scholarly journals Calcium and vitamin D nutrition and bone disease of the elderly

2001 ◽  
Vol 4 (2b) ◽  
pp. 547-559 ◽  
Author(s):  
C Gennari
Keyword(s):  
Vitamin D ◽  
Bone Loss ◽  
Bone Mass ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Calcium Intake ◽  
Osteoporotic Fractures ◽  
The Elderly ◽  
Vitamin D Insufficiency ◽  
High Incidence

AbstractOsteoporosis, a systemic skeletal disease characterized by a low bone mass, is a major public health problem in EC member states because of the high incidence of fragility fractures, especially hip and vertebral fracture. In EC member states the high incidence of osteoporotic fractures leads to considerable mortality, morbidity, reduced mobility and decreased quality of life. In 1995 the number of hip fractures in 15 countries of EC has been 382.000 and the estimated total care cost of about 9 billion of ECUs. Given the magnitude of the problem public health measures are important for preventive intervention.Skeletal bone mass is determined by a combination of endogenous (genetic, hormonal) and exogenous (nutritional, physical activity) factors. Nutrition plays an important role in bone health. The two nutrients essential for bone health are calcium and vitamin D. Reduced supplies of calcium are associated with a reduced bone mass and osteoporosis, whereas a chronic and severe vitamin D deficiency leads to osteomalacia, a metabolic bone disease characterized by a decreased mineralization of bone. Vitamin D insufficiency, the preclinical phase of vitamin D deficiency, is most commonly found in the elderly. The major causes of vitamin D deficiency and insufficiency are decreased renal hydroxylation of vitamin D, poor nutrition, scarce exposition to sunlight and a decline in the synthesis of vitamin D in the skin.The daily average calcium intake in Europe has been evaluated in the SENECA study concerning the diet of elderly people from 19 towns of 10 European countries. In about one third of subjects the dietary calcium intake results were very low, between 300 and 600 mg/day in women, and 350 and 700 mg/day in men. Calcium supplements reduce the rate of bone loss in osteoporotic patients. Some recent studies have reported a significant positive effect of calcium treatment not only on bone mass but also on fracture incidence. The SENECA study, has also shown that vitamin D insufficiency is frequent in elderly populations in Europe. There are a number of studies on the effects of vitamin D supplementation on bone loss in the elderly, showing that supplementations with daily doses of 400–800 IU of vitamin D, given alone or in combination with calcium, are able to reverse vitamin D insufficiency, to prevent bone loss and to improve bone density in the elderly.In recent years, there has been much uncertainty about the intake of calcium for various ages and physiological states. In 1998, the expert committee of the European Community in the Report on Osteoporosis-Action on prevention, has given the recommended daily dietary allowances (RDA) for calcium at all stage of life. For the elderly population, above age 65 the RDA is 700–800 mg/day. The main source of calcium in the diet are dairy products (milk, yoghurts and cheese) fish (sardines with bones), few vegetables and fruits. The optimal way to achieve adequate calcium intake is through the diet. However, when dietary sources are scarce or not well tolerated, calcium supplementation may be used. Calcium is generally well tolerated and reports of significant side-effects are rare.Adequate sunlight exposure may prevent and cure vitamin D insufficiency. However, the sunlight exposure or the ultraviolet irradiation are limited by concern about skin cancer and skin disease. The most rational approach to reducing vitamin D insufficiency is supplementation. In Europe, the RDA is 400–800 IU (10–20 μg) daily for people aged 65 years or over. This dose is safe and free of side effects.In conclusion, in Europe a low calcium intake and a suboptimal vitamin D status are very common in the elderly. Evidence supports routine supplementation for these people at risk of osteoporosis, by providing a daily intake of 700–800 mg of calcium and 400–800 IU of vitamin D. This is an effective, safe and cheap means of preventing osteoporotic fractures.

scholarly journals Nutrihealth Study: Seasonal Variation in Vitamin D Status Among the Slovenian Adult and Elderly Population

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1838 ◽  
Author(s):  
Maša Hribar ◽  
Hristo Hristov ◽  
Matej Gregorič ◽  
Urška Blaznik ◽  
Katja Zaletel ◽  
...  
Keyword(s):  
Vitamin D ◽  
Seasonal Variation ◽  
Vitamin D Deficiency ◽  
Elderly Population ◽  
Sun Exposure ◽  
Epidemiological Data ◽  
The Elderly ◽  
Vitamin D Insufficiency ◽  
Ultraviolet B ◽  
Vitamin D Status

Several studies conducted around the world showed substantial vitamin D insufficiency and deficiency among different population groups. Sources of vitamin D in the human body include ultraviolet B (UVB)-light-induced biosynthesis and dietary intake, but people’s diets are often poor in vitamin D. Furthermore, in many regions, sun exposure and the intensity of UVB irradiation during wintertime are not sufficient for vitamin D biosynthesis. In Slovenia, epidemiological data about vitamin D status in the population were investigated through a national Nutrihealth study—an extension to the national dietary survey SI.Menu (2017/18). The study was conducted on a representative sample of 125 adult (18–64 years) and 155 elderly (65–74 years old) subjects, enrolled in the study in different seasons. Their vitamin D status was determined by measuring the serum 25-hydroxy-vitamin D (25(OH)D) concentration. Thresholds for vitamin D deficiency and insufficiency were 25(OH)D levels below 30 and 50 nmol/L, respectively. Altogether, 24.9% of the adults and 23.5% of the elderly were found to be vitamin D deficient, while an insufficient status was found in 58.2% and 62.9%, respectively. A particularly concerning situation was observed during extended wintertime (November–April); vitamin D deficiency was found in 40.8% and 34.6%, and insufficient serum 25(OH)D levels were observed in 81.6% and 78.8%, respectively. The results of the study showed high seasonal variation in serum 25(OH)D levels in both the adult and elderly population, with deficiency being especially pronounced during wintertime. The prevalence of this deficiency in Slovenia is among the highest in Europe and poses a possible public health risk that needs to be addressed with appropriate recommendations and/or policy interventions.

Should We Be Concerned about the Vitamin D Status of Athletes?

2008 ◽  
Vol 18 (2) ◽  
pp. 204-224 ◽  
Author(s):  
Kentz S. Willis ◽  
Nikki J. Peterson ◽  
D. Enette Larson-Meyer
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Skin Pigmentation ◽  
Sun Exposure ◽  
The Elderly ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status ◽  
High Prevalence ◽  
The Hours ◽  
Human Immunity

A surprisingly high prevalence of vitamin D insufficiency and deficiency has recently been reported worldwide. Although very little is known about vitamin D status among athletes, a few studies suggest that poor vitamin D status is also a problem in athletic populations. It is well recognized that vitamin D is necessary for optimal bone health, but emerging evidence is finding that vitamin D deficiency increases the risk of autoimmune diseases and nonskeletal chronic diseases and can also have a profound effect on human immunity, inflammation, and muscle function (in the elderly). Thus, it is likely that compromised vitamin D status can affect an athlete’s overall health and ability to train (i.e., by affecting bone health, innate immunity, and exercise-related immunity and inflammation). Although further research in this area is needed, it is important that sports nutritionists assess vitamin D (as well as calcium) intake and make appropriate recommendations that will help athletes achieve adequate vitamin D status: serum 25(OH)D of at least 75 or 80 nmol/L. These recommendations can include regular safe sun exposure (twice a week between the hours of 10 a.m. and 3 p.m. on the arms and legs for 5–30 min, depending on season, latitude, and skin pigmentation) or dietary supplementation with 1,000–2,000 IU vitamin D3 per day. Although this is significantly higher than what is currently considered the adequate intake, recent research demonstrates these levels to be safe and possibly necessary to maintain adequate 25(OH)D concentrations.

scholarly journals Nutrition and osteoporosis prevention and treatment

2020 ◽  
Vol 7 (4) ◽  
pp. 3709-3720
Author(s):  
Jalal Hejazi ◽  
Ali Davoodi ◽  
Mohammadreza Khosravi ◽  
Meghdad Sedaghat ◽  
Vahideh Abedi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Mass ◽  
Vitamin K ◽  
Significant Role ◽  
Bone Health ◽  
The Elderly ◽  
Calcium Deficiency ◽  
Osteoporosis Prevention ◽  
Prevention And Treatment ◽  
Good Nutrition

Introduction: Osteoporosis falls among the major general health issues, specifically in the elderly, and is a widespread disease these days. According to various studies, good nutrition plays a significant role in osteoporosis prevention and treatment. The aim of this study was to conduct an extensive literature review on the effects of different nutrients to understand how macronutrients, micronutrients, and non-nutritive substances affect bone health. Methodology: To find relevant studies, the main keyword “osteoporosis” was searched in combination with “zinc,” “vitamin K,” “phosphorus,” “vitamin D,” “calcium,” “lipid,” “protein,” and “phytoestrogens” in PubMed (MEDLINE), Web of Science, SID, and Iran Medex databases. Findings: The most important element for bone health is calcium, which has a direct link to the bone mass density (BMD). In the case of calcium deficiency, high phosphorus content can damage bone tissue. The acceptable ratio of phosphorus to calcium is 0.5-1.5:1. Vitamin D is another important nutrient for bones; serum levels of vitamin D less than 20 ng/ml reduce bone density and increase the risk of fracture. High protein intake results in calcium excretion and loss of bone mass. In addition, calcium deficiency increases the risk of osteoporosis, specifically in the elderly. According to the literature, there is an inverse correlation between saturated fats and BMD. Vitamin K and magnesium deficiencies are correlated with BMD reduction and increased risk of osteoporosis. Copper and zinc are used as co-factors in the formation of collagen and elastin, and in mineralization of bone. As a result, deficiency of these elements may disrupt the process of incorporating minerals into the bone matrix. Conclusion: Good nutrition may play a significant role in osteoporosis prevention and treatment. Indeed, a healthy diet containing calcium (1,200 mg/day); vitamin D (600 IU); and certain amounts of protein, magnesium, and vitamin K can contribute greatly to bone health.

scholarly journals Vitamin D, Calcium, Parathyroid Hormone, and Sex Steroids in Bone Health and Effects of Aging

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Hitesh Kumar Bhattarai ◽  
Shreya Shrestha ◽  
Kabita Rokka ◽  
Rosy Shakya
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Bone Loss ◽  
Sex Hormones ◽  
Bone Health ◽  
The Elderly ◽  
Health Concern ◽  
Dietary Vitamin ◽  
Bone Modeling ◽  
Blood Calcium

Bone health of the elderly is a major global health concern, since about 1 in 3 women and 1 in 5 men suffer from bone loss and fractures, often called osteoporosis, in old age. Bone health is a complex issue affected by multiple hormones and minerals. Among all the hormones involved in bone health, calcitriol (also vitamin D), parathyroid, and sex hormones (especially estrogen) have been discussed in this review paper. We have discussed the metabolism of these hormones and their effects on bone health. Vitamin D can be obtained from diet or formed from 7-dehydrocholesterol found under the skin in the presence of sunlight. The active form, calcitriol, causes dimerization of vitamin D receptor and acts on the bones, intestine, and kidney to regulate the level of calcium in blood. Similarly, parathyroid hormone is secreted when the serum level of calcium is low. It helps regulate the level of blood calcium through calcitriol. Sex hormones regulate bone modeling at an early age and remodeling later in life. Loss of ovarian function and a decrement in the level of production of estrogen are marked by bone loss in elderly women. In the elderly, various changes in the calcium and vitamin D metabolism, such as decrease in the production of vitamin D, decrease in dietary vitamin D, decreased renal production, increased production of excretory products, decrease in the level of VDR, and decreased calcium absorption by the intestines, can lead to bone loss. When the elderly are diagnosed with osteoporosis, medications that directly target bone such as bisphosphonates, RANK ligand inhibitors, estrogen and estrogen analogues, estrogen receptor modulators, and parathyroid hormone receptor agonists are used. Additionally, calcium and vitamin D supplements are prescribed.

scholarly journals 149 Non-Pharmacological Treatment of Bone Health in Fallers

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
E Moran
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Calcium Intake ◽  
Daily Intake ◽  
Osteoporotic Fractures ◽  
Dietary Calcium ◽  
Urinary Stones ◽  
Dietary Calcium Intake ◽  
Increased Risk ◽  
Vitamin D Supplements

Abstract Introduction 1 in 2 women and 1 in 5 men will suffer a fragility fracture. Research into calcium and vitamin D supplements has found no consistent evidence to suggest that they reduce the risk of osteoporotic fractures. There has been little research to suggest that dietary calcium is effective at reducing the risk osteoporotic fractures, but supplements have been linked to increased risk of cardiovascular disease and urinary stones. Bisphosphonates have been shown to reduce the risk of osteoporotic fractures and are usually taken in combination with calcium and vitamin D supplements given that deficiencies must be corrected prior to starting. This study set out to assess the dietary calcium intake of patients who attend the falls clinic and explore their attitudes towards dietary change, as an alternative or adjunct to a calcium and vitamin D tablet. Methods Data was collected during private interviews conducted with patients who attended the falls clinic. The Edinburgh University Centre for Genomic and Experimental research (CGEM) food frequency calculator was used to calculate dietary calcium intake. Microsoft Excel was used to collate and analyse the data. Results No association was found between dietary calcium intake, age and sex. We did find that mean dietary calcium intake was significantly less than the recommended daily amount for adults with osteoporosis, with 80% not getting their recommended daily intake (p < 0.05). We identified patients who don’t receive a calcium and vitamin D supplement as an at-risk group who would benefit from advice on sources of dietary calcium and 83% of patients said that they would be interested in a leaflet on sources of dietary calcium. Conclusion This study has identified a group of patients who will hopefully benefit from a leaflet on sources of dietary calcium and as result improve their bone health.

scholarly journals EXPERIENCE OF TREATMENT OF MALE HYPERTENSION WITH OBESITY, FASTING HYPERGLYCEMIA AND DEFICIENCY OF VITAMIN D

2017 ◽  
Vol 25 (1) ◽  
pp. 69-75 ◽  
Author(s):  
T E. Filatova ◽  
A A. Nizov ◽  
V V. Davydov
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
The Elderly ◽  
Vitamin D Insufficiency ◽  
Hormone Deficiency ◽  
Fasting Glycemia ◽  
Increased Risk ◽  
Male Patients ◽  
Prostate Diseases ◽  
The Impact

Vitamin D insufficiency has been registered for almost half the world's population. Among the elderly, this figure reaches 80-90%, in Russia-78-83%. Men's patients of uroandrological profile with obesity, androgen deficiency, infertility and prostate diseases 69 associated with hypogonadism, obesity, insulin resistance and type 2 diabetes, the frequently detected (hormone) deficiency of vitamin D. In addition to the impact on calcium-phosphorous and carbohydrate metabolism, vitamin D deficiency is associated with an increased risk of developing hypertension.We have investigated male patients on the levels of vitamin D in the blood serum with immunoassay chemiluminescent method on microchasticah (full automatic Architect i2000 Abbot), the value of systolic and diastolic blood pressure (SAD and DAD) defined by a well-known method of Korotkov, fasting glycemia rates investigated by using the gluko-zooksidantmethod, body mass index (BMI) is calculated by the formula Quetelet.Elimination of vitamin D deficiency using a single succession introduction of 30004000 IU of cholecalciferol to the men of 40-50 years, suffering from different types of pathology, turns out to be effective not only in treating systolic-diastolic hypertension, but also in reducing, as fasting hyperglycemia and overweight.

scholarly journals Biochemical and Dietary Indicators of Bone Health in Rural Adolescent Girls from Konkan Region of Maharashtra, India (DERVAN-5)

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Patil SN ◽  
◽  
Patil N ◽  
Bhat P ◽  
Jadhav D ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Bone Mass ◽  
Adolescent Girls ◽  
Bone Health ◽  
Calcium Intake ◽  
Peak Bone Mass ◽  
Dietary Calcium Intake ◽  
Rural Adolescent

Adolescent period is marked by bone modeling and remodeling and leads to accrual of peak bone mass. Ideal peak bone mass depends on diet, hormones, genetic influence and environment and has consequences on bone health in adulthood. We measured biochemical indicators of bone health in rural adolescent girls. Methods: Five hundred fifty adolescent girls from longitudinal DERVAN cohort study from Indian state of Maharashtra underwent anthropometry. Biochemical parameters (intact parathyroid hormone, vitamin D, calcium, phosphorus and alkaline phosphatase) were measured. Results: Prevalence of underweight & stunting was 28.8%, 30.7% respectively. More than 56% were thin & only 5% were obese. Median body fat% & bone mass measured by bio-impedance were 23.3 and 1.6 Kg respectively. More than 80% were vitamin D deficient and 12.0% were calcium deficient. Median dietary calcium intake was 158.5mg/day which was far below recommended 850 mg/day. Median parathyroid hormone concentration was 8.49pmol/L and 66.7% had elevated concentrations (> 6.89pmol/L). Elevated phosphorus and alkaline phosphatase were observed in 23.3% and 23.0%. Parathyroid hormone was inversely associated with age (p<0.001) and vitamin D (p<0.001) and directly with phosphorus and alkaline phosphatase (p<0.05) for both. On multivariate analysis elevated parathyroid hormone was associated with low vitamin D (p<0.001). Conclusion: The adolescent girls of KONKAN are undernourished and vitamin D deficient. Despite poor dietary calcium intake the serum calcium levels were maintained at the cost of elevated parathyroid hormone. Thus parathyroid hormone may be used as a marker of bone health. This could be useful in planning early interventions to improve bone health.

scholarly journals Vitamin D Status Among Children aged 2 months to 13 years-a Hospital Based Study

2018 ◽  
Vol 3 (1) ◽  
pp. 381-384
Author(s):  
Hem Sagar Rimal ◽  
Shripad J Walavalkar
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Urban Area ◽  
Serum Calcium ◽  
Winter Season ◽  
College Teaching ◽  
Vitamin D Insufficiency ◽  
P Value ◽  
Strong Positive Correlation ◽  
Positive Correlation

Introduction: Vitamin D is an important micronutrient having crucial role in calcium and phosphate homeostasis but there is emerging evidence to suggest its role in prevention of infectious, inflammatory and neoplastic diseases. The vitamin D insufficiency/deficiency is a widely recognized problem among children in developed as well as developing countries.Objective: To find out the prevalence of vitamin D deficiency/insufficiency among children aged 2 months to 13 yrs and its correlation with serum calcium, phosphate and demographic factors.Methodology: Prospective, cross sectional, hospital based study conducted at Birat Medical College Teaching Hospital for a period of one year among children presented to pediatric OPD in whom pediatrician had a suspicion of Vitamin D Insufficiency /Deficiency. Venous blood Samples were taken for the estimation of 25(OH) Vitamin D, Calcium and Phosphate. Statistical analysis was done using SPSS software version 16. Results Among 174 children aged 2 months to 13 years, the prevalence of vitamin D insufficiency at the cutoff of <30ng/ml was 82.75% where as no cases of vitamin D deficiency was noted at cut off level of < 10 ng/ml. Children residing in urban area, samples taken in the winter season had higher prevalence of vitamin D insufficiency (p value <0.05). Serum calcium and phosphate level were found positively correlated with Vitamin D level (p<.05). However the relationship was very strong between Vitamin D and Calcium (r=0.402, p-value <0.001) and weak positive correlation was noted with phosphate(r=0.155, p value <0.05).Conclusion: There is very high prevalence of Vitamin D insufficiency among children. The vitamin D insufficiency was significantly higher in winter season as compared to summer. Children living in the urban area are more prone to Vitamin D insufficiency. Moderately strong positive correlation was observed between Vitamin D level and calcium but weak correlation existed with phosphate. BJHS 2018;3(1)5 : 381-384

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