The Vitamin D Newsletter March 2007 Supplement
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Why Athletic Performance Matters
Athletic Performance Is Physical Performance
Why is athletic performance medically important? If you think for a minute, you'd realize that athletic performance is the same as physical performance. What happens when physical performance is impaired? People fall and break their hip, resulting in death, disability, or nursing home admission. Many people don't realize how fatal falls can be in the elderly. In 2003, the CDC reported that 13,700 persons over 65 died from falls in the USA, with 1.8 million ending up in emergency rooms for treatment of nonfatal injuries from falls. Falls cause the majority of hip fractures which, if they don't result in death, often result in admission to a nursing home. That's 13,700 deaths, hundreds of thousands of surgeries, countless nursing home admissions, and tens of billions in health care costs every year—all from impaired athletic performance. That's why it matters. Centers for Disease Control (CDC). Fatalities and injuries from falls among older adults—United States, 1993–2003 and 2001–2005. MMWR Morb Mortal Wkly Rep. 2006 Nov 17;55(45):1221–4.
"Gold Standard" Evidence
The scientific evidence that vitamin D reduces falls in the elderly is quite strong. Despite this, some physicians say they must wait for randomized, placebo controlled, interventional trials. They say they need such "gold standard" evidence before they will act to prevent falls. Here it is:
Four "gold standard" vitamin D studies
- Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003 Feb;18(2):343–51.
- Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing. 2004 Nov;33(6):589–95.
- Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc. 2005 Nov;53(11):1881–8.
- A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Age Ageing. 2004 Jan;33(1):45–51.
Some say they require a meta-analysis of such "gold standard" studies, from a top-flight university, published in a respected journal. Here it is:
Harvard Meta-analysis published in JAMA
Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004 Apr 28;291(16):1999–2006.
Doctors Do What Drug Companies Tell Them
Will these "gold standard" studies prompt physicians to act? Will older patients finally get their vitamin D blood level tested and appropriate treatment of their vitamin D deficiency? No, most will not. I wish physicians acted on scientific studies, but they do not—no matter how many people are dying. Vitamin D scientists conducting such trials are in for a rude surprise. Because no matter how good, well-designed, or meticulously-conducted their studies are, no matter how good the journal, practicing physicians will continue to ignore them. Practicing physicians do what they learned in medical school, what their colleagues do, and what the drug company salespersons tell them. Very few keep abreast of medical research, unless a drug company representative puts that research under their nose.
That's why I wrote about athletic performance. Falling is a failure of athletic performance—anything that improves athletic performance will also reduce deaths from falls.
As far as athletic performance in younger people goes, I certainly got some interesting letters. One guy from Tennessee agreed to list his phone number, in case the press wants to call or come by and watch him do chin-ups.
Dr. Cannell: I've been reading your newsletter for about a year and started taking 5,000 units a day this last fall. I live in Minnesota and play a lot of basketball. I play outside during the summer and inside in the winter. I usually notice a winter slump, my friends have talked about it too. You feel tired, like not being able to jump, like your muscles are dead. This winter was different, I felt great all winter. I didn't realize it might be the vitamin D. I know what he means when he said the ball was "sweeter." It feels that way now. Greg Plymouth, Minnesota
Dr. Cannell: I play tennis inside during the winter. About January, I have always felt different; I couldn't get a jump on the ball or see it as well. Since I've been on 2,000 mg of vitamin D, I've been getting to the ball much faster. Now I feel like I do in the summer. I didn't realize it could be the vitamin D, until your latest newsletter. Thanks. I don't know if I should tell my friends because then they'll all start taking vitamin D and I won't be able to beat them? Maria Portland, Oregon
I hope that's 2,000 units, not 2,000 mg. 2,000 mg would be 80 million units (80,000 1,000 IU tablets). 5,000 IU (.05 mg) per day is enough if you are a small woman who gets some sunlight in the sunnier months. Tell your friends, it might save their lives and that's a better feeling than beating them in tennis.
Dr. Cannell: I'm a weight lifter and most lifters know that you can lift more in the summer than the winter. I never knew why until I saw all those old German and Russian studies. No wonder the Germans and Russians used to do so well in the Olympics. I started on vitamin D yesterday. I found it in Costco for almost nothing. Tom Redding, California
Dr. Cannell: My name is Ed Jones and I have been nuts about doing chin-ups for many years. Three years ago when I really got interested in the Vitamin D story in regard to health, I found that I was very low in D, (12ng/mL) I started supplementing and started to raise my level however it came slowly. In april of 2005 I decided to try to break a record on chin-ups and in front of several media people, I did 285 chin-ups. I quit doing chin-ups after this because it was so difficult however I continued to work at achieving 50ng/mL on my blood work. This January I finally got my D over 40ng/mL and started doing chin-ups again. I quickly found that chin-ups now were easier than ever! Last week, March 8, 2007, I completed 300 chin-ups and it was almost easy! I could not believe it. I am training now to do 500 chin-ups in the next three months and the only change in my supplements, diet, etc is increasing my D level. I completely agree with the relationship of Vitamin D to strength and stamina. Ed Jones Chattanooga, Tennessee
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John Jacob Cannell MD Executive Director