Taking vitamin D supplements does not appear to prevent fractures in older adults, but vitamin D is necessary for overall health.
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It’s that time of year when your body produces less vitamin D.
The sun is the main source of vitamin D, and we need it to keep our bones and muscles strong. Many people take supplements to make up the deficit, but they are not a silver bullet for protection.
Vitamin D and calcium supplements offer no ‘net benefit’ for preventing falls or fractures in older adults, says a draft recommendation of the U.S. Preventive Services Task Force, an expert group that reviewed all existing scientific evidence on supplements.
“This is not to say that vitamin D and calcium aren’t overall helpful for bone health and other body functions,” says Dr Goutham Raotask force member who also serves as chair of the Department of Family Medicine at Case Western Reserve University.
Vitamin D helps your body absorb calcium, keeping bones and muscles strong. It also plays a role in supporting your immune system. Lack of sun exposure during the winter months can increase the risk of deficiency.
The National Academy of Medicine recommends that adults consume between 600 and 800 international units (IU) of vitamin D per day. depending on your age.
Prevalence studies suggest that up to 40% of adults in the United States have insufficient vitamin D levels in their blood. In the absence of sun exposure, fortified foods like milk and yogurt can help meet daily recommendations. And more than 1 in 3 adults aged 60 and over take a vitamin D supplement.
“But when it comes to their effectiveness in preventing fractures or falls, we found no evidence to support this,” says Rao. The USPSTF Draft Recommendation is similar to the task force’s previous conclusion, as more research has questioned the usefulness of supplements in preventing age-related bone fractures in postmenopausal women and men over 60. The recommendation does not apply to people with osteoporosis or those at high risk who may require other treatments such as prescription medications.
So how should people interpret what seem to be mixed messages about vitamin D?
We turned to Dr. Wendee Gozanskygeriatrician at Kaiser Permanente for some answers. Vitamin D has “multiple effects” on the body, she explains. In addition to promoting good bone and muscle health in healthy people throughout life, research shows may help reduce the risk or severity of colds and flu. “It has direct effects on immune cells and functioning and a multitude of impacts throughout the body, which is why you need to make sure you get enough throughout your life,” says Gozansky.
“I think the key message is that just because vitamin D isn’t ideal for preventing falls and fractures, doesn’t mean adequate vitamin D intake doesn’t have a role to play in general health,” says Gozansky.
Strategies to reduce falls and fractures
Gozansky says people need to take extra steps to reduce the risk of falling. “We have to do several things, like weight-bearing exercises,” she says.
There is ample evidence that physical activity, including resistance training, can help maintain strength and prevent age-related muscle loss. Options include weight lifting, resistance bands, and other exercises that contract your muscles against the resistance of your body weight or other equipment.
The Centers for Disease Control and Prevention recommends 150 minutes of moderate-intensity aerobic exercise every week, about half an hour, five days a week. This can include brisk walking, dancing, water aerobics, swimming, hiking, or anything that gets your heart rate up.
And the CDC says people 65 and older should aim for a mix of aerobic exercisesmuscle strengthening and balance activities every week. Yoga, Pilates and tai chi classes are options to discover.
Gozansky says it’s very important to stay active because a fall can be devastating. Nearly 40% of older adults who fall and break their hip are no longer able to walk independently a year later.
Additionally, she says it’s important to keep an eye on your eyesight and hearing. If your hearing is diminishing, your risk of falling may increase, and hearing aids can help. “All of this sensory input is essential for balance,” says Gozansky.
Additionally, people should contact their doctor about medications that may increase the risk of falls.
The National Institute on Aging recommends these six tips to prevent fallsand people can use it as a checklist to reduce their risks.
How much vitamin D and what type do you need?
A blood test can determine if you have a vitamin D deficiency, says Gozansky. When she has patients who might benefit from a supplement, she typically recommends a daily D3 supplement.
“It’s a Goldilocks situation. You don’t want too little. You don’t want too much,” she says.
Vitamin D can be toxic at very high levels and supplementation can also increase the risk of kidney stones. So, she says, talk to your health care provider about taking supplements at the appropriate level.
People need to resist the idea that if a little of something is good for you, more of it must be better. She says studies show that when people get the right amounts of vitamin D, “adding more won’t make any difference.”
Edited by Jane Greenhalgh