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Pemau RC, González-Palacios P, Kerr KW. How quality of life is measured in studies of nutritional intervention: a systematic review. Health Qual Life Outcomes 2024; 22:9. [PMID: 38267976 PMCID: PMC10809546 DOI: 10.1186/s12955-024-02229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Nutrition care can positively affect multiple aspects of patient's health; outcomes are commonly evaluated on the basis of their impact on a patient's (i) illness-specific conditions and (ii) health-related quality of life (HRQoL). Our systematic review examined how HRQoL was measured in studies of nutritional interventions. To help future researchers select appropriate Quality of Life Questionnaires (QoLQ), we identified commonly-used instruments and their uses across populations in different regions, of different ages, and with different diseases. METHODS We searched EMCare, EMBASE, and Medline databases for studies that had HRQoL and nutrition intervention terms in the title, the abstract, or the MeSH term classifications "quality of life" and any of "nutrition therapy", "diet therapy", or "dietary supplements" and identified 1,113 studies for possible inclusion.We then reviewed titles, abstracts, and full texts to identify studies for final inclusion. RESULTS Our review of titles, abstracts, and full texts resulted in the inclusion of 116 relevant studies in our final analysis. Our review identified 14 general and 25 disease-specific QoLQ. The most-used general QoLQ were the Short-Form 36-Item Health Survey (SF-36) in 27 studies and EuroQol 5-Dimension, (EQ-5D) in 26 studies. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ), a cancer-specific QoLQ, was the most frequently used disease-specific QoLQ (28 studies). Disease-specific QoLQ were also identified for nutrition-related diseases such as diabetes, obesity, and dysphagia. Sixteen studies used multiple QoLQ, of which eight studies included both general and disease-specific measures of HRQoL. The most studied diseases were cancer (36 studies) and malnutrition (24 studies). There were few studies focused on specific age-group populations, with only 38 studies (33%) focused on adults 65 years and older and only 4 studies focused on pediatric patients. Regional variation in QoLQ use was observed, with EQ-5D used more frequently in Europe and SF-36 more commonly used in North America. CONCLUSIONS Use of QoLQ to measure HRQoL is well established in the literature; both general and disease-specific instruments are now available for use. We advise further studies to examine potential benefits of using both general and disease-specific QoLQ to better understand the impact of nutritional interventions on HRQoL.
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Affiliation(s)
| | - Patricia González-Palacios
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
- Biomedical Research Institute (IBS), Granada, Spain
| | - Kirk W Kerr
- Abbott Nutrition, 2900 Easton Square Place, Columbus, OH, 43219, USA.
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Nyakundi PN, Némethné Kontár Z, Kovács A, Járomi L, Zand A, Lohner S. Fortification of Staple Foods for Household Use with Vitamin D: An Overview of Systematic Reviews. Nutrients 2023; 15:3742. [PMID: 37686773 PMCID: PMC10489979 DOI: 10.3390/nu15173742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Vitamin D deficiency is a global public health concern with significant implications for bone health and chronic disease prevention. Our aim was to summarize the evidence from Cochrane and other systematic reviews evaluating the benefits or harms of vitamin D fortification of staple foods for household use. In April 2023, we systematically searched Ovid MEDLINE, Embase, Epistemonikos and the Cochrane Database of Systematic Reviews for systematic reviews investigating the effects of vitamin D fortification of food in general populations of any age. We used Cochrane methodology and assessed the methodological quality of included studies using AMSTAR (A MeaSurement Tool to Assess Systematic Reviews). We assessed the degree of overlap among reviews. All outcomes included in systematic reviews were assessed. The protocol is registered in PROSPERO (registration number: CRD42023420991). We included 27 systematic reviews out of 5028 records for analysis. Overall, 11 out of 12 systematic reviews calculating pooled estimates reported a significant increase in serum 25(OH)D concentrations. The mean change in serum 25(OH)D concentrations per additional 100 units of vitamin D ranged from 0.7 to 10.8 nmol/L. Fortification of food with vitamin D showed a reduction in the prevalence of vitamin D deficiency based on high-certainty evidence. Parathormone (PTH) levels were described to decrease, bone mineral density to increase, while the effects on other bone turnover markers were inconsistent. Fortification did not significantly impact most anthropometric parameters, but it seemed to positively influence lipid profiles. In summary, fortification of food with vitamin D results in a reduction of vitamin D deficiency and might increase serum 25(OH)D concentrations, to varying extents depending on the fortified vehicle and population characteristics. Additionally, fortification may have a positive impact on bone turnover and lipid metabolism but may only have a limited effect on anthropometric parameters.
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Affiliation(s)
- Patrick Nyamemba Nyakundi
- Department of Public Health Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | | | - Attila Kovács
- Cochrane Hungary, Clinical Center of the University of Pécs, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Luca Járomi
- Department of Public Health Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Afshin Zand
- Department of Public Health Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Szimonetta Lohner
- Department of Public Health Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Cochrane Hungary, Clinical Center of the University of Pécs, Medical School, University of Pécs, 7623 Pécs, Hungary
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3
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Feehan O, Magee PJ, Pourshahidi LK, Armstrong DJ, McSorley EM. Vitamin D deficiency in nursing home residents: a systematic review. Nutr Rev 2023; 81:804-822. [PMID: 36367832 PMCID: PMC10251303 DOI: 10.1093/nutrit/nuac091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
CONTEXT Vitamin D deficiency is a global public health issue, particularly in nursing home residents. OBJECTIVE This review critically summarizes the prevalence of vitamin D deficiency in nursing home residents worldwide. In addition, it outlines the effect of vitamin D intervention, alone or in combination with other nutrients or therapies, on improving vitamin D status and associated health outcomes in nursing home residents. DATA SOURCES, EXTRACTION, AND ANALYSIS Searches were conducted of electronic databases for articles published from 2010 to May 2021. After screening of the 366 papers initially identified, 58 articles were included. CONCLUSIONS A paucity of observational studies in nursing homes suggests a high prevalence of vitamin D deficiency ranging from 8% [25(OH)D <25 nmol/L], up to 94% [25(OH)D <50 nmol/L] in some cohorts where supplement use was low. Reported factors associated with deficiency and suboptimal vitamin D status include lack of sunlight exposure, poor dietary intake of vitamin D, limited vitamin D food fortification, frailty, poor renal function, and low use of vitamin D supplements. Residents who are severely deficient, deficient, or insufficient in vitamin D require remedial vitamin D supplementation prior to maintenance supplementation at doses >800 IU/day. High-dose vitamin D supplementation may reduce respiratory illness; however, supportive data are limited. Oral nutritional supplements, in combination with exercise, may benefit physical function and performance, whereas supplementation with vitamin D- and calcium-fortified foods has been associated with improved quality of life and reduced bone resorption. Globally, vitamin D deficiency is highly prevalent in nursing home residents. There is an urgent need for standardized dietary and supplementation guidelines to prevent deficiency in this vulnerable group.
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Affiliation(s)
- Orlagh Feehan
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Pamela J Magee
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - L Kirsty Pourshahidi
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
- are with the Department of Rheumatology, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, United Kingdom
| | - David J Armstrong
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
- are with the Department of Rheumatology, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, United Kingdom
| | - Emeir M McSorley
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
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Souza SVS, Borges N, Vieira EF. Vitamin d-fortified bread: Systematic review of fortification approaches and clinical studies. Food Chem 2022; 372:131325. [PMID: 34649031 DOI: 10.1016/j.foodchem.2021.131325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/13/2021] [Accepted: 10/02/2021] [Indexed: 12/18/2022]
Abstract
Vitamin d-fortified bread has been proposed as a strategy to increase the average daily intake and serum status of this nutrient. This review aimed to bring together the different types of scientific articles on vitamin d-fortified bread. The databases used for the research were PUBMED, WEB of SCIENCE and SCOPUS; all original indexed studies written in English, published between January 2000 and March 2021, were considered. Three important points were identified: i) theoretical models of fortification; ii) stability, bioaccessibility, and bioavailability studies of vitamin d-fortified breads; and iii) clinical effects of vitamin d-fortified breads. This review showed that vitamin d-fortified bread is a promising vehicle for fortification strategy effects, leading to increased serum concentrations of 25(OH)D and decreased parathyroid hormone. However, further studies are needed to elucidate the effects and effectiveness of this fortification strategy in the prevention/treatment of vitamin D deficiency.
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Affiliation(s)
- Suene V S Souza
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 4150-180 Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre, 4150-180 Porto, Portugal; CINTESIS, Center for Health Technology and Services Research (CINTESIS). Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Elsa F Vieira
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal
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Nutritional status and quality-of-life of older adults in aged care: A systematic review and meta-analysis. Exp Gerontol 2022; 162:111764. [PMID: 35271944 DOI: 10.1016/j.exger.2022.111764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/01/2022] [Accepted: 02/27/2022] [Indexed: 11/24/2022]
Abstract
The effect of malnutrition beyond morbidity and mortality has become a critical area of investigation in older people with an increased focus on quality-of-life (QoL), but as yet the relationship between malnutrition and QoL remains to be reviewed in older people from aged care settings. The current study conducted a systematic review and meta-analyses of studies published between the years 1995 and 2020 examining the relationship between nutritional status and QoL or the effects of a nutrition-based intervention on QoL in older people in residential aged care. Based on searches of the databases MEDLINE, PsycINFO, Emcare, and Embase, 21 studies were identified. Meta-analyses of the cross-sectional and quasi-experimental studies revealed a significant positive relationship between nutritional status and QoL and that nutritional intervention significantly improved QoL. By contrast, meta-analysis of randomised controlled trials revealed a non-significant but improved trend post-intervention in QoL. Although the effect sizes were small, the present findings indicate that nutrition-based interventions improve QoL in older people in residential aged care and align with previous reviews based on findings from other aged settings. Future research is needed to determine causality and to better identify and control for confounding factors which may influence both nutritional status and QoL.
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Sharifan P, Khoshakhlagh M, Khorasanchi Z, Darroudi S, Rezaie M, Safarian M, Vatanparast H, Afshari A, Ferns G, Ghazizadeh H, Ghayour Mobarhan M. Efficacy of low-fat milk and yogurt fortified with encapsulated vitamin D 3 on improvement in symptoms of insomnia and quality of life: Evidence from the SUVINA trial. Food Sci Nutr 2020; 8:4484-4490. [PMID: 32884728 PMCID: PMC7455959 DOI: 10.1002/fsn3.1750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Sleep disorders are a common condition globally. Vitamin D receptors are present on cells in several regions of the brain. It is possible that vitamin D status may affect brain function, including sleep patterns. We aimed to evaluate the 1,500 IU of Nano-encapsulated vitamin D fortified in dairy products on the symptoms of insomnia and associated improvement of quality of life. METHODS A case series was undertaken as part of the Survey of ultraviolent intake by nutritional approach project. Subjects enrolled among adults with abdominal obesity. Twenty-nine subjects with insomnia were selected according to the results of Insomnia Severity Index questionnaire and quality of life using a Short Form Health Survey (SF-36) questionnaire. Subjects were allocated to four groups: low-fat milk fortified by 1,500 IU vitamin D3 (n = 8), simple milk (n = 8), low-fat yogurt fortified by 1,500 IU vitamin D3 (n = 7), and simple yogurt (n = 6) and were treated for 10 weeks. RESULTS The insomnia score improved after the intervention in the group receiving vitamin D fortified milk compared to group receiving unfortified milk (p < .001). There were no significant differences between the two groups taking yogurt (fortified vs. unfortified). Comparison of quality of life scores between baseline and after intervention indicated significant improvements in both fortified and simple milk groups (p = .002 and p = .03, respectively); but no differences were found in the groups taking yogurt. CONCLUSION Fortified low-fat milk containing 1,500 IU vitamin D3 can improve insomnia symptoms and subsequently quality of life.Trial registration number: IRCT20101130005280N27, www.IRCT.ir.
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Affiliation(s)
- Payam Sharifan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mahdieh Khoshakhlagh
- Department of Medical BiochemistryFaculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zahra Khorasanchi
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Susan Darroudi
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mitra Rezaie
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohammad Safarian
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Hassan Vatanparast
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSKCanada
| | - Asma Afshari
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
| | - Gordon Ferns
- Brighton and Sussex Medical SchoolDivision of Medical EducationBrightonUK
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Majid Ghayour Mobarhan
- Department of NutritionSchool of MedicineMashhad University of Medical SciencesMashhadIran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
- International UNESCO center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
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7
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Habib AM, Nagi K, Thillaiappan NB, Sukumaran V, Akhtar S. Vitamin D and Its Potential Interplay With Pain Signaling Pathways. Front Immunol 2020; 11:820. [PMID: 32547536 PMCID: PMC7270292 DOI: 10.3389/fimmu.2020.00820] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/09/2020] [Indexed: 12/12/2022] Open
Abstract
About 50 million of the U.S. adult population suffer from chronic pain. It is a complex disease in its own right for which currently available analgesics have been deemed woefully inadequate since ~20% of the sufferers derive no benefit. Vitamin D, known for its role in calcium homeostasis and bone metabolism, is thought to be of clinical benefit in treating chronic pain without the side-effects of currently available analgesics. A strong correlation between hypovitaminosis D and incidence of bone pain is known. However, the potential underlying mechanisms by which vitamin D might exert its analgesic effects are poorly understood. In this review, we discuss pathways involved in pain sensing and processing primarily at the level of dorsal root ganglion (DRG) neurons and the potential interplay between vitamin D, its receptor (VDR) and known specific pain signaling pathways including nerve growth factor (NGF), glial-derived neurotrophic factor (GDNF), epidermal growth factor receptor (EGFR), and opioid receptors. We also discuss how vitamin D/VDR might influence immune cells and pain sensitization as well as review the increasingly important topic of vitamin D toxicity. Further in vitro and in vivo experimental studies will be required to study these potential interactions specifically in pain models. Such studies could highlight the potential usefulness of vitamin D either alone or in combination with existing analgesics to better treat chronic pain.
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Affiliation(s)
- Abdella M Habib
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Karim Nagi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Saghir Akhtar
- College of Medicine, QU Health, Qatar University, Doha, Qatar
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McCourt A, McNulty BA, Walton J, O'Sullivan A. Efficacy and safety of food fortification to improve vitamin D intakes of older adults. Nutrition 2020; 75-76:110767. [PMID: 32248053 DOI: 10.1016/j.nut.2020.110767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the best foods for potential vitamin D food fortification and to model the efficacy and safety of different food fortification scenarios in adults ≥50 y of age in Ireland. METHODS National Adult Nutrition Survey vitamin D data for participants ≥50 y of age were updated. Vitamin D from foods with natural and added vitamin D was estimated and daily vitamin D intake patterns were examined. Data modeling was used to estimate the effects of target food fortification scenarios. RESULTS Almost two-thirds of the mean daily vitamin D intake of adults ≥50 y of age (7 ± 7 µg) comes from foods with added vitamin D. Milk and bread are the most frequently consumed foods across all meals and were subsequently targeted for the data modeling exercise. Results from the data modeling show that vitamin D intake increased between 9 and 17 µg/d, depending on the fortification scenario. Fortifying milk or bread resulted in ∼30% or ∼55% of individuals meeting the Recommended Daily Allowance (RDA); however, fortifying both simultaneously resulted in ∼70% meeting the RDA. CONCLUSIONS Currently, the majority of Irish adults ≥50 y of age are not meeting dietary recommendations for vitamin D. Fortification of commonly consumed foods such as milk and bread could improve daily intakes such that ∼70% of the cohort would meet the minimum recommendation. Future research should examine the efficacy of different food fortification scenarios to improve vitamin D intakes for older adults.
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Affiliation(s)
- Aislinn McCourt
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Janette Walton
- School of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland.
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Cave DP, Abbey KL, Capra SM. Can foodservices in aged care homes deliver sustainable food fortification strategies? A review. Int J Food Sci Nutr 2019; 71:267-275. [PMID: 31462103 DOI: 10.1080/09637486.2019.1658722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Food fortification is used as a nutrition support strategy in aged care homes, for residents who are malnourished or at risk of malnutrition. The aim of this review was to determine the scope and strength of published works exploring relationships between food fortification strategies, mode of delivery and sustainability in aged care homes. Literature from four databases and grey literature was searched. A total of 3152 articles were screened. Seventeen studies were included. Results showed that the majority of studies used pre-made food fortification, rather than fortifying foods on-site. There was heterogeneity across studies, including the mode of delivery and ingredients used for food fortification. Only two studies measured any aspect of costs. No clear sustainable strategies for implementing food fortification in this setting could be identified. Research is required to provide further insight into the acceptability and sustainability of food fortification interventions.
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Affiliation(s)
- Danielle P Cave
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Karen L Abbey
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Sandra M Capra
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
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10
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Matthews J, Torres SJ, Milte CM, Hopkins I, Kukuljan S, Nowson CA, Daly RM. Effects of a multicomponent exercise program combined with calcium-vitamin D 3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial. Eur J Nutr 2019; 59:1081-1091. [PMID: 30993400 DOI: 10.1007/s00394-019-01969-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Osteoporosis is associated with both lower health-related quality of life and depression in older people. We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin D3 fortified milk on health-related quality of life (HR-QoL) and depression in older men. METHODS In this 12-month, factorial design randomized controlled trial, 180 healthy community-dwelling men aged 50-79 years with normal to below average bone mineral density were allocated into one of four groups: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of high-intensity resistance training with weight-bearing exercise (3 days per week; 60-75 min per session). Men assigned to fortified milk consumed 400 ml/day of low-fat milk containing 1000 mg/day calcium and 800IU/day vitamin D3. Questionnaires were used to assess HR-QoL (SF-36) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) at baseline, and 6 and 12 months. A linear mixed model analysis was used to test whether there was a synergistic interaction between exercise and calcium-vitamin D3. If no significant interactions were detected, the main effects of exercise and fortified milk were examined. RESULTS Mean adherence to the exercise program and fortified milk was 67% (95% CI 61, 73%) and 90% (95% CI 86, 93%), respectively. There were no exercise-by-fortified milk interactions nor main effects of exercise or calcium-vitamin D for any of the HR-QoL measures or depressive symptoms. CONCLUSION In healthy community-dwelling older men, exercise training and/or calcium-vitamin D fortified milk did not improve HR-QoL or depressive symptoms.
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Affiliation(s)
- Joshua Matthews
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Indee Hopkins
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Sonja Kukuljan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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11
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Tangestani H, Djafarian K, Emamat H, Arabzadegan N, Shab-Bidar S. Efficacy of vitamin D fortified foods on bone mineral density and serum bone biomarkers: A systematic review and meta-analysis of interventional studies. Crit Rev Food Sci Nutr 2019; 60:1094-1103. [DOI: 10.1080/10408398.2018.1558172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Hadith Tangestani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hadi Emamat
- Student Research Committee, Department and Faculty of Nutrition Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloufar Arabzadegan
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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12
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Efficacy of a Standardized Oral Vitamin D Dosing Regimen in Nursing Home Residents. Drugs Aging 2018; 35:1079-1087. [PMID: 30345478 DOI: 10.1007/s40266-018-0601-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The prevalence of vitamin D deficiency in nursing home residents ranges from 79% to 98%. OBJECTIVES The aim of this cross-sectional observational study in somatic and psychogeriatric nursing home residents was to determine the efficacy of a standardized oral vitamin D dosing regimen (VDDR) consisting of a loading dose (LD) of cholecalciferol 200,000 IU followed by a maintenance dose (MD) of 100,000 IU every 13 weeks in obtaining and maintaining an adequate and safe vitamin D trough level (VDTL), defined as 75-220 nmol/L (reference range). METHODS Blood samples of nursing home residents who had received the LD followed by at least one MD were analyzed for VDTL, calcium, parathyroid hormone, and creatinine. Data on age, sex, race, body weight and height, co-morbidity, co-medication, number of MDs, calcium supplementation, smoking, and use of alcohol were obtained from patient charts. The primary outcome for the efficacy of the VDDR was the percentage of nursing home residents with a VDTL 75-220 nmol/L, with a target percentage of 85% for the dosing regimen to be considered efficacious. RESULTS In 91 (58%; 95% confidence interval [CI] 50-66) of 156 included nursing home residents, a VDTL within the reference range was measured (mean [standard deviation] 81 [28] nmol/L, range 13-150 nmol/L). The only variable that was identified as a significant risk indicator for obtaining a VDTL ≥ 75 nmol/L was the number of MDs being four or more (≥ 4 vs. < 4; odds ratio 2.7; 95% CI 1.4-5.3). CONCLUSION This standardized VDDR was not efficacious in obtaining and maintaining an adequate VDTL in this nursing home resident population. CLINICAL TRIALS REGISTRATION NUMBER NTR6029 (The Netherlands National Trial Register).
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13
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Vitamin D fortification of foods and prospective health outcomes. J Biotechnol 2018; 285:91-101. [PMID: 30176270 DOI: 10.1016/j.jbiotec.2018.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/23/2018] [Accepted: 08/22/2018] [Indexed: 12/19/2022]
Abstract
Vitamin D is essential for bone health and has significant roles in non-skeletal health and organ function. Dermal synthesis through exposure to ultraviolet B light is the major natural source of vitamin D, while only a small portion of the necessary amount can be acquired by a diet without fortified foods. In recent years, vitamin D deficiency as a result of lifestyles with inadequate sun exposure, has received increased attention due to its association with the increased risk of serious chronic diseases. This review summarizes our current understanding of food fortification strategies with vitamin D and the resulting health impact. Conventional and biotechnological approaches can be used for the production of new and novel vitamin D rich or vitamin D fortified foods. The availability of a wider range of every-day consumed fortified foods as part of a "Daily D" public health policy can contribute to the improvement of vitamin D status and to prevention of vitamin D deficiency.
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Huffman FG, Vaccaro JA, Zarini GG, Vieira ER. Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants. Geriatrics (Basel) 2018; 3:E24. [PMID: 31011062 PMCID: PMC6319217 DOI: 10.3390/geriatrics3020024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 11/18/2022] Open
Abstract
Osteoporosis, a chronic disease that results in low bone mass with an increased risk of fragility fractures, is prevalent in older adults. Diet can prevent or lessen the severity of osteoporosis. The purpose of this cross-sectional study was to assess differences in diet, quality of life, self-rated health, and physical function between congregate meal participants with and without osteoporosis. Data were from telephone survey, 10th Annual National Survey of Older American Act Participants, a representative sample of congregate meal attendees across the United States. (N = 888). Osteoporosis was present in 20% of this population. Participants with, as compared to without, osteoporosis reported that their physical health limited moderate activities (31.5% vs. 18.9%, p = 0.026), stair climbing (32.2% vs. 22.8%, p = 0.032), and shopping (27.4 vs. 15.3, p = 0.018). More than half of the participants consumed less than the recommended servings of dairy, meat, grains, and fruits/vegetables regardless of osteoporosis status. Participants with osteoporosis had lower self-rated health and more physical limitations than people without osteoporosis. Although congregate meals are a way to improve nutritional intake, additional methods to improve nutrition (including education) may be of benefit, since undernutrition is a concern in this population.
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Affiliation(s)
- Fatma G Huffman
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA.
| | - Joan A Vaccaro
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA.
| | - Gustavo G Zarini
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA.
| | - Edgar R Vieira
- Department of Physical Therapy, Florida International University, Miami, FL 33199, USA.
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Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents. Nutr Res Rev 2018; 31:131-151. [PMID: 29679994 DOI: 10.1017/s0954422417000270] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Emerging literature suggests that diet constituents may play a modulatory role in chronic pain (CP) through management of inflammation/oxidative stress, resulting in attenuation of pain. We performed a narrative review to evaluate the existing evidence regarding the optimum diet for the management of CP, and we built a food pyramid on this topic. The present review also describes the activities of various natural compounds contained in foods (i.e. phenolic compounds in extra-virgin olive oil (EVO)) listed on our pyramid, which have comparable effects to drug management therapy. This review included 172 eligible studies. The pyramid shows that carbohydrates with low glycaemic index should be consumed every day (three portions), together with fruits and vegetables (five portions), yogurt (125 ml), red wine (125 ml) and EVO; weekly: legumes and fish (four portions); white meat, eggs and fresh cheese (two portions); red or processed meats (once per week); sweets can be consumed occasionally. The food amounts are estimates based on nutritional and practical considerations. At the top of the pyramid there is a pennant: it means that CP subjects may need a specific customised supplementation (vitamin B12, vitamin D, n-3 fatty acids, fibre). The food pyramid proposal will serve to guide dietary intake with to the intent of alleviating pain in CP patients. Moreover, a targeted diet can also help to solve problems related to the drugs used to combat CP, i.e. constipation. However, this paper would be an early hypothetical proposal due to the limitations of the studies.
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Lam IT, Keller HH, Pfisterer K, Duizer L, Stark K, Duncan AM. Micronutrient Food Fortification for Residential Care: A Scoping Review of Current Interventions. J Am Med Dir Assoc 2016; 17:588-95. [DOI: 10.1016/j.jamda.2016.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 11/30/2022]
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Nikooyeh B, Neyestani TR, Zahedirad M, Mohammadi M, Hosseini SH, Abdollahi Z, Salehi F, Mirzay Razaz J, Shariatzadeh N, Kalayi A, Lotfollahi N, Maleki MR. Vitamin D-Fortified Bread Is as Effective as Supplement in Improving Vitamin D Status: A Randomized Clinical Trial. J Clin Endocrinol Metab 2016; 101:2511-9. [PMID: 27115063 DOI: 10.1210/jc.2016-1631] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Bread can potentially be a suitable vehicle for fortification with vitamin D. OBJECTIVE This study was undertaken to evaluate the following: 1) the bioavailability of vitamin D from the fortified Iranian bread and 2) the possible effects of daily consumption of the fortified bread on certain health aspects. DESIGN, SETTING, AND PARTICIPANTS This was a randomized, double-blind, placebo-controlled trial conducted over 8 weeks in 90 healthy subjects aged 20-60 years. INTERVENTION Subjects were randomly allocated to one of three groups: 1) fortified bread (FP; 50 g bread fortified with 25 μg vitamin D3 plus placebo daily; n = 30); 2) supplement (SP; 50 g plain bread plus 25 μg vitamin D supplement daily; n = 30); and 3) control (CP; 50 g plain bread plus placebo daily; n = 30). OUTCOME MEASURES Initial and final anthropometric and biochemical assessments were performed. RESULTS The within-group changes of serum 25-hydroxyvitamin D concentrations were 39.0 ± 22.6 (P < .001), 28.9 ± 31.2 (P < .001), and -9.2 ± 12.3 nmol/L in the FP, SP, and CP groups, respectively. Only in FP and SP groups, serum intact PTH concentrations decreased approximately 13.5% and 14.5%, respectively. Visceral fat also showed a significant decrement in FP (-1.05% ± 1.4%; P ≤ .001) and SP (-0.96% ± 1.7%; P = .006). Serum low-density lipoprotein cholesterol concentration showed a within-group reduction in FP (-10.4 ± 11.2 mg/dL; P < .001) and an insignificant decrement in SP (-6.6 ± 20.2 mg/dL; P = .083). Serum high-density lipoprotein increased in both vitamin D-supplemented groups (FP: 9.7 ± 7.6 vs SP: 5.7 ± 6.7 mg/dL; P < .001). CONCLUSION Vitamin D-fortified bread could be potentially effective in raising circulating 25-hydroxyvitamin D levels of the population to nearly adequate levels.
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Affiliation(s)
- Bahareh Nikooyeh
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Tirang R Neyestani
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Mehrdad Mohammadi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - S Hedayat Hosseini
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Zahra Abdollahi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Foroozan Salehi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Jalaledin Mirzay Razaz
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Nastaran Shariatzadeh
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Neda Lotfollahi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Mohammad-Reza Maleki
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
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Economic evaluation of vitamin D and calcium food fortification for fracture prevention in Germany. Public Health Nutr 2015; 20:1874-1883. [PMID: 26568196 DOI: 10.1017/s1368980015003171] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The study evaluates the economic benefit of population-wide vitamin D and Ca food fortification in Germany. DESIGN Based on a spreadsheet model, we compared the cost of a population-wide vitamin D and Ca food-fortification programme with the potential cost savings from prevented fractures in the German female population aged 65 years and older. SETTING The annual burden of disease and the intervention cost were assessed for two scenarios: (i) no food fortification; and (ii) voluntary food fortification with 20 µg (800 IU) of cholecalciferol (vitamin D3) and 200 mg of Ca. The analysis considered six types of fractures: hip, clinical vertebral, humerus, wrist, other femur and pelvis. SUBJECTS Subgroups of the German population defined by age and sex. RESULTS The implementation of a vitamin D and Ca food-fortification programme in Germany would lead to annual net cost savings of €315 million and prevention of 36 705 fractures in the target population. CONCLUSIONS Vitamin D and Ca food fortification is an economically beneficial preventive health strategy that has the potential to reduce the future health burden of osteoporotic fractures in Germany. The implementation of a vitamin D and Ca food-fortification programme should be a high priority for German health policy makers because it offers substantial cost-saving potential for the German health and social care systems.
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Kim HJ, Lee JY, Kim TJ, Lee JW. Association between serum vitamin D status and health-related quality of life (HRQOL) in an older Korean population with radiographic knee osteoarthritis: data from the Korean national health and nutrition examination survey (2010-2011). Health Qual Life Outcomes 2015; 13:48. [PMID: 25927585 PMCID: PMC4424888 DOI: 10.1186/s12955-015-0245-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 04/11/2015] [Indexed: 11/10/2022] Open
Abstract
Background Vitamin D is important in bone health and its relationship with osteoarthritis has recently been reported. Both vitamin D deficiency and knee osteoarthritis are age dependent and are known to affect quality of life (QOL) in older populations. In this study, we aimed to determine the association between vitamin D status and health-related quality of life (HRQOL) in an older Korean population with knee osteoarthritis. Methods A total of 2,165 participants aged ≥50 years with radiographic knee osteoarthritis defined as Kellgren-Lawrence (KL) grade ≥2 were selected from data from the 5th Korean National Health and Nutrition Examination Survey (KNHANES V), a representative cross-sectional nationwide survey conducted in 2010–2011. They stratified into two levels by vitamin D status (deficiency <10 ng/dL and normal ≥10 ng/dL). HRQOL was measured using the EuroQOL visual analogue scale (EQ-VAS) and the five dimensions and summary index of the EuroQOL-5 dimension (EQ-5D). Results The vitamin D deficiency group was more likely to report problems with mobility, self-care, and usual activities. Vitamin D deficiency was significantly associated with poor HRQOL indicated by the lowest quartile of EQ-VAS (unadjusted odds ratio [OR] =1.832, p = 0.006) and the lowest quartile of the EQ-5D index (unadjusted OR = 1.992, p = 0.003). Theses associations of vitamin D status with EQ-VAS and EQ-5D index were maintained after adjustment for age and sex (Model 1: OR = 1.677, p = 0.022 and OR = 1.701, p = 0.021, respectively). The significant associations of vitamin D status with EQ-VAS were maintained after adjustment for other possible covariates (Model 3: OR = 1.562, p = 0.044). Also, a trend of associations between vitamin D status and EQ-5D index were shown after adjustment for other covariates (Model3: OR = 1.681, p = 0.056). Conclusion This is the first study to reveal that vitamin D status is independently associated with HRQOL in an older Korean population with knee osteoarthritis. Our results suggest that the maintenance of sufficient vitamin D status may be important to prevent QOL decline in older populations with knee osteoarthritis. Electronic supplementary material The online version of this article (doi:10.1186/s12955-015-0245-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye-Jung Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Jee-Yon Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Tae-Jong Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Grant WB, Wimalawansa SJ, Holick MF, Cannell JJ, Pludowski P, Lappe JM, Pittaway M, May P. Emphasizing the health benefits of vitamin D for those with neurodevelopmental disorders and intellectual disabilities. Nutrients 2015; 7:1538-64. [PMID: 25734565 PMCID: PMC4377865 DOI: 10.3390/nu7031538] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/16/2015] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
People with neurodevelopmental disorders and intellectual disabilities have much greater health care needs. Mainly staying indoors, such people generally have low 25-hydroxyvitamin D (25(OH)D) concentrations. The Vitamin D Task Force of the American Academy of Developmental Medicine and Dentistry (AADMD) reviewed the evidence of 25(OH)D concentrations that benefit the health of persons with developmental disabilities. Maintaining recommended optimal serum 25(OH)D concentrations year long will benefit skeletal development in infants, children, and adolescents, and benefit musculoskeletal health and neuromuscular coordination in adult patients, and decrease risk of falls. Maintaining optimal concentrations decreases risks and severities of autoimmune diseases, cardiovascular disease, many types of cancer, dementia, types 1 and 2 diabetes mellitus, and respiratory tract infections. Other benefits include improved dental and oral health and improved physical performance. The Task Force recommends that 25(OH)D concentrations for optimal health to be in the range of 75 to 125 nmol/L, which can be achieved using between 800 and 4000 IU/day vitamin D3 and sensible exposure to solar UVB radiation. The paper also discusses the potential risks of higher 25(OH)D concentrations, the evidence from and limitations of randomized controlled trials, and the recommendations by various groups and agencies.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, PO Box 641603, San Francisco, CA 94164-1603, USA.
| | - Sunil J Wimalawansa
- Department of Medicine & Endocrinology, Cardio Metabolic Institute, Somerset, NJ 08873, USA.
| | - Michael F Holick
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, and the Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston, MA 02118, USA.
| | - John J Cannell
- Vitamin D Council and San Luis Obispo Integrative Medicine, San Luis Obispo, CA 93401, USA.
| | - Pawel Pludowski
- Department of Biochemistry, Radioimmunology, and Experimental Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
| | - Joan M Lappe
- Creighton University School of Medicine, Omaha, NE 68131, USA.
| | - Mary Pittaway
- Global Clinical Advisor-Health Promotion, Special Olympics International and Affiliate Faculty, College of Education and Human Sciences, University of Montana, Missoula, MT 59812, USA.
| | - Philip May
- International Foundation for Chronic Disabilities, Inc., PO Box 166, Oxford, NJ 07863, USA.
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Abstract
PURPOSE OF REVIEW Circumstantial evidence suggests that vitamin D deficiency may contribute to age-related changes in skeletal muscle. This review discusses recent clinical trials examining effects of vitamin D on muscle function in the elderly, and poses the important question: can vitamin D reverse muscle ageing? RECENT FINDINGS Observational studies report an association between vitamin D and muscle atrophy/weakness in elderly subjects. Interventional studies suggest that frail, elderly subjects may benefit from vitamin D supplementation by displaying reduced falls, improved muscle function and increased muscle fibre size. However, meta-analyses do not report convincing effects of vitamin D in the elderly. This may be because of multiple factors including lack of standardized endpoints for muscle function, variable study design and different doses of vitamin D supplementation amongst these studies. The evidence base is therefore inconsistent. SUMMARY Vitamin D deficiency may exacerbate ageing of skeletal muscle. However, current evidence that vitamin D supplementation reverses age-related muscle dysfunction is equivocal and does not justify stringent vitamin D targets in the elderly. Until these issues are clarified, the safest option is to aim for conservative vitamin D targets that are sufficient for normal calcium homeostasis.
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Affiliation(s)
- Christian M Girgis
- aGarvan Institute of Medical Research bFaculty of Medicine, University of Sydney, Sydney, NSW, Australia
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