Microsoft word - bischoff_324_e.doc

Doctoral Program in Nutrition at Harvard School of Public Health in Boston,
USA, Vitamin D.

Projekt: 324
Prof. Dr. med. Heike A. Bischoff-Ferrari, MPH
UniversitätsSpital Zürich, Abteilung Rheumatologie, Gloriastrasse 25, 8091 Zürich

Vitamin D reduces fracture risk by enhancing bone density and reducing the risk of falling[1, 2].
The effects of vitamin D on muscle strength and falls occur early after 2-3 months [3], which may explain early anti-fracture effects of vitamin D. As a large part of the older population, community- dwelling or institutionalized, have low 25-hydroxyvitamin D levels[4, 5], general vitamin D supplementation may be warranted. Such a recommendation is possible, for vitamin D (cholecalciferol) is inexpensive and well tolerated. Results of a recent meta-analysis of high quality randomized controlled trials indicate that 400 IU vitamin D per day is not enough for fracture or fall prevention, while a daily intake of at least 800-1000 IU vitamin D may achieve these benefits [1, 6, 7]. A combination of vitamin D with calcium may be important, however the amount of additional calcium is unclear and may depend on daily intake of calcium from food sources and 25- hydroxyvitamin D status[8]. An advantage of milk products as a source of calcium is the additional protein. According to results from fracture studies and data from epidemiologic studies on hip bone density and lower extremity function [9], a serum levels of at least 75 nmol/l 25-hydroxyvitamin D 1. Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW, et al.: Effect of vitamin D on falls: a meta-analysis. JAMA 2004; 291(16):
2. Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B: Effect of cholecalciferol plus calcium on falling in ambulatory older men and
women: a 3-year randomized controlled trial. Arch Intern Med. 2006; 166(4): 424-30.
3. Bischoff HA, Stahelin HB, Dick W, et al.: Effects of vitamin D and calcium supplementation on falls: a randomized controlled
trial. J Bone Miner Res 2003; 18(2): 343-51.
4. Bischoff HA, Dietrich T, Orav JE, Dawson-Hughes B: Positive Association between 25-Hydroxyvitamin D Levels and Bone
Mineral Density: a Population-Based Study of Younger and Older US Adults. Abstract; Annual Meeting of the Americal College of
Rheumatology 2002 2002.
5. Theiler R, Stahelin HB, Tyndall A, Binder K, Somorjai G, Bischoff HA: Calcidiol, calcitriol and parathyroid hormone serum
concentrations in institutionalized and ambulatory elderly in Switzerland. Int J Vitam Nutr Res 1999; 69(2): 96-105.
6. Bischoff-Ferrari HA, Rees JR, Grau MV, Barry EL, Baron JA: Effect of calcium supplementation on fracture risk:
a double-blind randomized controlled trial
Journal of Bone and Mineral Research 2006; 21 Simple 1, abstract 1225: S60.
7. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP: A higher dose of vitamin d reduces the risk of falls in
nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007; 55(2): 234-9.
8. Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G: Relationship between serum parathyroid hormone
levels, vitamin D sufficiency, and calcium intake. Jama. 2005; 294(18): 2336-41.
9. Bischoff-Ferrari HA, Dietrich T, Orav EJ, et al.: Higher 25-hydroxyvitamin D concentrations are associated with better lower-
extremity function in both active and inactive persons aged >=60 y. Am J Clin Nutr 2004; 80(3): 752-8.
10. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B: Estimation of optimal serum concentrations of
25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84(1): 18-28.


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Oral health care for people with mental health problems guidelines and recommendations

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