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Physical Performance, Muscle Strength, Falls, and Vitamin D

  • Paul LipsEmail author
  • Natasja M. van Schoor
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Abstract

Vitamin D status is associated with muscle strength, physical performance, and falls as has been observed in many epidemiological studies. When serum 25-hydroxyvitamin D increases from very low levels to 50 nmol/l, physical performance increases and plateaus with higher levels of serum 25(OH)D. Randomized controlled clinical trials were performed with vitamin D alone or with vitamin D and calcium with the endpoint falls. Eight of thirteen studies showed a significant decrease of fall incidence, and in six of seven significant double-blind studies, vitamin D was combined with calcium and compared with double placebo. The decrease of fall incidence ranged from −19 to −70 %. One study with vitamin D3 dose of 500,000 IU once per year showed an increased fall incidence in the vitamin D group compared with the placebo group. The increased fall incidence was observed in the first 3 months after the high vitamin D dose. Eight meta-analyses have been performed on the effects of vitamin D on fall incidence. One may conclude from these that vitamin D3 is effective in doses of 800 IU/day or more and preferably combined with calcium. Vitamin D may influence muscle strength through genomic and non-genomic pathways. The active metabolite 1,25-dihydroxyvitamin D binds to the nuclear vitamin D receptor and can activate more than 300 genes, and it may also bind to a membrane receptor thus activating second messengers leading to fast calcium influx. Vitamin D may influence muscle fiber proliferation and differentiation, and calcium influx and calcium transport to the sarcoplasmic reticulum. There is still some debate on the presence of the vitamin D receptor in human muscle tissue because it was demonstrated by some but not by other investigators.

In conclusion, vitamin D can influence muscle strength, balance, and prevent falls.

Keywords

Physical performance Muscle strength Falls Vitamin D Vitamin D receptor Genomic and non-genomic pathways Meta-analyses Prevention of falls 

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of Internal Medicine, Section EndocrinologyVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands

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