Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial

Khaw, Kay‐Tee; Stewart, Alistair; Waayer, Debbie; Lawes, Carlene M.M.; Toop, Les; Camargo, Carlos A.; Scragg, Robert

doi:10.1016/s2213-8587(17)30103-1

Cited by 174 publications

(159 citation statements)

References 28 publications

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“…For example, a Mendelian randomization study suggested that the association between genetically low vitamin D status and areal BMD was not causal [3], which agrees with the effect of vitamin D supplementation on areal BMD [4] and would be compatible with compensatory adaptation of bone to mechanical strain that is a prominent mechanism in the skeleton [5][6][7]. Furthermore, in the randomized, double-blind, placebo-controlled ViDA trial, monthly high-dose vitamin D supplementation of 100 000 IU colecalciferol for 3-4 years did not change the risk of fractures, and the result was independent of baseline S-25OHD levels including even less than 25 nmol L À1 and over 75 nmol L À1 [8]. The same interpretation can be applied to observational studies showing the association between use of proton pump inhibitors and an increased risk of hip fracture [9,10].…”

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confidence: 80%

Vitamin D and bone health: interpreting observational studies

Sugiyama

2017

J Intern Med

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In a population-based cohort of approximately 5000 women (mean age 68 years), Micha€ elsson et al. [1] recently showed a marked seasonal difference in the association between serum 25-hydroxyvitamin D (S-25OHD) levels and areal bone mineral density (BMD) at the total hip, femoral neck and lumbar spine as well as of the total body. There was positive association between S-25OHD concentrations up to 40 nmol L À1 and areal BMD during summer. By sharp contrast, during winter, areal BMD was not associated with S-25OHD concentrations and similar between even below 20 nmol L À1 and over 80 nmol L À1. I agree with one reasonable explanation of the seasonal difference that a season-related dynamic process influenced the association between S-25OHD levels and areal BMD [1] and would also like to discuss this important evidence from another point of view.Of note, S-25OHD levels were predominantly linked to season-related ultraviolet type B (UV-B) radiation doses, and the difference during summer in areal BMD was relatively greater at the total hip and femoral neck compared with the lumbar spine [1]. The degree of mechanical loading is higher at the former sites than at the latter site, and skeletal loading from activity outdoors can be a major determinant of areal BMD. Consequently, the obvious seasonal discrepancy [1] seems to suggest that the association during summer could result from physical activity, whilst S-25OHD levels might not directly affect areal BMD.In consistent with the above logic, recent evidence is unlikely to support a cause and effect relationships between vitamin D status and musculoskeletal as well as nonmusculoskeletal [2] health in observational studies. For example, a Mendelian randomization study suggested that the association between genetically low vitamin D status and areal BMD was not causal [3], which agrees with the effect of vitamin D supplementation on areal BMD [4] and would be compatible with compensatory adaptation of bone to mechanical strain that is a prominent mechanism in the skeleton [5][6][7]. Furthermore, in the randomized, double-blind, placebo-controlled ViDA trial, monthly high-dose vitamin D supplementation of 100 000 IU colecalciferol for 3-4 years did not change the risk of fractures, and the result was independent of baseline S-25OHD levels including even less than 25 nmol L À1 and over 75 nmol L À1 [8]. The same interpretation can be applied to observational studies showing the association between use of proton pump inhibitors and an increased risk of hip fracture [9,10].As discussed by the authors [1], the effect of vitamin D supplementation on areal BMD appears to be indirect. On the basis of suggestion by the Scientific Advisory Committee on Nutrition (SACN) in adults aged 50 years or older that vitamin D supplementation improves muscle strength/function and increases areal BMD, especially at the femoral neck rather than total hip and notably not at the lumbar spine [11], we suggested that an increase in areal BMD by vitamin D supplementation can result indirectly fro...

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confidence: 80%

Vitamin D and bone health: interpreting observational studies

Sugiyama

2017

J Intern Med

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“…Therefore, it is one of the most frequently used ‘drugs’ in the world. A large RCT (VIDA) recently demonstrated that monthly doses of vitamin D3, equivalent to about 3000 IU per day for 3.4 years., did not reduce the risk of nonvertebral fractures . Fractures were only a secondary end‐point, and the study was not fully powered to answer the question of antifracture efficacy.…”

Section: Biochemical and Clinical Implications Of Vitamin D Statusmentioning

confidence: 99%

How much vitamin D is needed for healthy bones?

Bouillon

2017

J Intern Med

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“…There was no difference in falls between vitamin D and placebo over up to 4 years of follow up. Reported falls were 1312 (52%) vitamin D vs. 1326 (53%) placebo; HR=0.99 (0.92, 1.07) p=0.82 [27,28].…”

Section: Finally Dr Moray Campbell (Ohio State University) Examined mentioning

confidence: 97%

Highlights from the 21st Workshop on Vitamin D in Barcelona, May 2018

Fleet

Campbell

Carlberg

et al. 2019

The Journal of Steroid Biochemistry and Molecular Biology

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The 21st Workshop on Vitamin D was held at the Centre de Convencions Internacional de Barcelona (CCIB) from May 16-19, 2018. The Workshop was organized by Dr Martin Hewison (Chair, University of Birmingham, Birmingham, UK) with the invaluable support of Dr JoEllen Welsh (CFO, SUNY Albany, USA) and Roxanne Hall (Meetings Plus). Invited presentations and topical sessions were chosen by the Workshop Executive Committee, with

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Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial

Abstract: Health Research Council of New Zealand and Accident Compensation Corporation of New Zealand.

Cited by 174 publications

References 28 publications

Vitamin D and bone health: interpreting observational studies

Vitamin D and bone health: interpreting observational studies

How much vitamin D is needed for healthy bones?

Highlights from the 21st Workshop on Vitamin D in Barcelona, May 2018

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