Falling for vitamin D

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Cheap way to help strengthen bones

Whoever coined the word vitamin was either a genius or a marketing wizard. By connecting it to the words vital and vitality, vitamin consumption has become a preoccupation, if not an obsession, for millions.

Unfortunately, when subjected to rigorous scrutiny, most vitamins, when provided as supplements, are a disappointment. Although vitamins in a regular diet are indeed essential, the benefits of taking more has nearly always resulted in dashed hopes; the one exception to this appears to be vitamin D. It has been well established as being effective in cancer prevention and cancer survival. Let's look at vitamin D and fall prevention in elderly nursing home residents.

Montreal -

Whoever coined the word vitamin was either a genius or a marketing wizard. By connecting it to the words vital and vitality, vitamin consumption has become a preoccupation, if not an obsession, for millions.

Unfortunately, when subjected to rigorous scrutiny, most vitamins, when provided as supplements, are a disappointment. Although vitamins in a regular diet are indeed essential, the benefits of taking more has nearly always resulted in dashed hopes; the one exception to this appears to be vitamin D. It has been well established as being effective in cancer prevention and cancer survival. Let's look at vitamin D and fall prevention in elderly nursing home residents.

How can vitamin D help your health?

Vitamin D has several established uses and is being researched for its potential benefit in a number of others.

This organic compound is produced naturally in the body through exposure to the sun's ultraviolet rays. Living in cold climates like ours means that getting enough of what has become known as the sunshine vitamin during the dark winter months requires daily supplementation.

The Canadian Cancer Society recommends a daily intake of 1,000 IU during the winter months. They cite research from over 20 years that has shown a relationship between lack of vitamin D and cancer risk. In 2008, a report by the International Agency for Research on Cancer (IARC) concluded that there is a relationship between low vitamin D and colorectal cancer.

There is little credible research, however, on the use of vitamin D in preventing cardiovascular disease, but some studies conducted for other purposes, such as improvement in bone density and reduction in fractures, have suggested that vitamin D supplementation may be associated with reductions in blood pressure.

In addition, vitamin D is essential for promoting calcium absorption and for bone growth. Without sufficient levels, a person's bones can become thin, brittle, or misshapen.

In the face of all this, a chicken-and-egg question arises: low vitamin D levels are linked with poor health, but is it the lack of vitamin D that causes illness, or is it that people in poor health have reduced appetites and don't go outside enough and therefore don't get enough vitamin D?

Why are the elderly at greater risk of falling?

Some medical conditions can cause loss of balance, confusion, dizziness or impaired perception of one's surroundings causing accidents; for example, "missing" the chair or sofa when trying to sit down.

The elderly also frequently take multiple medications, some of which may have side-effects, including fatigue and blurred vision, that can affect one's ability to move around properly.

What are the consequences of falls in the elderly?

The issue is a crucial one since falling - generally nothing more than a painful nuisance for most of us - can be a life-altering event for many elderly and the beginning of an unstoppable downward spiral in their health.

Twenty-five to 35 per cent of seniors fall in any given year, placing them at risk of future falls, as well as serious health problems and even death.

In fact, women who have fallen have a 27 per cent increased risk for hip fracture. Between 25 and 35 per cent of elderly people who fall die within one year of the fall.

The study: Cameron ID, Murray GR, Gillespie LD et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database of Systematic Reviews 2010, Issue 1. CD005465.

What was this study about?

Conducted by an international group of scientists known collectively as the Cochrane Collaboration, this study review addressed a core question in geriatric medicine: how can we prevent the elderly from falling?

Specifically, the researchers set out to compile all of the high-quality studies conducted around the world with a view toward determining what works in fall prevention.

Can anything prevent the elderly from falling in nursing homes?

While there are no magical solutions, the answer seems to be "yes."

Although much of the media attention around this project was directed at vitamin D, the Cochrane reviewers actually looked at a number of different kinds of treatments.

Exercise, especially if focused on balance, has been proven to be effective in the elderly who live on their own, but did not show a particularly protective effect in this study of nursing home and hospitalized patients.

The exception was patients who received their exercise training from a multidisciplinary group of providers presumably made up of nurses, physiotherapists and occupational therapists, as opposed to any one group alone. In this way, many different aspects of fall prevention were addressed.

What about vitamin D?

Once again there is more good news to report for the vitamin that seems to outperform other health supplements.

Taken in doses of anywhere from 200 to 1,000 units a day, vitamin D reduces the number of falls by 30 per cent, but its effect on the risk of experiencing that first fall was shown to be non-existent.

How does vitamin D work?

Good question.

We don't know for sure and speculation is the order of the day, but a generally increased level of health and bone strength may simply be making the elderly who take vitamin D more vigorous and sturdy.

Should elderly nursing home residents take vitamin D?

The risk-benefit considerations are strongly in favour of a "yes" to that question.

Vitamin D supplements are inexpensive, have few side-effects and seem to result in a number of positive health effects.

All told, one small part of the puzzle of how to stay healthier for years to come seems to reside in the little vitamin that could.

The material provided here is designed for general educational purposes only and does not pertain to individual cases. The information included should not replace necessary medical consultations with your own doctor or medical professional. Montreal Gazette

Organizations: Canadian Cancer Society, International Agency for Research on Cancer, IARC Cochrane Montreal Gazette

Geographic location: Montreal

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Recent comments

  • wavy
    July 02, 2010 - 13:32

    A simple blood test told me a few years ago my Vit. D level was deficient. I've come to learn that, because of our climate and our tendencey to stay indoors when the weather is bad (which is a lot!), most Newfoundlanders are Vit. D deficient and a lot don't know it. Pretty much everyone in Newfoundland, including kids, could benefit from Vit D supplements. Studies have shown, and doctors agree, it's a safer way to get the extra Vit D you need without increased risk from exposure to excessive UV from direct sunlight.

  • Percy
    July 02, 2010 - 13:19

    There is 110% of Vitamin D in one can of good old Brunswick (CANADIAN) SARDINES...available in Spring Water, and other varieties...plus 20/25 % of your daily intake of calcium..and 15% Iron...and 250 mg of Potassium...and, high in the good Monounsaturated fat..and a good supply of protein.....all in 1 can of Sardines....wonderful food in a little can.and, so cheap....and great on whole wheat toast with mustard...(I am getting hungry)..and best of all..from the best country in the world..CANADA...who said brain food had to be expensive?

    Cheers~~~

  • Marie
    July 02, 2010 - 13:14

    The picture accompanying the article is deceptive - one would think they are about to read about Omega 3 rather than D - as Omega capsules appear the same as the pic, and are in the same foods as the pic. D comes as a tablet. Just sayin.

  • taxpayertoo
    July 02, 2010 - 13:12

    My doctor has also recommended taking vit. D as not only do we not have alot of sun here but folks who are continually using sun block are indeed also preventing themselves from getting the recommended dosages from simply being outside. you have to eat a hell of alot of food with vit D in it to get the amount you need. The best source is rthe sun itself, so I guess sun bathing is not so bad after all.

  • wavy
    July 01, 2010 - 20:20

    A simple blood test told me a few years ago my Vit. D level was deficient. I've come to learn that, because of our climate and our tendencey to stay indoors when the weather is bad (which is a lot!), most Newfoundlanders are Vit. D deficient and a lot don't know it. Pretty much everyone in Newfoundland, including kids, could benefit from Vit D supplements. Studies have shown, and doctors agree, it's a safer way to get the extra Vit D you need without increased risk from exposure to excessive UV from direct sunlight.

  • Percy
    July 01, 2010 - 20:01

    There is 110% of Vitamin D in one can of good old Brunswick (CANADIAN) SARDINES...available in Spring Water, and other varieties...plus 20/25 % of your daily intake of calcium..and 15% Iron...and 250 mg of Potassium...and, high in the good Monounsaturated fat..and a good supply of protein.....all in 1 can of Sardines....wonderful food in a little can.and, so cheap....and great on whole wheat toast with mustard...(I am getting hungry)..and best of all..from the best country in the world..CANADA...who said brain food had to be expensive?

    Cheers~~~

  • Marie
    July 01, 2010 - 19:53

    The picture accompanying the article is deceptive - one would think they are about to read about Omega 3 rather than D - as Omega capsules appear the same as the pic, and are in the same foods as the pic. D comes as a tablet. Just sayin.

  • taxpayertoo
    July 01, 2010 - 19:49

    My doctor has also recommended taking vit. D as not only do we not have alot of sun here but folks who are continually using sun block are indeed also preventing themselves from getting the recommended dosages from simply being outside. you have to eat a hell of alot of food with vit D in it to get the amount you need. The best source is rthe sun itself, so I guess sun bathing is not so bad after all.