The D-Lightful Vitamin D for Good Health

Adequate vitamin D nutrition has been known to prevent rickets in children, but, until fairly recently, little thought has been given to the consequences of vitamin D deficiency in adults. It is now becoming clear that vitamin D plays an important role in maintaining bone health from birth until death. Of equal importance is that vitamin D has a multitude of other biologic functions in the body that may be important for the prevention of common cancers, hypertension, type-1 diabetes, as well as a host of other common maladies that afflict elders.

Dr. Holick has established global recommendations advising sunlight exposure as an integral source of vitamin D. He has helped increase awareness in the pediatric and medical communities regarding the vitamin D deficiency pandemic, and its role in causing not only metabolic bone disease, and osteoporosis in adults, but increasing risk of children and adults developing pre-eclampsia, common deadly cancers, schizophrenia, infectious diseases including TB and influenza, autoimmune diseases including type 1 diabetes and multiple sclerosis, type 2 diabetes, stroke and heart disease.

Michael F. Holick, Ph.D., M.D. is a Professor of Medicine, Physiology and Biophysics; Director of the General Clinical Research Unit; Director of the Bone Health Care Clinic and the Director of the Vitamin D, Skin and Bone Research Laboratory at Boston University Medical Center. Dr. Holick has made numerous contributions to the field of the biochemistry, physiology, metabolism, and photobiology of vitamin D for human nutrition. He has acted as editor and/or co-editor on 10 books, and has written The UV Advantage, and The Vitamin D Solution.

This video is entertaining and informative.

https://www.youtube.com/watch?feature=player_embedded&v=hiGBVDcbFVk

The Creative Destruction of Medicine by Dr. Eric Topal

The revolution Dr. Eric Topal describes, and which is the grand theme of this book, is the inevitable move from population-based medicine to that of the science and health of the individual. Doctors, and the medical education system that produces them, are out of touch, conservative and slow to change. Today’s evidence-based medicine tends to be based on studies of populations rather than on individuals. A population-based study of a drug which claims to reduce the risk of myocardial infarction (MI) by 36%, for example, sounds much less impressive to a patient when he realizes that 100 individuals will need to take the drug in order to prevent one MI. He also criticizes the use of surrogate end points in studies (e.g., cholesterol/LDL) and the development of expert-based guidelines around these and puts mass population screening tests like PSA under the microscope. He introduces the idea that it is now possible, using pharmacogenomic studies, to perform real evidence-based studies based on individuals rather than populations. He predicts that because many of the changes he describes will be resisted by doctors and others within the health sciences, that patients/consumers are likely to lead this revolution.

http://www.ronankavanagh.ie/blog/book-review-the-creative-destruction-of-medicine-by-dr-eric-topol/

Effect of Strontium Ranelate on the Risk of Osteoporotic Fractures

Summary

The aim of the present study was to determine the efficacy of strontium ranelate as a function of baseline fracture risk. Treatment with strontium ranelate was associated with a significant 31% decrease in all clinical osteoporotic fractures (vertebral fractures included). Hazard ratios for the effect of strontium ranelate on the fracture outcome did not change significantly with increasing fracture probability.

Introduction

 Two previous studies have suggested that the efficacy of intervention may be greater in the segment of the population at highest fracture risk as assessed by the FRAX® algorithms. The aim of the present study was to determine whether the anti-fracture efficacy of strontium ranelate was dependent of the level of fracture risk.

Methods

The primary data of the two phase III studies (SOTI and TROPOS) of the effects of strontium ranelate in postmenopausal osteoporosis were combined. Country-specific probabilities were computed using the FRAX® tool (version 2.0). The primary outcome variable comprised all clinical osteoporotic fractures (including clinical vertebral fractures). Interactions between fracture probability and efficacy were explored by Poisson regression.

Results

The 10-year probability of major osteoporotic fractures (with BMD) ranged from 2.5% to 90.8%. FRAX®-based hip fracture probabilities ranged from 0.1% to 90.3%. The incidence of clinical osteoporotic fractures (vertebral fractures excluded) and morphometric vertebral fractures increased with increasing baseline fracture probabilities. Treatment with strontium ranelate was associated with a 31% (95% CI = 20–39%) decrease in osteoporotic clinical fractures and a 40% decrease in vertebral fractures assessed by semiquantitative morphometry (95% CI = 31–48%) Hazard ratios for the effect of strontium ranelate on the fracture outcomes did not change significantly with increasing fracture probability.

Conclusion

Strontium ranelate significantly decreased the risk of osteoporotic clinical fractures, non vertebral fractures and morphometric vertebral fractures in women. Overall, the efficacy of strontium ranelate was not dependent of the level of fracture risk assessed by FRAX.

A meta-analysis of the effect of strontium ranelate on the risk of vertebral and non-vertebral...

 
http://link.springer.com/article/10.1007/s00198-010-1474-0#page-1

Vitamin D Status in Non-supplemented Postmenopausal Taiwanese Women with Osteoporosis and Fragility Fractures

 

Vitamin D is essential for calcium metabolism. Vitamin D deficiency can precipitate osteoporosis, cause muscle weakness and increase the risk of fracture. The aim of this study was to assess the prevalence of vitamin D inadequacy among non-supplemented postmenopausal women with osteoporosis and fragility fractures of the hip or vertebrae in Taiwan.

This multi-center, cross-sectional, observational study analyzed the vitamin D inadequacy [defined as 25(OH) D level less than 30 ng/mL] in Taiwanese postmenopausal osteoporotic patients who suffered from a low trauma, non-pathological fragility hip or vertebral fracture that received post-fracture medical care when admitted to hospital or at an outpatient clinic. A total of 199 patients were enrolled at eight medical centers in Taiwan; 194 patients met the study criteria with 113 (58.2%) and 81 (41.8%) patients diagnosed with hip and vertebral fracture, respectively.

The mean serum 25(OH) D level was 21.1 +/-9.3 ng/mL, and 86.6% of the patients were found to be vitamin D inadequate. This study found a high prevalence of vitamin D inadequacy across all age groups among non-supplemented women with osteoporosis and fragility hip or vertebral fracture in Taiwan.

http://www.biomedcentral.com/1471-2474/15/257/abstract