January 17, 2019 by John Fernandez
Can Vitamin D Supplements Help With Bone Health? Debate Intensifies With New Study
Vitamin D helps balance the amount calcium and phosphate in our bodies, which is crucial for healthy bones, teeth and muscles. In older adults, bone health is vital for preventing falls and serious fractures.
But can vitamin D supplements — in contrast to vitamin D consumed naturally through certain foods and exposure to sunlight — decrease the risk of conditions, such as osteoporosis and hypertension, in addition to keeping bones strong by helping the body absorb calcium? A major new study says there is “little justification” that vitamin D supplements improve bone mineral density or prevent fractures in adults.
“Our findings suggest that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density,” the authors of the study, published in the Lancet Diabetes & Endocrinology, state. “There were no differences between the effects of higher and lower doses of vitamin D.”
These findings re-affirm previous research indicating that vitamin D supplements do not prevent disease for most users. Before considering taking vitamin D supplements, you should consult with your primary care doctor. The researchers did concede that supplements can be beneficial in preventing rare conditions, such as rickets and osteomalacia, in high risk groups. These conditions can result after going through a long period without exposure to sunshine, resulting in a serious deficiency.
About a quarter of the population is at risk for vitamin D “inadequacy,” and a smaller percentage are at risk for vitamin D deficiency, according to the U.S. Centers for Disease Control and Protection (CDC). A simple blood test can detect if this becomes vitamin D deficiency.
For most adults, vitamin D deficiency is not a health issue. However, some people who are obese and who are older than age 65 may have lower levels of vitamin D due to their diets, little sun exposure or other factors. In older adults, vitamin D deficiency can cause osteomalacia, which can result in falls and poor healing following fractures. Sign and symptoms of vitamin D deficiency can be subtle to non-existent in the early stages.
“Even if people don’t have symptoms, they should be evaluated for osteoporosis after the age of 65,” said Nathalie Regalado, M.D., an internal medicine physician with Baptist Health Primary Care. “Because we’re trying to get ahead of the game and prevent fractures.”
Your body forms vitamin D naturally after exposure to sunlight. But over exposure to the sun can lead to skin aging and skin cancer, so people try to get their vitamin D from other sources.
The new study looked at data from 81 randomized controlled trials — involving more than 53,000 people — that examined if over-the-counter supplements helped in fractures, falls and bone density. Most studies included women over the age of 65. A recent report found that one-quarter of all American women age 65 or older suffer from osteoporosis, which weakens bones and greatly increases a person’s risk for dangerous hip, back or other fractures. With three million baby boomers reaching retirement age every year, half of all Americans over 50 are expected to have, or be at risk of developing, osteoporosis of the hip, while more people will be at risk of the disease at any area in the skeleton.
The U.S. Preventive Services Task Force, an independent panel of experts in primary care and prevention, recommends that all women age 65 and older be screened for osteoporosis. The task force also recommends screening for women under the age of 65 who are at high risk for fractures. Men over the age 65 who are at high risk for fractures should talk to their doctor about screening. If you are over 50 and have broken a bone, you may have osteoporosis or be at increased risk for the disease.
Natural, healthy sources of vitamin D include fatty fish, such as cod and salmon; yogurt; and fortified milk and orange juice. Some packaged foods are fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
The study on vitamin D is the latest to shed doubt on the effectiveness of relying too much on over-the-counter supplements, instead of obtaining these nutrients through a healthy diet.
“The majority of vitamins, minerals or herbs in the market have not been studied well enough or not proven to be effective for health,” says Carla Duenas, registered dietitian with Community Health at Baptist Health South Florida. “Some can be effective if taken correctly and with a doctor or registered dietitian’s supervision.”