B Dawson-Hughes

..Trials testing additional doses of vitamin D in different segments of the population are needed...

..The minimal 25-hydroxyvitamin D level needed for benefit was 60 nmol/l...

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..Many elderly persons in the United States and elsewhere have serum 25-hydroxyvitamin D concentrations below these levels. For this reason, supplementation is likely to provide significant benefit to this segment of the population...

..Bicarbonate has been implicated in bone health in older subjects on acid-producing diets in short-term studies...

..Bicarbonate reduced NAE, and the decrement was associated with a decrease in nitrogen excretion. Treatment also improved muscle power and endurance in the women...

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..The possibility that Ca intake may influence the impact of dietary protein on the skeleton warrants further investigation...

..This position paper of the International Osteoporosis Foundation makes recommendations for vitamin D nutrition in elderly men and women from an evidence-based perspective...

..Broad-based vitamin D supplementation is needed to remove vitamin D insufficiency as a contributing cause of osteoporosis...

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..The mechanisms involved are not certain but these findings suggest a role for the calcium sensor receptor...

..Serum 25-hydroxyvitamin D (25OHD) concentrations greater than 30 ng/ml have been recommended for lowering fracture risk...

..Recent public health efforts to promote higher calcium and vitamin D intakes, targeted predominantly to older Caucasians, should also be directed to older African-Americans...

..In conclusion, low body weight and low BMI at menarche appear to be significant predictors of reduced bone mass in healthy premenopausal women ages 40-45 years...

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..Vitamin K has been associated with bone mineral density (BMD) and risk of hip fracture. The apolipoprotein (apo) E4 allele (APOE*E4) has been associated with bone fracture through a putative effect on vitamin K transport in blood...

..More than 90% of the men and women had calcidiol concentrations below this value in the wintertime. The high prevalence of lower wintertime calcidiol values may increase risk of bone loss in elderly men and women...

..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...

..Educational strategies aimed at improving the use of bone density testing should consider these factors...

..However, no studies have examined the association between vitamin D status, dementia, and cranial MRI indicators of cerebrovascular disease (CVD)...

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..5; 95% CI: 0.2 to 0.9). CONCLUSION: These findings suggest that intake levels of calcium and vitamin D aimed at preventing osteoporosis have a beneficial effect on tooth retention...

..These findings indicate that the calcium sensor receptor plays a role in the regulation of gastric acid...

..The failure to identify certain menstrual characteristics as exposures for subsequent disease may reflect limitations in the accuracy and precision of the recalled measures...

..To assess the genetic and nongenetic correlates of circulating measures of vitamins K and D status in a community-based sample of men and women...

..Based on the results of this survey, many elderly men and women may benefit from increased utilization of calcium supplements and bone-active medications...

..Osteocalcin has been reported to contribute to the regulation of glucose tolerance and insulin secretion and sensitivity in experimental animals...

..This is important in view of worldwide increases in overweight and obesity and the potential contribution of elevated PTH to morbidity and mortality...

..Additional studies are needed to further explore the relationships among body fat, storage of vitamin K in adipose tissue, and implications for vitamin K status and function...

..Since vitamin D insufficiency is readily amenable to supplementation, it is important to understand what factors are associated with serum 25 hydroxy vitamin D (25(OH)D) response to vitamin D supplementation...

..5% lower than with the 24-h urine method; however, it rank orders subjects accurately thus making it a useful alternative method in clinical research applications...

..In summary, the results of this study suggest that for a given body weight, a higher proportion of fat and a higher serum leptin concentration have negative associations with bone mass in premenopausal women...

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..We sought to compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in nondiabetic adults aged > or =65 years...

..Vitamin K modulates cytokines involved in bone turnover, including interleukin-6 (IL-6) and osteoprotegerin in vitro...

..In conclusion, an adequate calcium intake may help promote a favorable effect of dietary protein on the skeleton in older individuals...

..Vitamin K has been implicated in bone health, primarily in observational studies. However, little is known about the role of phylloquinone supplementation on prevention of bone loss in men and women...

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..Clinical trials are required to isolate any putative effects of vitamin K on rates of bone loss. The target population in these trials, particularly in regard to estrogen use, may be critical, as suggested by the findings of this study...

..Although several studies have suggested that early menarche is associated with the development of adult overweight, few have accounted for childhood overweight before menarche...

..Low dietary vitamin K intake has been associated with an increased risk of hip fracture in men and women. Few data exist on the association between dietary vitamin K intake and bone mineral density (BMD)...

..Vitamin K has a potentially beneficial role in insulin resistance, but evidence is limited in humans. We tested the hypothesis that vitamin K supplementation for 36 months will improve insulin resistance in older men and women...

..Protein is an essential component of muscle and bone. However, the acidic byproducts of protein metabolism may have a negative impact on the musculoskeletal system, particularly in older individuals with declining renal function...

..There is currently no consensus on the effect of dietary protein intake on the skeleton, but there is some indication that low calcium intakes adversely influence the effect of dietary protein on fracture risk...

..A preventive role for vitamin K in CAC progression has been proposed on the basis of the properties of matrix Gla protein (MGP) as a vitamin K-dependent calcification inhibitor...

..The observation that high vitamin K status was associated with lower concentrations of inflammatory markers suggests that a possible protective role for vitamin K in inflammation merits further investigation...

..Polymorphisms in genes encoding enzymes involved in vitamin K metabolism may modulate plasma concentrations of phylloquionone and percent carboxylation of osteocalcin...

..The implications of higher doses for the entire adult population should be addressed in future studies...

..This method can thus be a useful approach to study potential relationships between muscle fiber subtypes and vitamin D receptor expression...

..001) but had no effect on fasting plasma glucose, serum insulin, or HOMA-IR. In conclusion, bicarbonate supplementation does not appear to improve insulin sensitivity or glucose control in non-diabetic older adults...

..This study was conducted to determine whether there are age differences in the plasma parent vitamin D and 25-hydroxyvitamin D (25OHD) responses to eight weeks of supplementation with 20 microg/day of vitamin D3...

..Greater adiposity is associated with lower blood levels of 25-hydroxyvitamin D [25(OH)D]. The extent to which this results from reduced sun exposure among heavier individuals is unknown...

..In conclusion, at their current dietary vitamin D intake levels, most patients at this latitude will need vitamin D supplements in the wintertime...

..The role of total calcium intake in the prevention of hip fracture risk has not been well established...

..Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce...

..Compatible with the long-standing concept that fat tissue is a storage site for vitamin D, fat tissue and serum vitamin D(3) concentrations were positively correlated...

..The role and dose of oral vitamin D supplementation in nonvertebral fracture prevention have not been well established...

..No other associations were observed for BMD at any other site. Further study is necessary for elucidation of the gender differences in the possible influence of IGF system components on bone mass...

..The objective of this study was to examine the association between 25-hydroxyvitamin D, 25(OH)D, and cognitive function...

..The purpose of this study was to prospectively examine the association between vitamin D and calcium intake and risk of type 2 diabetes...

..The results of this study suggest a role for MGP genetic variants in coronary atherosclerosis among men that is not reflected in serum MGP concentrations...

..Falls among elderly individuals occur frequently, increase with age, and lead to substantial morbidity and mortality. The role of vitamin D in preventing falls among elderly people has not been well established...

..When data were available to combine, meta-analyses were performed, and summary odds ratios (OR) are presented...

..Vitamin D may improve muscle strength through a highly specific nuclear receptor in muscle tissue...

..Further work is needed to determine the relevance of these results to the general population...

..To determine the association between 25-hydroxyvitamin D (25-OHD) concentration and risk of incident type 2 diabetes...

..Mono- and polyunsaturated fats may have opposing effects on vitamin D absorption...

..Therefore, the hypothesis that vitamin D may modify diabetes risk needs to be confirmed in trials specifically designed for that purpose...

..A larger study is needed to determine whether proximal tibia BMD measurements have research or clinical application for osteoarthritis or other conditions...

..An important approach to reducing the rate of fractures is first to target our treatments to patients at high risk for fracture and then to develop strategies to improve treatment continuation rates...

..CONCLUSIONS: Diet changes that increase renal NAE are associated with increases in serum PTH, bone resorption, and calcium excretion over a 60-day period...

..However, little is known about whether supplemental cholecalciferol plus calcium citrate malate will lower the long-term risk of falling in men, active older individuals, and older individuals with higher 25-hydroxyvitamin D levels...

..Based on the available evidence, we believe that if older men and women maintain serum levels of 25(OH)D that are higher than the consensus median threshold of 75 nmol/l, they will be at lower risk of fracture...

..6, 8.7) nmol/liter. In older men and women, the level of calcium intake, within the range of 500-1500 mg/d, does not have an important effect on the rise in serum 25(OH)D that occurs in response to 800 IU (20 microg)/d vitamin D(3)...

..Periodontal disease (PD) is a common chronic inflammatory disease and an important risk factor for tooth loss. Vitamin D might affect periodontal disease risk via an effect on bone mineral density (BMD) or via immunomodulatory effects...

..This suggests that the primary care physician is well positioned to bring about much needed change in the quality of care of fracture patients...

..Matrix Gla protein (MGP) is an inhibitor of calcification in vivo. However, little is known regarding the distribution of circulating MGP and its associations with CHD risk factors or with CAC in humans...

..Total fractures were >2 million, costing nearly $17 billion in 2005. Men account for >25% of the burden. Rapid growth in the disease burden is projected among nonwhite populations...

..94% for total body fat tissue, and 0.77% for total body nonfat soft tissue. We conclude that precision overall is excellent and that femoral neck precision can be improved with bilateral compared with the traditional single hip scans...

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..Specific efforts include supporting the National Osteoporosis Data Group, collecting and disseminating definitive statistics on bone diseases and on conditions co-morbid with osteoporosis, and preparing summary reports. ..