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Lääkäri Juha-Petri Ruoholan väitöskirjan mukaan liian vähäinen D-vitamiinin saanti voi altistaa rasitusmurtumien syntymiselle urheilijoille. Tutkimuksen mukaan murtumapotilailla oli selkeästi normaalia alhaisemmat D-vitamiinitasot. On olemassa erityinen TRACP5b-entsyymi (tartrate-resistant acid phosphatase 5b), joka antaa aika selvän kuvan luun hajotuksen määrästä elimistössä. Tätä entsyymiä mitataan osteoporoosin (luukato) diagnostiikassa ja yllätyksettömästi sama entsyymi soveltui myös rasitusmurtumien osoittamiseen. Kohonnut seerumin TRACP5b-arvo nosti murtuman todennäköisyyden kahdeksankertaiseksi verrokkeihin nähden näissä Ruoholan tutkimuksissa. D-vitamiinia voi siis lämpimästi suositella urheilijoille varsinkin talvikuukausina, jolloin auringon kautta saatava D-vitamiinivaikutus on Suomessa lähes olematon.

Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Avenell A, Gillespie WJ, Gillespie LD, O'Connell D. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD000227. Review. PMID: 19370554 DOI: 10.1002/14651858.CD000227.pub3 AUTHORS' CONCLUSIONS: Frail older people confined to institutions may sustain fewer hip fractures if given vitamin D with calcium. Vitamin D alone is unlikely to prevent fracture. Overall there is a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D or its analogues. Calcitriol is associated with an increased incidence of hypercalcaemia.

Robert P. Heaney is John A. Creighton University Professor, Creighton University, Omaha, Nebraska, United States. Hominid evolution took place in an environment (equatorial East Africa) that provided a superabundance of both calcium and vitamin D, the first in available foods and the second through conversion of 7-dehydrocholesterol to pre-vitamin D in the skin, a reaction catalysed by the intense solar ultraviolet (UV) radiation. Seemingly as a consequence, the evolving human physiology incorporated provisions to prevent the potential of toxic excesses of both nutrients. For vitamin D the protection was of two sorts: skin pigmentation absorbed the critical UV wavelengths and thereby limited dermal synthesis of cholecalciferol; and slow delivery of vitamin D from the skin into the bloodstream left surplus vitamin in the skin, where continuing sun exposure led to its photolytic degradation to inert compounds. For calcium, the adaptation consisted of very inefficient calcium absorption, together with poor to absent systemic conservation. The latter is reflected in unregulated dermal calcium losses, a high sensitivity of renal obligatory calcium loss to other nutrients in the diet and relatively high quantities of calcium in the digestive secretions. Today, chimpanzees in the original hominid habitat have diets with calcium nutrient densities in the range of 2 to 2.5 mmol per 100 kcal, and hunter-gatherer humans in Africa, South America and New Guinea still have diets very nearly as high in calcium (1.75 to 2 mmol per 100 kcal) (Eaton and Nelson, 1991). With energy expenditure of 3 000 kcal per day (a fairly conservative estimate for a contemporary human doing physical work), such diets would provide substantially in excess of 50 mmol of calcium per day. By contrast, median intake in women in North America and in many European countries today is under 15 mmol per day. Two factors altered the primitive situation: the migration of humans from Africa to higher latitude

Vitamin D3 and calcium to prevent hip fractures in the elderly women. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. N Engl J Med. 1992 Dec 3;327(23):1637-42. PMID: 1331788 CONCLUSIONS. Supplementation with vitamin D3 and calcium reduces the risk of hip fractures and other nonvertebral fractures among elderly women.

Reducing fracture risk with calcium and vitamin D. Lips P, Bouillon R, van Schoor NM, Vanderschueren D, Verschueren S, Kuchuk N, Milisen K, Boonen S. Clin Endocrinol (Oxf). 2009 Sep 10. [Epub ahead of print] PMID: 19744099 DOI: 10.1111/j.0300-0664.2009.03701.x

Estimates of optimal vitamin D status. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Osteoporos Int. 2005 Jul;16(7):713-6. Epub 2005 Mar 18. PMID: 15776217

Kovaa harjoittelevat urheilijat! Lukekaa tämä teksti! Kova harjoittelu voi aiheuttaa rasitusmurtumia alaraajan luihin ja D-vitamiinia nauttimalla voidaan rasitusmurtumien synty ehkäistä. Lääkäri Juha-Petri Ruoholan väitöskirjan mukaan liian vähäinen D-vitamiinin saanti voi altistaa rasitusmurtumien syntymiselle urheilijoille. Tutkimuksen mukaan murtumapotilailla oli selkeästi normaalia alhaisemmat D-vitamiinitasot.

The same annual dose of 292 000 IU of vitamin D(3) (cholecalciferol) on either daily or four monthly basis for elderly women: 1-year comparative study of the effects on serum 25(OH)D(3) concentrations and renal function. Pekkarinen T, Välimäki VV, Aarum S, Turpeinen U, Hämäläinen E, Löyttyniemi E, Välimäki MJ. Clin Endocrinol (Oxf). 2009 May 25. [Epub ahead of print] PMID: 19486025 DOI: 10.1111/j.1365-2265.2009.03637.x

Long-term effects of giving nursing home residents bread fortified with 125 {micro}g (5000 IU) vitamin D3 per daily serving. Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, Vieth R. Am J Clin Nutr. 2009 Feb 25. [Epub ahead of print] PMID: 19244376

Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J. Arch Intern Med. 2009 Mar 23;169(6):551-61. PMID: 19307517 Conclusion Nonvertebral fracture prevention with vitamin D is dose dependent, and a higher dose should reduce fractures by at least 20% for individuals aged 65 years or older.

Long-term effects of giving nursing home residents bread fortified with 125 microg (5000 IU) vitamin D(3) per daily serving. Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, Vieth R. Am J Clin Nutr. 2009 Apr;89(4):1132-7. Epub 2009 Feb 25. PMID: 19244376 doi:10.3945/ajcn.2008.26890

Holick MF. Vitamin D: A millenium perspective. J Cell Biochem. 2003 Feb 1;88(2):296-307. Review. PMID: 12520530 [PubMed - indexed for MEDLINE]

Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev. 2005 Jun;10(2):94-111. Review. PMID: 15989379

Lips P. Vitamin D physiology. Prog Biophys Mol Biol. 2006 Sep;92(1):4-8. Epub 2006 Feb 28. Review. PMID: 16563471 [PubMed - indexed for MEDLINE]

Bikle DD. What is new in vitamin D: 2006-2007. Curr Opin Rheumatol. 2007 Jul;19(4):383-8. PMID: 17551371 [PubMed - in process]

Vitamin D fortification of milk products does not resolve hypovitaminosis D in young Finnish men. Välimäki VV, Löyttyniemi E, Välimäki MJ. Eur J Clin Nutr. 2007 Apr;61(4):493-7. Epub 2006 Nov 29. PMID: 17136043 doi:10.1038/sj.ejcn.1602550

McCollum Award Lecture, 1994: vitamin D--new horizons for the 21st century. Holick MF. Am J Clin Nutr. 1994 Oct;60(4):619-30. Review. PMID: 8092101

Vitamin D: A millenium perspective. Holick MF. J Cell Biochem. 2003 Feb 1;88(2):296-307. Review. PMID: 12520530