabecular bone score did not change in response to treatment , but improved after PTX . Postoperatively , PTH remained lower in the cholecalciferol group compared with the placebo group ( P = .04 ) . Plasma creatinine and plasma and urinary calcium did not differ between groups . CONCLUSIONS Daily supplementation with a high vitamin D dose safely improves vitamin D status and decreases PTH in PHPT patients . The vitamin D treatment is accompanied by reduced bone resorption and improved bone mineral density before operation BACKGROUND Vitamin K modulates cytokines involved in bone turnover , including interleukin-6 ( IL-6 ) and osteoprotegerin in vitro . OBJECTIVE The objective of this study was to assess 1 ) associations between measures of vitamin K status [ plasma phylloquinone and serum percentage of undercarboxylated osteocalcin ( % ucOC ) ] and IL-6 , osteoprotegerin , and C-reactive protein ( CRP ) concentrations and 2 ) the effect of daily 500 mug phylloquinone supplementation for 3 y on cytokine concentrations . DESIGN Concentrations of IL-6 , osteoprotegerin , and CRP and bone mineral density ( BMD ) were measured at baseline and after 3 y of follow-up in 379 healthy men and women ( 60 - 81 y ; 58.5 % women ) participating in a r and omized trial that studied the effect of vitamin K supplementation on bone loss . RESULTS Cross-sectionally , plasma phylloquinone was inversely associated with IL-6 and CRP , whereas serum % ucOC was inversely associated with IL-6 . Osteoprotegerin was associated positively with plasma phylloquinone and inversely with % ucOC . No differences were observed in the 3-y change in IL-6 , osteoprotegerin , and CRP concentrations between participants who received phylloquinone supplementation and those who did not . Overall , no association was observed between the 3-y changes in circulating cytokines and BMD . CONCLUSIONS Poor vitamin K status was associated with high concentrations of cytokines involved in bone turnover , but vitamin K supplementation did not confer a decrease in cytokine concentrations . The healthy status of this cohort may explain a lack of effect of vitamin K supplementation on cytokine concentrations . This trial was registered with www . clinical trials.gov as NCT00183001 Summary Whether infant vitamin D supplementation may have long-term bone benefits is unclear . In this study , breastfed infants who received vitamin dosages greater than 400 IU/day did not have higher bone mineralization at 3 years . This study provides important data to inform pediatric public health recommendations for vitamin D. Introduction North American health agencies recommend breastfed infants should be supplemented with 400 IU of vitamin D/day to support bone health . Few studies examined the long-term benefits of early life vitamin D supplementation on bone mineralization . The objective of this study was to determine if a dose-response relationship exists between infant vitamin D supplementation , vitamin D status , and bone outcomes at 3 years of age . Methods This was a double-blind r and omized trial of 132 , 1-month-old healthy , breastfed infants from Montréal , Canada , between 2007 and 2010 . In this longitudinal analysis , 87 infants ( 66 % ) returned for follow-up at 3 years of age , between 2010 and 2013 . At 1 month of age , participants were r and omly assigned to receive oral cholecalciferol ( vitamin D3 ) supplements of 400 , 800 , 1200 , or 1600 IU/day until 12 months of age . Lumbar spine vertebrae 1–4 ( LS ) bone mineral density ( BMD ) , LS and whole body bone mineral content ( BMC ) , and mineral accretion were measured by dual-energy x-ray absorptiometry at 3 years . Results At follow-up , the treatment groups were similar in terms of diet , sun exposure , and demographics . There were no significant differences among the groups in LS or whole body BMC , BMD , or accretion . Although , 25(OH)D concentrations were not different among the groups , higher doses ( 1200 and 1600 IU/day ) achieved higher 25(OH)D area under the curve from 1 to 36 months vs. 400 IU/day . Conclusions This is the first longitudinal follow-up of an infant vitamin D dose-response study which examines bone mineralization at 3 years of age . Dosages higher than 400 IU/day do not appear to provide additional benefits to the bone at follow-up . Larger studies with more ethnically diverse groups are needed to confirm these results CONTEXT Dosages of vitamin D necessary to prevent or treat vitamin D deficiency in children remain to be clarified . OBJECTIVE To determine the effects of vitamin D3 1000 IU/d on serum 25-hydroxyvitamin D [ 25(OH)D ] , PTH , and markers of bone turnover ( osteocalcin and collagen type 1 cross-linked C-telopeptide ) in black children and white children , and to explore whether there is a threshold level of 25(OH)D associated with maximal suppression of serum PTH concentration . DESIGN Healthy 8- to 14-year-old Pittsburgh-area black ( n = 84 ) and white ( n = 73 ) children not receiving vitamin supplements , enrolled from October through March from 2008 through 2011 , were r and omized to vitamin D3 1000 IU or placebo daily for 6 months . RESULTS The mean baseline concentration of 25(OH)D was < 20 ng/mL in both the vitamin D-supplemented group and the placebo group ( 19.8 ± 7.6 and 18.8 ± 6.9 ng/mL , respectively ) . The mean concentration was higher in the supplemented group than in the placebo group at 2 months ( 26.4 ± 8.1 vs 18.9 ± 8.1 ng/mL ; P < .0001 ) and also at 6 months ( 26.7 ± 7.6 vs 22.4 ± 7.3 ; P = .003 ) , after adjusting for baseline 25(OH)D , race , gender , pubertal status , dietary vitamin D intake , body mass index , and sunlight exposure . Increases were only significant in black children , when examined by race . The association between 25(OH)D and PTH concentrations was inverse and linear , without evidence of a plateau . Overall , vitamin D supplementation had no effect on PTH and bone turnover  . CONCLUSIONS Vitamin D3 supplementation with 1000 IU/d in children with mean baseline 25(OH)D concentration < 20 ng/mL effectively raised their mean 25(OH)D concentration to ≥20 ng/mL but failed to reach 30 ng/mL.  Vitamin D supplementation had no effect on PTH concentrations The aim of this study was to determine whether early changes in bone markers could predict long-term response in bone mineral density ( BMD ) after calcium ( 500 mg ) and vitamin D ( 400 IU ) supplementation twice daily in ambulatory elderly women with vitamin D insufficiency ( 25-hydroxyvitamin D , < 12 ng/ml ) . One hundred and ninety-two women ( mean age , 75 + /- 7 yr ) were r and omized to receive either the supplementation ( n = 95 ) or a placebo ( n = 97 ) in a double-blind , controlled clinical trial for 1 yr . In comparison with the placebo group , supplementation significantly increased BMD , normalized 25-hydroxyvitamin D and significantly decreased intact PTH and bone remodeling markers . The initial values of telopeptide cross-links were correlated with improvement in total body BMD [ urinary N-telopeptides ( NTX ) , r = 0.38 ; C-telopeptides ( CTX ) , r = 0.32 ; serum CTX , r = 0.28 ] , and the 3-month changes in the same markers were correlated with improvement in total body ( urinary N-telopeptides , r = -0.29 ; serum CTX , r = -0.26 ) and vertebral BMD ( CTX , r = -0.26 ; all P < 0.05 ) . We concluded that short-term changes in bone resorption markers can predict long-term variations in BMD in elderly women with vitamin D insufficiency receiving calcium  and vitamin D supplementation Because of its role in osteoblastic metabolism , vitamin K has been studied with respect to bone . However , there has been limited research examining the influence of long-term vitamin K supplementation on bone mineral density ( BMD ) . Therefore , the purpose of this study was to assess the impact of 6 months of vitamin K supplementation on BMD and biomarkers of bone in pre- and perimenopausal women . Based on previous work , we hypothesized that vitamin K would improve BMD and biochemical markers of bone formation . A double-blind , placebo-controlled , r and omized trial is an effective way to study the impact of long-term supplementation . Thus , 14 pre- and perimenopausal women , 25 to 50 years of age , were r and omly assigned to an experimental group ( E ) that received 600 microg/d of vitamin K in the form of phylloquinone ( K(1 ) ) or a control group ( C ) that received identical-looking placebo tablets .  Regional BMD and percent body fat , measured by dual-energy x-ray absorptiometry , and serum osteocalcin and urinary N-telopeptide levels were all assessed at 0 , 3 , and 6 months . When BMD was measured across time , C had a significant increase ( P = .011 ) in greater trochanter BMD compared to E. The E group had a nonsignificant increase ( P = .067 ) in shaft BMD compared to the C group . There was no significant difference between E and C in serum osteocalcin concentrations over time . Urinary N-telopeptide levels increased significantly over time in E compared to C ( P = .008 ) . Six months of 600 microg/d vitamin K(1 ) supplementation did not improve regional BMD in this group of pre- and perimenopausal women Patients with primary hyperparathyroidism ( PHPT ) have higher bone turnover , lower bone mineral density ( BMD ) , and an increased risk of fractures . They also have a high incidence of low vitamin D levels ( 25-OH-vitamin D < 50 nmol/L ) that could worsen the negative effect on the bone . In this double-blinded clinical trial , 150 patients with PHPT were r and omized , after successful parathyroidectomy ( PTX ) , to 1-year daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg ( D+ ) or calcium carbonate alone ( D- ) . BMD was measured in the lumbar spine , femoral neck , total hip , distal and 33 % radius using dual-energy X-ray absorptiometry ( DXA ) before surgery and after 1 year of study medication . Median age was 60 ( range 30 - 80 ) years and there were 119 ( 79 % ) women and 31 ( 21 % ) men ; 76 % had 25-OH-D < 50 nmol/L before PTX and 50 % had persistent elevated parathyroid hormone ( PTH ) 6 weeks after PTX . A similar increase in BMD in the lumbar spine , femoral neck , and total hip was observed in both groups ( D+ : 3.6 % , 3.2 % , and 2.7 % , p<0.001 , respectively ; and D- : 3.0 % , 2.3 % , and 2.1 % , respectively , p<0.001 ) . Patients with vitamin D supplementation also increased their BMD in distal radius ( median 2.0 % ; interquartile range , -1.7 % to 5.4 % ; p=0.013 ) . The changes in BMD , especially in the hips , were correlated to the baseline concentrations of PTH , ionized calcium , and bone markers ( p<0.001 ) . A benefit from vitamin D substitution was observed among patients with a persistent postoperative PTH elevation , who also improved their BMD at 33 % radius and radius ultradistal ( p<0.05 ) . In conclusion , except for a minor improvement of radius BMD , our data show no beneficial effect on BMD or bone turnover markers of vitamin D supplementation after PTX . Preoperative PTH seems to have the strongest association with improvement in BMD Summary The effects of higher than recommended vitamin D doses on bone mineral density ( BMD ) and quality are not known . In this study , higher intakes , in postmenopausal women undergoing weight control over 1 year , had no effect on areal or volumetric BMD but prevented the deterioration in cortical bone geometry . Introduction Studies examining how bone responds to a st and ard dose of vitamin D supplementation have been inconsistent . In addition , the effects of higher doses on BMD and quality are not known . Postmenopausal women undergoing weight control to improve health outcomes are particularly at risk for bone loss and might benefit from supplemental vitamin D intake above the recommended allowance . Methods This 1-year-long , r and omized , double-blind controlled study addresses whether vitamin D supplementation , in healthy overweight/obese older women , affects BMD and bone structural parameters . In addition , bone turnover and serum total , free , and bioavailable 25-hydroxyvitamin D ( 25OHD ) responses to one of three daily levels of vitamin D3 ( 600 , 2000 , 4000 IU ) with 1.2 Ca g/day during weight control were examined . Results Fifty-eight women ( age , 58 ± 6 years ; body mass index , 30.2 ± 3.8 kg/m2 , serum 25OHD , 27.3 ± 4.4 ng/mL ) were r and omized to treatment . After 1 year , serum 25OHD concentrations increased to 26.5 ± 4.4 , 35.9 ± 4.5 , and 41.5 ± 6.9 ng/mL , in groups 600 , 2000 , and 4000 IU , respectively , and differed between groups ( p < 0.01 ) . Weight change was similar between groups ( −3.0 ± 4.1 % ) . Cortical ( Ct ) thickness of the tibia changed by −1.5 ± 5.1 % , + 0.6 ± 3.2 % , and + 2.0 ± 4.5 % in groups 600 , 2000 , and 4000 IU , respectively , and each group was significantly different from each other ( p < 0.05 ) . Conclusion The decline in Ct thickness was prevented with higher vitamin D3 supplementation , but there were no other significant changes due to treatment over 1 year . Whether these findings translate to changes in biomechanical properties leading to reduced fracture risk should be addressed in future studies Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn 's disease ( CD ) , this needs to be confirmed in double-blind , r and omised controlled trials ( RCT ) with phylloquinone ( vitamin K1 ) . By conducting two RCT , the present study aim ed to first establish whether supplementation with 1000 μg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum ( % ucOC ; marker of vitamin K status ) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass . The initial dose-ranging RCT was conducted in adult patients with CD ( n 10 per group ) using 0 ( placebo ) , 1000 or 2000 μg of phylloquinone daily for 2 weeks . In the main RCT , the effect of placebo v. 1000 μg vitamin K/d ( both co-administered with Ca ( 500 mg/d ) and vitamin D3 ( 10 μg/d ) ) for 12 months ( n 43 per group ) on the biochemical indices of bone turnover ( determined by enzyme immunoassay ) and bone mass ( determined by dual-energy X-ray absorptiometry ) were investigated . At baseline , the mean % ucOC was 47 % , and this was suppressed upon supplementation with 1000 μg of phylloquinone daily ( - 81 % ; P < 0·01 ) and not suppressed further by 2000 μg of phylloquinone daily . Compared with the placebo , supplementation with 1000 μg of phylloquinone daily for 12 months had no significant effect ( P>0·1 ) on bone turnover markers or on the bone mass of the lumbar spine or femur , but modestly increased ( P < 0·05 ) the bone mass of the total radius . Despite near maximal suppression of serum % ucOC , supplementation with 1000 μg of phylloquinone daily ( with Ca and vitamin D3 ) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency
Vitamin D supplementation had no statistically significant effects on total body bone mineral content ( BMC ) , hip bone mineral density ( BMD ) or forearm BMD .
These results do not support vitamin D supplementation to improve bone density in healthy children with normal vitamin D levels , but suggest that supplementation of deficient children may be clinical ly useful .
BACKGROUND Results of r and omised controlled trials ( RCTs ) of vitamin D supplementation to improve  bone density in children are inconsistent .
OBJECTIVES To determine the effectiveness of vitamin D supplementation for improving  bone mineral density in children , whether any effect varies by sex , age or pubertal stage , the type or dose of vitamin D given or baseline vitamin D status , and if effects persist after cessation of supplementation .