Microsoft word - bischoff_324_e.doc
Doctoral Program in Nutrition at Harvard School of Public Health in Boston,
USA, Vitamin D.
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 , 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. 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 , a serum levels of at least 75 nmol/l 25-hydroxyvitamin D
Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW, et al.: Effect of vitamin D on falls: a meta-analysis. JAMA 2004; 291(16):
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.
MEDICAL & DENTAL HISTORY FORM PATIENT INFORMATION Patient’s Last Name: First Name: FAMILY INFORMATION (IF PATIENT IS A MINOR) Responsible Party: Relationship to Patient (eg Mom, Stepmom, Guardian, Other): Marital Status: ( ) Married ( ) Single ( ) Separated ( ) Divorced ( ) Widowed Spouse’s Name: Spouse’s Relationship to Patient: ( ) Mom ( ) Dad ( ) Stepmo
UNLOCKING BARRIERS TO CARE Oral Health Care for People with Mental Health Problems Guidelines and Recommendations Report of BSDH Working Group J. Griffiths I. Leeman K. Wilson R. Blankenstein Revised January, 2000 BRITISH SOCIETY FOR DISABILITY AND ORAL HEALTH Registered Charity No: 1044867 BRITISH SOCIETY FOR DISABILITY AND ORAL HEALTH CONTENTS Guidelines: