The Nutrition Examination Research Digest (NERD) aims to provide rigorous, unbiased analysis of the latest and most important nutrition and supplementation studies. Click here to subscribe or login if already a subscriber .

In this article

Vitamin D dosing downer: implications for bone density

More isn't always better when it comes to vitamin D preventing bone density loss.

Study under review: Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial

Introduction

Vitamin D has been a major focus in the context of musculoskeletal conditions, especially osteoporosis and bone fractures, due to its role in bone formation. Vitamin D is required for the optimal formation of bone tissue and functions largely because it modulates key bone cells called osteoblasts and osteoclasts[1]. Vitamin D also works indirectly to improve bone mineral density (BMD) by increasing intestinal calcium absorption[2], and other ways laid out in Figure 1. As such, supplementing with vitamin D, specifically D3, the most biologically active form, has been investigated as an intervention to improve BMD.

Previous trials have yielded disparate results, and a recent meta-analysis[3] suggested that vitamin D supplementation does not have any meaningful effect on bone mineral density or the risk of fractures among adults. One of the major shortcomings of earlier trials and those included in the abovementioned meta-analysis is their reliance on dual x-ray absorptiometry (DXA) scans to measure BMD, which does not address all the important components of bone strength: bone mass, morphology, and architecture. Recently, more sensitive measurements have been developed that can provide a more accurate representation of bone strength: peripheral quantitative computed tomography (HR-pQCT). This method can measure aspects of bone structure related to bone strength beyond density. Also, measurements derived from this method have been found to predict[4] fracture risk independent of BMD.

The study under review explored the dose-response effects of vitamin D supplementation among healthy community-dwelling adults over 36 months using HR-pQCT to assess BMD and bone strength. This study used relatively high doses at 4000 and 10000 IU per day.

Vitamin D plays a key role in bone formation and bone strength. Previous studies have found that vitamin D supplementation does not improve bone strength among otherwise healthy adults. However, more sensitive and accurate measures have been developed that may provide a more accurate view on exactly how vitamin D supplementation might affect bones in otherwise healthy adults.

Who and what was studied?

Become a subscriber to the Nutrition Examination Research Digest to read the full article.

Becoming a member will keep you updated on the most important nutrition studies every month, and give you access to our back catalog of over 500 other articles. It also includes access to Examine Plus.

I want to learn more about nutrition

Already a member? Please login to read this article.

What were the findings?

Subscribe to the Nutrition Examination Research Digest to unlock this article.

Best of all - only $1 for the first month!

Already a member? Please login to read this article.

What does this study really tell us?

Subscribe to the Nutrition Examination Research Digest to unlock this article.

Already a member? Please login to read this article.

The big picture

Subscribe to the Nutrition Examination Research Digest to unlock this article.

Already a member? Please login to read this article.

Frequently Asked Questions

Subscribe to the Nutrition Examination Research Digest to unlock this article.

Already a member? Please login to read this article.

What should I know?

Subscribe to the Nutrition Examination Research Digest to unlock this article.

Already a member? Please login to read this article.

NEW: Examine Personalized — Easily keep up with the latest research.

You select up to 25 health categories.

🔬We screen thousands of new studies.

📝We summarize the most important.

📧We email you a monthly report.

Get it while it's on sale »

Other Articles in Issue #59 (September 2019)

NEW: Examine Personalized — Never miss an important study again. Get it while it's on sale »