For those concerned with bone mets and interested in enhancing their bone
density this is an interesting article about Vitamin D supplements to help
prevent fractures. Although I shown no sign of bone mets, I have added
calcium and Vitamin D3 supplements to be sure that my bones have enough.

Fred

Vitamin D Does Prevent Fractures in Elderly
By Ed Edelson

HealthDay Reporter Tue May 10, 7:01 PM ET

TUESDAY, May 10 (HealthDay News) -- Vitamin D supplements can prevent
fractures in elderly people, according to new research that comes hard on
the heels of two British studies that found just the opposite.
This latest research is a major review of data from clinical trials that met
rigid standards for quality, said Dr. Heike A. Bischoff-Ferrari, an
instructor in the

Harvard Medical School department of medicine. She is lead author of the
report, which appears in the May 11 issue of the Journal of the American
Medical Association.

One of the two studies that came to the opposite conclusion, published on
April 30 in the British Medical Journal, "would not have met our quality
standards," she said, for several reasons. For example, the study of 3,314
women aged 70 and older was not double-blind, meaning those in the control
group knew they were in a study and might have increased their vitamin D
intake even though they were not supposed to do so.

And the results of the other study, of 5,292 older people hospitalized with
fractures, might be doubtful because it was done in a population at
especially high risk -- older people who already had suffered fractures and
people who did not take vitamin D doses high enough to overcome initially
low levels, she said.

That study, reported in the April 27 issue of The Lancet, did meet the
standards, Bischoff-Ferrari said, but her interpretation of the results
actually supports the use of vitamin D supplements to prevent fractures, she
said.

At any rate, both of those studies were published too late to be included in
the new report, and would not have changed the conclusion that vitamin D
supplements are beneficial, Bischoff-Ferrari said.

Dr. Adrian Grant, director of the health services research unit at the
University of Aberdeen in Scotland, who led the Lancet study, begged to
differ.

Just as Bischoff-Ferrari picked holes in his study, he found flaws in hers.
The Scottish trial was designed to find out whether the combination of
vitamin D and calcium supplements affected the risk of fracture, Grant said,
while the new study "tried to disentangle the effects of calcium in addition
to vitamin D."

"They make a distinction between high-dose and low-dose vitamin D
supplementation, and high-dose supplementation generally included calcium,"
he said.
In addition, "their finding is very heavily dependent on two trials
conducted in France on frail, elderly institutionalized individuals," Grant
said. "If you take those two trials out, the evidence really becomes much
weaker." And "they excluded many trials of vitamin D that other reviewers
might have included," he said.

That fact that the report is published in a medical journal, rather than in
electronic form, also drew his criticism. "Paper-based reviews are out of
date by the time they are published," Grant said.

Grant said he did not feel that he could make recommendations about the use
of vitamin D supplements to prevent the fractures that affect so many
elderly people.
Bischoff-Ferrari said she was quite ready to make a recommendation, in view
of the high incidence of fractures in elderly Americans. One of every three
women and one of every six men who live to be 90 will sustain a hip
fracture, her report said, with 10 percent to 20 percent of them dying
within a year and 15 percent to 25 percent requiring long-term nursing home
care.

"If someone did not have a fracture yet, I would recommend 700 to 800
International Units (IU) of vitamin D a day, with at least 700 milligrams of
calcium," she said. "If you have had a fracture, you should discuss with
your physician whether you may need more. The

National Science Foundation says the safe upper limit is 2,000 units a day,
so you can go to 1,500 units or higher, especially if you live in a country
like the United Kingdom, where you have little exposure to sunlight."
Sunlight enhances the body's production of vitamin D.