Volume 197 - Issue 10
Vitamin D and health in adults in Australia and New Zealand: a position statement
Authors: Caryl A Nowson, Peter R Ebeling and Rebecca S Mason, On behalf of the Working Group of the Australian and New Zealand Bone and Mineral Society, Endocrine Society of Australia and Osteoporosis Australia
Med J Aust 2012; 197 (10): 553-554. || doi: 10.5694/mja12.11230
Published online: 19 November 2012
Published online: 19 November 2012
In reply: Our position statement summarised findings from the most relevant peer-reviewed literature.1 We clearly acknowledged that there are inconsistencies in the literature, as is often the case in many fields of medicine.
Most Level I evidence indicates that vitamin D (combined with adequate calcium) reduces falls and fractures
in older people. Mortality is also reduced.2 The combination of vitamin D supplementation with adequate calcium does ...
In reply: Our position statement summarised findings from the most relevant peer-reviewed literature.1 We clearly acknowledged that there are inconsistencies in the literature, as is often the case in many fields of medicine.
Most Level I evidence indicates that vitamin D (combined with adequate calcium) reduces falls and fractures in older people. Mortality is also reduced.2 The combination of vitamin D supplementation with adequate calcium does not detract from the beneficial effect of adequate vitamin D status. Many of these studies were conducted in women and in frail older populations who were not necessarily institutionalised. Indeed, a recent meta-analysis of pooled participant-level data (n = 31 022) found fairly consistent benefits across age groups and types of dwelling.3
Although the United States Preventive Services Task Force draft statement recommended against use of calcium and vitamin D, its recent final recommendation states that taking vitamin D supplements can help prevent falls in older adults.4
Finally, we did not propose vitamin D supplementation for the general population, but for the clearly identified high-risk groups (Box 3 in the position statement).1
Competing interests
No relevant disclosures.
References
- Nowson CA, McGrath JJ, Ebeling PR, et al. Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 2012; 196: 686-687. 0_CHDDGHCG
- Rejnmark L, Avenell A, Masud T, et al. Vitamin D with calcium reduces mortality: patient level pooled analysis of 70,528 patients from eight major vitamin D trials. J Clin Endocrinol Metab 2012; 97: 2670-2681. 0_CBBGFFAD
- Bischoff-Ferrari HA, Willett WC, Orav EJ, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 2012; 367: 40-49. 0_CBBIAJBH
- US Preventive Services Task Force. Preventing falls in older adults: Task Force final recommendation. Rockville, Md: USPSTF, 2012. http://www.uspreventiveservicestaskforce.org/uspstf11/fallsprevention/fallsprevfact.pdf (accessed Nov 2012).