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as good quality included maternal BMD as an outcome, and there was no relationship between vitamin D status and postpartum changes in BMD. Information on the four studies can be found in Appendix C. AHRQ-Tufts found no new RCTs.

Summary Evidence regarding serum 25OHD concentrations and BMC/BMD measures varied by life stage. The findings from the AHRQ analyses are summarized by DRI-relevant life stage group in Box 4-3 below.


Bone mineral content/bone mineral density: Vitamin D supplementation with or without calcium AHRQ addressed data primarily for menopausal women. One RCT for girls was also identified. Overall, AHRQ-Ottawa concluded that there is good evidence that vitamin D3 plus calcium supplementation resulted in small increases in BMD of the spine, total body,

results showed that there were no significant differences in lumbar spine BMD changes between the groups receiving two doses of vitamin D3 (400 or 800 IU/day) and the placebo group.


51–70 years: Discordance between the results from RCTs and the majority of observational studies in postmenopausal women and elderly men. Based on results of the observational studies, there is fair evidence to support an association between serum 25OHD concentration and BMD or changes in BMD at the femoral neck. One new RCT identified by AHRQ-Tufts enrolled some men in this life stage. The results showed that there were no significant differences in lumbar spine BMD changes between the groups receiving two doses of vitamin D3 (400 or 800 IU/day) and the placebo group.


71 years: Discordance between the results from RCTs and the majority of observational studies in postmenopausal women and elderly men. Based on results of the observational studies, there is fair evidence to support an association between serum 25OHD and BMD or changes in BMD at the femoral neck. One new RCT identified by AHRQ-Tufts enrolled only elderly women in this life stage. The results showed that vitamin D2 supplementation (1,000 IU/day) had no additional effect on hip BMD compared with calcium supplementation alone.


Pregnant or lactating women: Insufficient evidence for an association between a specific serum 25OHD concentration and the bone health outcome BMC.

  

*Evidence from AHRQ-Ottawa; information from AHRQ-Tufts as noted.

SOURCE: Modified from Chung et al. (2009).



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