IOF position statement: vitamin D recommendations for older adults

Abstract

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

Oral supplementation with 25(OH)D3 versus vitamin D3: Effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity

“…(2,3) Our trial has several strengths despite its small size. We had complete adherence to the study protocol and 100% of participants attended 14 clinical visits.…”

“…Although the 2010 Institute of Medicine (IOM) recommendations support a 25(OH)D threshold of 20 ng/mL for bone health, (1) the International Osteoporosis Foundation, in their 2010 position paper on vitamin D, recommends a threshold of 30 ng/mL for optimal fall and fracture reduction, (2) consistent with the most recent recommendations by the U.S. Endocrine Society published in June 2011. (3) The recommendations by the International Osteoporosis Foundation (IOF) and the Endocrine Society are based on two meta-analyses of double-blind randomized controlled trials that suggested fall reduction required a threshold of at least 24 ng/mL (4) and fracture reduction a threshold of at least 30 ng/mL.…”

“…During the first week of the study, participants attended five daily visits. The baseline visit (visit 2) included 24-hour pharmacokinetic profiling for HyD and vitamin D 3 , with repeated measurements of serum levels of calcium, creatinine, and 25(OH)D. Additionally, a baseline level of intact parathyroid hormone (PTH), albumin, insulin, fasting glucose, 1,25(OH) 2 Further, all subjects underwent functional testing of lower extremities, including validated and standardized procedures for knee flexor/extensor strength, timed up-and-go test, and repeated sit-to-stand test. (24) The remaining four daily visits of the first week (visits 3-6) included measurements of circulating 25(OH)D, immunity markers, albumin, serum calcium, and creatinine.…”

Analytical and clinical performance of the new Fujirebio 25-OH vitamin D assay, a comparison with liquid chromatography-tandem mass spectrometry (LC-MS/MS) and three other automated assays

“…Currently, there is no consensus on the optimum threshold concentration of 25(OH)D, but the Institute of Medicine (IOM) recommends a threshold of 50 nmol/L for bone health [3], whereas the International Osteoporosis Foundation (IOF) [4] and the Endocrine Society [5] recommend a threshold of 75 nmol/L for optimal reductions in fall or fracture risk. However, the question of whether this higher threshold is associated with improvements in other health outcomes remains controversial [6].…”

“…In addition to the classical role of vitamin D in the maintenance of bone health, vitamin D deficiency has been associated with increased risks of a number of chronic conditions, including cardiovascular disease, diabetes, hypertension, some cancers, autoimmune diseases, and infectious diseases [3][4][5][6][7][8]. This growing awareness that adequate vitamin D status has potentially beneficial effects on a variety of health outcomes has led to a marked increase in research in this field.…”