For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .
Delivery of a Vitamin D Intervention in Homebound Older Adults Using a Meals-on-Wheels Program: A Pilot Study.
OBJECTIVES To assess the feasibility of a vitamin D intervention delivered through a Meals-on-Wheels ( MOW ) program to improve 25-hydroxyvitamin D ( 25(OH)D ) concentrations and reduce falls in homebound older adults . DESIGN Single-blind , cluster r and omized trial . SETTING MOW , Forsyth County , North Carolina . PARTICIPANTS Community-dwelling homebound adults aged 65 to 102 ( N = 68 ) . INTERVENTION MOW clients were r and omized to vitamin D3 ( 100,000 IU/month ; n = 38 ) or active placebo ( 400 IU vitamin E/month ; n = 30 ) according to MOW delivery route . MEASUREMENTS Serum 25(OH)D was assessed at baseline and 5-month follow-up ; proportions of participants in 25(OH)D categories were compared using Fisher exact test . Falls were assessed using monthly fall calendars , and rate of falls was estimated using negative binomial generalized estimating equation models . RESULTS Mean ± st and ard deviation 25(OH)D concentrations were 20.9 ± 11.5 ng/mL at baseline , with 57 % having 25(OH)D concentrations less than 20 ng/mL. Retention and adherence were high ( > 90 % ) . After the 5-month intervention , only one of 34 participants r and omized to vitamin D3 had 25(OH)D concentrations less than 20 ng/mL , compared with 18 of 25 participants r and omized to placebo ( P < .001 ) . In unadjusted analyses , the rate of falls over 5 months was not significantly different according to intervention group ( risk ratio ( RR ) = 0.48 , 95 % confidence interval ( CI ) = 0.19 - 1.19 ) , but after adjustment for sex , race , season of year , baseline 25(OH)D status , and history of falls , participants r and omized to vitamin D3 had a lower rate of falling than those r and omized to placebo ( RR = 0.42 , 95 % CI = 0.21 - 0.87 ) . CONCLUSION A vitamin D intervention delivered through MOW was feasible , result ing in improvements in 25(OH)D concentrations and a lower rate of falls in adjusted analyses . Further research is needed to vali date the reduction in falls from this type of intervention
For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .