title: Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study High-Dose Vitamin D Supplementation in People With Prediabetes and Hypovitaminosis D The effect of calcium and vitamin D supplementation on obesity in postmenopausal women: secondary analysis for a large-scale, placebo controlled, double-blind, 4-year longitudinal clinical trial Supplementation with calcium + vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations. Aging, body composition, and lifestyle: the Fels Longitudinal Study. Effects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Supplementation with cholecalciferol does not result in weight reduction in overweight and obese subjects. Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control. A 12-week double-blind randomized clinical trial of vitamin D3 supplementation on body fat mass in healthy overweight and obese women Effect of adiposity on vitamin D status and the 25-hydroxycholecalciferol response to supplementation in healthy young and older Irish adults. Long-term vitamin D3 supplementation may have adverse effects on serum lipids during postmenopausal hormone replacement therapy. Vitamin D, Insulin Secretion, Sensitivity, and Lipids Role of Vitamin D in Insulin Secretion and Insulin Sensitivity for Glucose Homeostasis Not a simple fat-soluble vitamin: Changes in serum 25-(OH)D levels are predicted by adiposity and adipocytokines in older adults. Influence of Calcium and Vitamin D Supplementation on Weight and Fat Loss in Obese Women Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Measurement of muscle and fat in postmenopausal women: precision of previously reported pQCT imaging methods. Skeletal site-dependent response of bone mineral density and quantitative ultrasound parameters following a 12-month dietary intervention using dairy products fortified with calcium and vitamin D: the Postmenopausal Health Study. Supplementation with cholecalciferol does not improve glycaemic control in diabetic subjects with normal serum 25-hydroxyvitamin D levels Anabolic Therapy with Growth Hormone Accelerates Protein Gain in Surgical Patients Requiring Nutritional Rehabilitation Distribution and correlates of serum 25-hydroxyvitamin D levels in a sample of patients with hip fracture. Dexfenfluramine as adjuvant to a low-calorie formula diet in the treatment of obesity: a randomized clinical trial. Predictive value of waist-to-hip ratio on cardiovascular risk events Age-related changes in resting energy expenditure in normal weight, overweight and obese men and women. Proton magnetic resonance spectroscopy reveals increased hepatic lipid content after a single high-fat meal with no additional modulation by added protein. Mediterranean diet and colorectal cancer risk: results from a European cohort VITAL-Bone Health: rationale and design of two ancillary studies evaluating the effects of vitamin D and/or omega-3 fatty acid supplements on incident fractures and bone health outcomes in the VITamin D and OmegA-3 TriaL (VITAL). Impact of Vitamin D Supplementation on Inflammatory Markers in African Americans: Results of a Four-Arm, Randomized, Placebo-Controlled Trial Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. Calcium plus vitamin D supplementation and the risk of postmenopausal weight gain. Treatment with one-alpha-hydroxycholecalciferol in middle-aged men with impaired glucose tolerance--a prospective randomized double-blind study. A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Dose Response to Vitamin D Supplementation in Postmenopausal Women No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year.
abstract: Vitamin D insufficiency and low calcium intake contribute to increase parathyroid function and bone fragility in elderly people .  Calcium and vitamin D supplements can reverse secondary hyperparathyroidism thus preventing hip fractures , as proved by Decalyos I. Decalyos II is a 2-year , multicenter , r and omized , double-masked , placebo-controlled confirmatory study . The intention-to-treat population consisted of 583 ambulatory institutionalized women ( mean age 85.2 years , SD = 7.1 ) r and omized to the  calcium – vitamin D3  fixed combination group ( n= 199 ) ; the calcium plus vitamin D3 separate combination group ( n= 190 ) and the placebo group ( n= 194 ) . Fixed and separate combination groups received the same daily amount of calcium ( 1200 mg ) and vitamin D3 ( 800 IU ) , which had similar pharmacodynamic effects . Both types of calcium-vitamin D3 regimens increased serum 25-hydroxyvitamin D and decreased serum intact parathyroid hormone to a similar extent , with levels returning within the normal range after 6 months . In a subgroup of 114 patients  , femoral neck bone mineral density ( BMD ) decreased in the placebo group ( mean = –2.36 % per year , SD = 4.92 ) , while remaining unchanged in women treated with calcium-vitamin D3 ( mean = 0.29 % per year , SD = 8.63 ) . The difference between the two groups was 2.65 % ( 95 % CI = –0.44 , 5.75 % ) with a trend in favor of the active treatment group . No significant difference between groups was found for changes in distal radius BMD and quantitative ultrasonic parameters at the os calcis . The relative risk ( RR ) of HF in the placebo group compared with the active treatment group was 1.69 ( 95 % CI = 0.96 , 3.0 ) , which is similar to that found in Decalyos I ( RR = 1.7 ; 95 % CI = 1.0 , 2.8 ) . Thus , these data are in agreement with those of Decalyos I and indicate that calcium and vitamin D3 in combination reverse senile secondary hyperparathyroidism and reduce both hip bone loss and the risk of hip fracture  in elderly institutionalized women OBJECTIVE Low vitamin D levels predict the development of diabetes . This double-blind , r and omized , control study in subjects with prediabetes and hypovitaminosis D evaluated whether high doses of vitamin D for 1 year affected insulin secretion , insulin sensitivity , and the development of diabetes . RESEARCH DESIGN AND METHODS A total of 1,551 subjects ≥40 years of age not known to have diabetes were screened with A1C levels . Subjects with A1C levels of 5.8–6.9 % underwent an oral glucose tolerance test ( OGTT ) . Subjects with prediabetes and 25-OH vitamin D ( 25-OHD ) levels < 30 ng/mL were r and omized to receive weekly placebo ( n = 53 ) or vitamin D ( n = 56 ) with doses based on body weight and baseline 25-OHD levels . OGTTs were performed 3 , 6 , 9 , and 12 months later . Insulin secretion and sensitivity were measured , and the proportion of subjects developing diabetes was assessed . RESULTS 25-OHD levels rapidly rose from 22 to nearly 70 ng/mL after vitamin D supplementation with a mean weekly dose of 88,865 IU . There were no differences between the placebo and vitamin D groups regarding fasting plasma glucose , 2-h glucose , or insulin secretion and sensitivity or in the percent developing diabetes or returning to normal glucose tolerance . No subjects experienced increased serum or urinary calcium levels . At 12 months , A1C levels were significantly slightly less ( 0.2 % ) in the vitamin D group . CONCLUSIONS In individuals with prediabetes and hypovitaminosis D , doses of vitamin D supplementation design ed to raise serum 25-OHD levels into the upper-normal range for 1 year had no effect on insulin secretion , insulin sensitivity , or the development of diabetes  compared with placebo administration Background It is undetermined whether calcium supplementation has an effect on obesity or body composition in postmenopausal women . The purpose of the study is to detect the effect of calcium supplementation on indices of obesity and body composition . Methods This is a secondary analysis of data from a population -based , double-blind , placebo-controlled , r and omized trial design ed to determine the effects of calcium and vitamin D on osteoporotic fractures . The cohort included 1179 postmenopausal women who were r and omly assigned into one of three groups : 1 ) supplemental calcium ( 1400 mg/d or 1500 mg/d ) plus vitamin D placebo ( Ca-only group ) ; 2 ) supplemental calcium ( 1400 mg/d or 1500 mg/d ) plus supplemental vitamin D3 ( 1100 IU/d ) ( Ca + D group ) ; or , 3 ) two placebos ( placebo group ) . After applying the exclusion criteria for this analysis , 870 subjects were included in this study . The primary outcomes for the present study were changes in body mass index , trunk fat , trunk lean , and percentage of trunk fat after calcium supplementation . Results Changes in trunk fat , trunk lean , and percentage of trunk fat were significantly different between the calcium intervention groups ( Ca-only group or Ca + D group ) and the placebo group during the trial ( P < 0.05 ) . The calcium intervention groups gained less trunk fat and maintained more trunk lean when compared to the placebo group . No significant difference was observed for body mass index between groups . Conclusion Calcium supplementation over four years has a beneficial effect on body composition in postmenopausal women BACKGROUND Adequate calcium intake can have a favorable effect on some metabolic variables . OBJECTIVE The objective of the study was to determine the effects of daily calcium intake and of supplementation with calcium and vitamin D ( calcium+D ) during a weight-loss intervention on blood pressures , plasma lipid and lipoprotein concentrations , and glucose and insulin concentrations in low calcium consumers . DESIGN Healthy , overweight or obese women ( n = 63 ) with a daily calcium intake of < 800 mg/d were r and omly assigned in a double-blind manner to 1 of 2 groups : the group consuming 2 tablets/d of a calcium + vitamin D supplement ( 600 mg elemental calcium and 200 IU vitamin D/tablet ) or the group consuming placebo ; both groups observed a 700 kcal/d energy restriction . These 63 women then completed a 15-wk weight-loss intervention . RESULTS Initial daily calcium intake was significantly correlated with plasma HDL cholesterol ( r = 0.41 , P < 0.001 ) and with 2-h postload glycemia ( r = -0.29 , P < 0.05 ) during an oral-glucose-tolerance test , independent of fat mass and waist circumference . After the 15-wk intervention , significantly greater decreases in total : LDL and LDL : HDL ( P < 0.01 for both ) and of LDL cholesterol ( P < 0.05 ) were observed in the calcium+D group than in the placebo group . The differences in total : HDL and LDL : HDL were independent of changes in fat mass and in waist circumference . A tendency for more beneficial changes in HDL cholesterol , triacylglycerol , and total cholesterol was also observed in the calcium+D group ( P = 0.08 ) . CONCLUSION Consumption of calcium+D during a weight-loss intervention enhanced the beneficial effect of body weight loss on the lipid and lipoprotein profile in overweight or obese women with usual low daily calcium intake BACKGROUND Changes in body composition in men and women occur with age , but these changes are affected by numerous covariate factors . OBJECTIVE The study examined patterns of change in body composition and determined the effects of long-term patterns of change in physical activity in older men and women and in menopausal status and estrogen use in women . DESIGN Serial measures of height , weight , body mass index ( BMI ) , total body fat ( BF ) , percentage BF , and fat-free mass ( FFM ) from underwater weighing of 102 men and 108 women enrolled in the Fels Longitudinal Study were analyzed . Physical activity levels and menopausal status were included as covariates . RESULTS There were significant age-related decreases in FFM and height and increases in total BF , percentage BF , weight , and BMI . Physical activity was associated with decreases in total BF , percentage BF , weight , and BMI in men and were associated with increases in FFM and decreases in total BF and percentage BF in women . Postmenopausal women had significantly higher total BF and percentage BF than did pre- and perimenopausal women . The longer the time since menopause the greater were the increases in weight , BMI , total BF , and percentage BF ; however , estrogen use attenuated these increases . CONCLUSIONS Low FFM can be improved by increased physical activity . The effects of an intervention program on body composition can be masked if only body weight or BMI is measured . The effects of physical activity were more profound in postmenopausal than in premenopausal women , and estrogen use had beneficial effects on body composition BACKGROUND Ergocalciferol ( vitamin D(2 ) ) supplementation plays a role in fall prevention , but the effect in patients living in the community in sunny climates remains uncertain . We evaluated the effect of ergocalciferol and calcium citrate supplementation compared with calcium alone on the risk of falls in older women at high risk of falling . METHODS A 1-year population -based , double-blind , r and omized controlled trial of 302 community-dwelling ambulant older women aged 70 to 90 years living in Perth , Australia ( latitude , 32 degrees S ) , with a serum 25-hydroxyvitamin D concentration of less than 24.0 ng/mL and a history of falling in the previous year . Participants were r and omized to receive ergocalciferol , 1000 IU/d , or identical placebo ( hereinafter , ergocalciferol and control groups , respectively ) . Both groups received calcium citrate , 1000 mg/d . Fall data were collected every 6 weeks . RESULTS Ergocalciferol therapy reduced the risk of having at least 1 fall over 1 year after adjustment for baseline height , which was significantly different between the 2 groups ( ergocalciferol group , 53.0 % ; control group , 62.9 % ; odds ratio [ OR ] , 0.61 ; 95 % confidence interval [ CI ] , 0.37 - 0.99 ) . When those who fell were grouped by the season of first fall or the number of falls they had , ergocalciferol treatment reduced the risk of having the first fall in winter and spring ( ergocalciferol group , 25.2 % ; control group , 35.8 % ; OR , 0.55 ; 95 % CI , 0.32 - 0.96 ) but not in summer and autumn , and reduced the risk of having 1 fall ( ergocalciferol group , 21.2 % ; control group , 33.8 % ; OR , 0.50 ; 95 % CI , 0.28 - 0.88 ) but not multiple falls . CONCLUSION Patients with a history of falling and vitamin D insufficiency living in sunny climates benefit from ergocalciferol supplementation in addition to calcium , which is associated with a 19 % reduction in the relative risk of falling , mostly in winter OBJECTIVE A possible role for vitamin D deficiency in contributing to the winter increase in  cardiovascular disease  mortality was investigated by testing the effect of vitamin D supplementation on blood pressure and other cardiovascular risk factors during winter . DESIGN R and omised double-blind trial of vitamin D supplementation in winter . SUBJECTS Men and women , mean age 70 years ( range 63 - 76 ) recruited from general practitioner age-sex registers in Cambridge ( UK ) . INTERVENTION 95 people received a single oral dose of 2.5 mg cholecalciferol and 94 received the placebo at baseline interviews during December 1991 . Follow-up assessment was 5 weeks later during January 1992 . RESULTS Comparing follow-up with baseline assessment , serum 25-hydroxyvitamin D increased in the treated group and decreased slightly in the placebo group [ mean ( s.d . ) change : 7.2 ( + /- 3.8 ) vs -1.4 ( + /- 1.1 ) ng/ml , P = 0.0001 ] ; while parathyroid hormone decreased in the treated , and increased in the placebo , group [ -0.27 ( + /- 0.78 ) vs 0.13 ( + /- 0.75 ) pmol/l , P = 0.0004 ] . However , the mean change in blood pressure was similar in both groups : systolic -5 ( + /- 13 ) vs -5 ( + /- 16 ) mmHg , P = 0.81 ; diastolic -1 ( + /- 9 ) vs -1 ( + /- 9 ) , P = 0.92 ; as was the mean change in serum cholesterol [ -0.07 ( + /- 0.52 ) vs -0.05 ( + /- 0.60 ) mmol/l , P = 0.81 ] . In contrast , the mean change in radial pulse was significantly decreased in the treated group compared with placebo [ -2 ( + /- 9 ) vs 1 ( + /- 7 ) beats per min , P = 0.030 ] . CONCLUSIONS The failure of vitamin D supplementation to change blood pressure or serum cholesterol suggests that the winter increase in these factors is not caused by decreased vitamin D levels OBJECTIVE Investigate whether cholecalciferol supplementation leads to weight loss in overweight and obese adults . DESIGN R and omized double blind clinical trial with 20,000 IU cholecalciferol twice a week , or 20,000 IU once a week plus placebo , or placebo twice a week , for 12 months . All subjects were given 500 mg calcium supplementation . METHODS Four hundred and forty five healthy , overweight , and obese men and women ( age 21 - 70 years , body mass index ( BMI ) 28.0 - 47.0 kg/m(2 ) ) .  Body weight , fatness , and fat distribution parameters were measured by dual-energy X-ray absorptiometry and anthropometry , blood sample s and 24-h urinary sample s were collected . RESULTS At baseline , there were no significant differences between the groups , but there was a significant inverse relation between serum 25-hydroxyvitamin D ( 25(OH)D ) levels and BMI , and a significant positive association between calorie intake and BMI .  Three hundred and thirty four subjects completed the study . During the study , there was no significant change in weight , waist-to-hip ratio ( WHR ) or percentage body fat in any of the groups , nor between them . Parathyroid hormone decreased and 25(OH)D increased significantly in both groups receiving cholecalciferol , and serum levels of 25(OH)D stabilized after 3 months . Serum calcium was unchanged in all groups . Urinary calcium excretion increased in all groups , but there was no significant difference between the groups . Weekly dosage of 20,000 - 40,000 IU cholecalciferol for 12 months was associated with a low risk of adverse effects , at least in overweight and obese adults living at latitude 70 degrees N. CONCLUSION Significant weight reduction in overweight and obese subjects is unlikely to occur with cholecalciferol supplementation This r and omized , double-blind , placebo-controlled study was conducted to compare the effect of a 15-week weight-reducing programme ( -2900 kJ/d ) coupled with a calcium plus vitamin D ( calcium+D ) supplementation ( 600 mg elemental calcium and 5 microg vitamin D , consumed twice a day ) or with a placebo , on body fat and on spontaneous energy/macronutrient intake . Sixty-three overweight or obese women ( mean age 43 years , mean BMI 32 kg/m2 ) reporting a daily calcium intake < 800 mg participated in present study . Anthropometric variables , resting energy expenditure and spontaneous energy intake were measured before and after the 15-week programme . The calcium+D supplementation induced no statistically significant increase in fat mass loss in response to the programme . However , when analyses were limited to very low-calcium consumers only ( initial calcium intake < or = 600 mg/d , n 7 for calcium+D , n 6 for placebo ) , a significant decrease in body weight and fat mass ( P < 0.01 ) and in spontaneous dietary lipid intake ( P < 0.05 ) was observed in the calcium+D but not in the placebo group . In very low-calcium consumers , change in fat mass was positively correlated with change in lipid intake . During the weight-reducing programme , a calcium+D supplementation was necessary in female overweight/obese very low-calcium consumers to reach significant fat mass loss that seemed to be partly explained by a decrease in lipid intake . We propose that this change in lipid intake could be influenced by a calcium-specific appetite control Background Vitamin D concentrations are linked to body composition indices , particularly body fat mass . Relationships between hypovitaminosis D and obesity , described by both BMI and waist circumference , have been mentioned . We have investigated the effect of a 12-week vitamin D3 supplementation on anthropometric indices in healthy overweight and obese women . Methods In a double-blind , r and omized , placebo-controlled , parallel-group trial , seventy-seven participants ( age 38±8.1 years , BMI 29.8±4.1 kg/m2 ) were r and omly allocated into two groups : vitamin D ( 25 μg per day as cholecalciferol ) and placebo ( 25 μg per day as lactose ) for 12 weeks . Body weight , height , waist , hip , fat mass , 25(OH ) D , iPTH , and dietary intakes were measured before and after the intervention . Results Serum 25(OH)D significantly increased in the vitamin D group compared to the placebo group ( 38.2±32.7 nmol/L vs. 4.6±14.8 nmol/L ; P<0.001 ) and serum iPTH concentrations were decreased by vitamin D3 supplementation ( -0.26±0.57 pmol/L vs. 0.27±0.56 pmol/L ; P<0.001 ) . Supplementation with vitamin D3 caused a statistically significant decrease in body fat mass in the vitamin D group compared to the placebo group ( -2.7±2.1 kg vs. -0.47±2.1 kg ; P<0.001 ) . However , body weight and waist circumference did not change significantly in both groups . A significant reverse correlation between changes in serum 25(OH ) D concentrations and body fat mass was observed ( r = -0.319 , P = 0.005 ) . Conclusion Among healthy overweight and obese women , increasing 25(OH ) D concentrations by vitamin D3 supplementation led to body fat mass reduction . This trial is registered at clinical trials.gov as NCT01344161 There is increasing epidemiological evidence linking sub-optimal vitamin D status with overweight and obesity . Although increasing BMI and adiposity have also been negatively associated with the change in vitamin D status following supplementation , results have been equivocal . The aim of this r and omised , placebo-controlled study was to investigate the associations between anthropometric measures of adiposity and the wintertime serum 25-hydroxycholecalciferol ( 25(OH)D ) response to 15 μg cholecalciferol per d in healthy young and older Irish adults . A total of 110 young adults ( 20 - 40 years ) and 102 older adults ( ≥ 64 years ) completed the 22-week intervention with > 85 % compliance . The change in 25(OH)D from baseline was calculated . Anthropometric measures of adiposity taken at baseline included height , weight and waist circumference ( WC ) , along with skinfold thickness measurements to estimate fat mass ( FM ) . FM was subsequently expressed as FM ( kg ) , FM ( % ) , FM index ( FMI ( FM kg/height m2 ) ) and as a percentage ratio to fat-free mass ( FFM ) . In older adults , vitamin D status was inversely associated with BMI ( kg/m2 ) , WC ( cm ) , FM ( kg and % ) , FMI ( kg/m2 ) and FM : FFM ( % ) at baseline ( r - 0·33 , - 0·36 , - 0·33 , - 0·30 , - 0·33 and - 0·27 , respectively , all P values < 0·01 ) . BMI in older adults was also negatively associated with the change in 25(OH)D  following supplementation ( β - 1·27 , CI - 2·37 , - 0·16 , P = 0·026 ) ; however , no such associations were apparent in younger adults . Results suggest that adiposity may need to be taken into account when determining an adequate wintertime dietary vitamin D intake for healthy older adults residing at higher latitudes OBJECTIVE The positive short-term effects of postmenopausal hormone replacement therapy ( HRT ) on serum lipids are well known , but it has been suggested that they vanish with time . Cholecalciferol ( vitamin D3 ) is widely used to prevent postmenopausal osteoporosis but the influence of vitamin D3 on serum lipids is poorly known . The long-term effects of HRT and vitamin D3 on the concentrations of serum lipids were studied in a population -based prospect i ve 3-year study . DESIGN AND METHODS 464 women were r and omized into four treatment groups : ( i ) HRT ( sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate ) , ( ii ) Vit D3 ( vitamin D3 300 IU/day ) , ( iii ) HRT+Vit D3 ( both as above ) , ( iv ) placebo ( calcium lactate 500 mg/day ) . RESULTS 320 women completed the study . After three years of treatment , serum concentrations of low density lipoprotein ( LDL ) cholesterol decreased in the HRT group ( 10.1 % , P<0.001 ) and the HRT+Vit D3 group ( 5.9 % , P=0.005 ) , increased in the Vit D3 group ( 4.1 % , P=0.035 ) but remained unchanged in the placebo group . The concentrations of total cholesterol decreased by 5.8 % in the HRT group ( P<0.001 ) and by 3.3 % in the HRT+Vit D3 group ( P=0.023 ) , but did not change in the other two groups . Serum concentrations of high density lipoprotein ( HDL ) cholesterol decreased in the Vit D3 group ( 5.2 % , P=0.001 ) , HRT+Vit D3 group ( 3.7 % , P=0.046 ) , and the placebo group ( 4.5 % , P=0.006 ) but did not change significantly in the HRT group . The HDL/LDL ratio increased in the HRT group ( 10.5 % , P=0.006 ) and decreased in the Vit D3 group ( 10.5 % , P<0.001 ) whereas no changes occurred in the other two groups . In addition , serum triglycerides increased similarly in all groups ( 14.0 - 18.8 % , P<0.05 - 0.001 ) . CONCLUSIONS Our results confirm the positive long-term effect of HRT with sequential estradiol valerate and cyproterone acetate on serum lipid concentrations . In addition , the results suggest that vitamin D3 supplementation may have unfavorable effects on lipids in postmenopausal women .  Pure vitamin D3 treatment was associated with increased serum LDL cholesterol . Furthermore , the beneficial effects of HRT on serum LDL cholesterol content were reduced when estradiol valerate was combined with vitamin D3 . However , the relevance of these associations to cardiovascular morbidity remains to be established OBJECTIVE Vitamin D deficiency is associated with an unfavorable metabolic profile in observational studies . The intention was to compare insulin sensitivity ( the primary end point ) and secretion and lipids in subjects with low and high serum 25(OH)D ( 25-hydroxyvitamin D ) levels and to assess the effect of vitamin D supplementation on the same outcomes among the participants with low serum 25(OH)D levels . RESEARCH DESIGN AND METHODS Participants were recruited from a population -based study ( the Tromsø Study ) based on their serum 25(OH)D measurements . A 3-h hyperglycemic clamp was performed , and the participants with low serum 25(OH)D levels were thereafter r and omized to receive capsules of 20,000 IU vitamin D3 or identical-looking placebo twice weekly for 6 months . A final hyperglycemic clamp was then performed . RESULTS The 52 participants with high serum 25(OH)D levels ( 85.6 ± 13.5 nmol/L [ mean ± SD ] ) had significantly higher insulin sensitivity index ( ISI ) and lower HbA1c and triglycerides ( TGs ) than the 108 participants with low serum 25(OH)D ( 40.3 ± 12.8 nmol/L ) , but the differences in ISI and TGs were not significant after adjustments . After supplementation , serum 25(OH)D was 142.7 ± 25.7 and 42.9 ± 17.3 nmol/L in 49 of 51 completing participants r and omized to vitamin D and 45 of 53 r and omized to placebo , respectively . At the end of the study , there were no statistically significant differences in the outcome variables between the two groups . CONCLUSIONS Vitamin D supplementation to apparently healthy subjects with insufficient serum 25(OH)D levels does not improve insulin sensitivity or secretion or serum lipid profile Vitamin D functions are not limited to skeletal health benefits and may extend to preservation of insulin secretion and insulin sensitivity . This review summarizes the literature related to potential vitamin D influences on glucose homeostasis and insulin sensitivity . Cross-sectional data provide some evidence that circulating 25-hydroxyvitamin D ( 25(OH)D ) is inversely associated with insulin resistance , although direct measurements of insulin sensitivity are required for confirmation . Reported associations with insulin secretion , however , are contradictory . Available prospect i ve studies support a protective influence of high 25(OH)D concentrations on type 2 diabetes mellitus risk . There is a general lack of consistency in vitamin D intervention outcomes on insulin secretion and sensitivity , likely due to differences in subject population s , length of interventions , and forms of vitamin D supplementation . Vitamin D receptor gene polymorphisms and vitamin D interactions with the insulin like growth factor system may further influence glucose homeostasis . The ambiguity of optimal vitamin D dosing regimens and optimal therapeutic concentrations of serum 25(OH)D limit available intervention studies . Future studies , including cross-sectional and prospect i ve , should be performed in population s at high risk for both vitamin D deficiency and type 2 diabetes mellitus . Well- design ed , placebo-controlled , r and omized intervention studies are required to establish a true protective influence of  vitamin D on glucose homeostasis OBJECTIVE To determine the associations between body adiposity and change in serum 25-(OH)D levels over 2.6 years , and if these associations are mediated by metabolic and inflammatory factors in older adults . METHODS This is a longitudinal study of 859 r and omly selected subjects ( mean 62 years , range 51 - 80 , 49 % women ) . Serum 25-hydroxyvitamin D [ 25-(OH)D ] was assessed by radioimmunoassay at baseline and 2.6 years later . Baseline serum level of leptin  was assessed by radioimmunoassay and interleukin (IL)-6 by a chemiluminescent immunoassay in the first 183 subjects . RESULTS In multivariable analyses , body mass index , trunk fat percentage and waist-to-hip ratio were significant predictors of increased incident vitamin D deficiency [ a 25-(OH)D < 50 nmol L⁻¹ at follow-up when ≥50 nmol L⁻¹ at baseline ] and decreased recovery of vitamin D deficiency [ a 25-(OH)D ≥ 50 nmol L⁻¹ at follow-up when < 50 nmol L⁻¹ at baseline ] . Change in 25-(OH)D levels per annum was also independently predicted by baseline leptin ( β : -0.09/unit , 95 % CI : -0.17 , -0.03 ) , IL-6 ( β : -0.68/quartile , 95 % CI : -1.35 , -0.02 ) and total cholesterol/high-density lipoprotein ( HDL ) ratio ( β : -0.51 , 95 % CI : -0.88 , -0.14 ) . The associations between body adiposity measures and change in 25-(OH)D completely disappeared after adjustment for leptin , diminished after adjustment for IL-6 , but remained unchanged after adjustment for total cholesterol/HDL ratio . All associations were independent of season and sun exposure . CONCLUSIONS Body fat is not simply a passive reservoir for 25-(OH)D. In addition to season and sun exposure , 25-(OH)D levels appear to be determined by metabolic and , to a lesser extent , inflammatory factors , and these appear to mediate the effects of adiposity on change in Background : Dairy products not only reduce the risk of hypertension and cardiovascular diseases but may play a role in the treatment of obesity . As there is some evidence that calcium ( Ca ) and vitamin D may play a role in effective weight management , we decided to evaluate the influence of Ca and vitamin D supplementation on weight and fat loss  in obese women . Material and Methods : Forty obese women were enrolled in this study . Subjects were divided into 2 groups comparable with body mass index ( BMI ) and age . Group 1 was provided with calcium carbonate and 1-(OH)-vitamin D supplementation . Group 2 was provided with only a diet . Subjects participated in a 3-month weight reduction therapy ( balanced diet , modification of life style , and regular physical exercise ) . Blood sample s ( serum concentration of Ca , phosphorus ( P ) , parathormone ( PTH ) , 25-(OH)-D3 ) and clinical characteristics ( weight , height , BMI , body composition ) were taken at baseline and after the 3-month program . Results : No significant differences of body weight , body fat content , serum parathormone , 25-(OH)-D3 concentration , and plasma total Ca and P concentration were observed between analyzed groups both before and after the treatment . Additionally , we did not observe any significant influence of Ca and vitamin D supplementation on weight and fat loss . Conclusion : Ca plus vitamin D supplementation during a 3-month low caloric diet has no additional effect on weight and fat loss in obese women OBJECTIVES To determine whether relative vitamin D deficiency during the winter months contributes to age-related bone loss  and whether rates of change in hard- and soft-tissue mass vary during the year . DESIGN Double-blind , placebo-controlled , 1-year trial in 249 women in which equal numbers of women were r and omized to either placebo or 400 IU of vitamin D daily . All women received 377 mg/d of supplemental calcium largely as calcium citrate malate . PATIENTS Healthy , ambulatory postmenopausal women with usual intakes of vitamin D of 100 IU/d . MEASUREMENTS Duplicate spine and whole-body scans were done by dual energy x-ray absorptiometry at 6-month intervals that were timed to periods when 25-hydroxyvitamin D levels were highest and lowest . Period 1 was June-July to December-January and period 2 was December-January to the next June-July . Serum parathyroid hormone and plasma 25-hydroxyvitamin D levels were measured during periods 1 and 2 . MAIN RESULTS In the placebo group , spinal bone mineral density increased in period 1 , decreased in period 2 , and sustained no net change . Women treated with vitamin D had a similar spinal increase in period 1 ( 1.46 % compared with 1.40 % in placebo ) , less loss in period 2 ( -0.54 % compared with -1.22 % , CI for the difference , 0.05 % to 1.31 % , P = 0.032 ) and a significant overall benefit ( 0.85 % compared with 0.15 % , CI for the difference , 0.03 % to 1.37 % , P = 0.04 ) . In period 2 , 25-hydroxyvitamin D levels were lower and parathyroid hormone levels were higher in the placebo than in the vitamin D group . Whole-body lean and fat tissue and bone mineral density varied during the year but did not change overall . CONCLUSIONS At latitude 42 degrees , healthy postmenopausal women with vitamin D intakes of 100 IU daily can significantly reduce late wintertime bone loss and improve net bone density of the spine over one year by increasing their intake of vitamin D to 500 IU daily . A long-term benefit of preventing vitamin D insufficiency in the winter seems likely although it remains to be shown . Observed changes in bone as well as in fat and lean tissue appear to be related to season Peripheral quantitative computed tomography ( pQCT ) imaging has been used to quantify muscle area and density as well as intermuscular adipose tissue ( IMAT ) and subcutaneous adipose tissue ( SAT ) area in the lower and upper limb . Numerous protocol s have been reported to derive these soft-tissue outcomes , but their precision has not been assessed in community-dwelling postmenopausal women . The objective of this study was to compare the precision of previously reported analysis protocol s for quantifying muscle area and density , as well as IMAT and SAT area in postmenopausal women . Six image analysis protocol s using two available software suites ( Stratec XCT , BoneJ ) were identified from the pQCT literature . Analysis protocol s were applied to a sample of 35 older female adults ( mean age 73.7 ; SD 7.2 years ) , r and omly selected from a population based-cohort and scanned twice within an average of 9.7 ( SD 3.6 ) days . Relative precision was calculated as absolute values and as a percentage of the sample mean ( root mean square coefficient of variation ; CV%RMS ) . Soft-tissue outcomes across protocol s were compared on their log-transformed coefficients of variation using multilevel linear models and Tukey contrasts . For most protocol s , CV%RMS for muscle area , density , and SAT area ranged between 2.1 and 3.7 % , 0.7 and 1.9 % , and 2.4 and 6.4 % , respectively . Precision for IMAT area varied considerably , from 3 to 42 % . Consideration of these study results will aid in the selection of appropriate image analysis protocol s for pQCT-derived soft-tissue outcomes in postmenopausal women The aim of the current study was to examine whether calcium supplementation could prevent bone loss in postmenopausal women or more favourable outcomes could be obtained via the consumption of dairy products fortified with calcium and vitamin D3 . For this purpose changes in bone mineral density ( BMD ) at different skeletal sites , assessed by dual-energy X-ray absorptiometry , as well as in quantitative ultrasound ( QUS ) parameters of the calcaneus over 12 months were estimated . A population of 101 postmenopausal women ( 55 - 65 years old ) was r and omized into a dairy group ( DG : n 39 ) , receiving approximately 1200 mg calcium/d and 7.5 microg vitamin D3/d through fortified dairy products ; a calcium-supplemented group ( CaG : n 26 ) provided with a calcium supplement of 600 mg/d ; and a control group ( CG : n 36 ) . Over the intervention period the DG was found to have more favourable changes in pelvis ( P=0.040 ) , total spine ( P<0.001 ) and total body BMD ( P<0.001 ) than the other groups . A significant increase was also observed for DG in lumbar spine BMD ( 2.0 % ; 95 % CI 0.5 , 3.5 ) although it did not differentiate significantly compared to the other groups . No significant differences were observed with respect to the changes in QUS parameters . The current study revealed that recommended intakes of vitamin D3 and calcium via fortified dairy products for 12 months can induce favourable changes in pelvis , total spine and total body BMD in postmenopausal women but not in QUS parameters . No such favourable changes were observed via supplementation of calcium alone Background Studies have suggested that vitamin D may be important for both insulin sensitivity and insulin secretion , and that supplementation with vitamin D may subsequently prevent development of type 2 diabetes . Aim of the study The objective of the current study was to test the hypothesis that supplementation with vitamin D would improve glycaemic control in subjects with type 2 diabetes . Methods Thirty-six subjects with type 2 diabetes , treated with metformin and bed-time insulin  , were r and omised to supplementation with cholecalciferol ( 40,000 IU per week ) versus placebo for 6 months . Thirty-two subjects participated throughout the entirety of the study . Fasting blood sample s were drawn before and at the end of the 6 month study without the previous bed-time insulin injection . The insulin and metformin doses were not changed throughout the study . Results After 6 months , the fasting glucose , insulin , C-peptide , fructosamine , and HbA1c levels were not significantly different from baseline values . In addition , changes in these parameters ( values at 6 months minus values at baseline ) did not differ between the vitamin D and the placebo group . Conclusions We were not able to demonstrate that vitamin D supplementation had a significant effect on glucose metabolism in subjects with type 2 diabetes but without vitamin D deficiency . Further studies are needed in larger groups of subjects with type 2 diabetes or impaired glucose tolerance , who also exhibit low serum 25-hydroxyvitamin D levels Objective The authors investigated the effects of exogenous growth hormone ( GH ) on protein accretion and the composition of weight gain in a group of stable , nutritionally compromised postoperative patients receiving st and ard hypercaloric nutritional therapy .  Summary Background Data A significant loss of body protein impairs normal physiologic functions and is associated with increased postoperative complications and prolonged hospitalization . Previous studies have demonstrated that st and ard methods of nutritional support enhance the deposition of fat and extracellular water but are ineffective in repleting body protein . Methods Fourteen patients requiring long-term nutritional support for severe gastrointestinal dysfunction received st and ard nutritional therapy ( STD ) providing approximately 50 kcal/kg/day and 2 g of protein/kg/day during an initial 7-day equilibrium period . The patients then continued on STD ( n = 4 ) or , in addition , received GH 0.14 mg/kg/day ( n = 10 ) . On day 7 of the equilibrium period and again after 3 weeks of treatment , the components of body weight were determined ; these included body fat , mineral content , lean ( nonfat and nonmineral-containing tissue ) mass , total body water , extracellular water ( ECW ) , and body protein . Daily and cumulative nutrient balance and substrate oxidation studies determined the distribution , efficiency , and utilization of calories for protein , fat , and carbohydrate deposition . Results The GH-treated patients gained minimal body fat but had significantly more lean mass ( 4.311 ± 0.6 kg vs. 1.988 ± 0.2 kg , p ≤ 0.03 ) and more protein ( 1.417 ± 0.3 kg vs. 0.086 ± 0.1 kg , p ≤ 0.03 ) than did the STD-treated patients . The increase in lean mass was not associated with an inappropriate expansion of ECW . In contrast , patients receiving  STD therapy tended to deposit a greater proportion of body weight as ECW and significantly more fat than did GH-treated patients ( 1.004 ± 0.3 kg vs. 0.129 ± 0.2 kg , p < 0.05 ) . GH administration altered substrate oxidation ( respiratory quotient = 0.94 ± 0.02 GH vs. 1.17 ± 0.05 STD , p ≤ 0.0002 ) and the use of available energy , result ing in a 66 % increase in the efficiency of protein deposition ( 13.37 ± 0.8 g/1000 kcal vs. 8.04 g ± 3.06 g/1000 kcal , p ± 0.04 ) . Conclusions GH administration accelerated protein gain in stable adult patients receiving aggressive nutritional therapy without a significant increase in body fat or a disproportionate expansion of ECW . GH therapy accelerated nutritional repletion and , therefore , may shorten the convalescence of the malnourished patient requiring a major surgical procedure BACKGROUND Vitamin D deficiency is common in older population s , particularly during the winter months due to low levels of ultraviolet light exposure , and in nursing home residents . OBJECTIVE The main objective of the current study was to assess the distribution of serum 25-hydroxyvitamin D and its correlates in a sample of men and women with recent hip fractures who were part of a large clinical trial . METHODS This was a cross-sectional exploratory study of screened and ultimately r and omized patients with hip fractures . They were part of a multinational ( 115 clinical centers in 20 countries ) , r and omized , placebo-controlled , double-blind study testing the efficacy of a yearly IV bisphosphonate ( zoledronic acid ) in the prevention of new clinical fractures in patients with recent hip fracture repair .  Levels of 25-hydroxyvitamin D , calcium , alkaline phosphatase , creatinine clearance , and albumin were measured at a screening visit using blood serum . Demographic variables were assessed by patient self-report . Bone mineral density ( BMD ) was assessed by dual-energy x-ray absorptiometry of the nonfractured hip . RESULTS This report included 1174 screened patients ( 526 with vitamin D measured ) and 655 ( 385 with vitamin D measured ) patients r and omized before the protocol amendment . In screened patients , levels of 25-hydroxyvitamin D were low ( median , 14.7 ng/mL ; interquartilc range , 7.6 , 21.65 ) . Overall , 51 % were at or below the clinical ly meaningful threshold of 15 ng/mL. Among those patients r and omized , the level of 25-hydroxyvitamin D was significantly positively related to male sex ( rho , 0.13 ; P < 0.05 ) , serum calcium ( rho , 0.16 ; P < 0.01 ) , and BMD at the femoral neck ( rho , 0.22 ; P < 0.01 ) in bivariate analyses . Low serum 25-hydroxyvitamin D ( < 15 ng/mL ) was related only to low serum calcium ( odds ratio , 0.16 ; 95 % CI , 0.05 - 0.52 ) in multivariable logistic models controlling for sex , age , race , body mass index , living at home , alkaline phosphatase , and creatinine clearance . CONCLUSIONS We concluded that vitamin D insufficiency was a common problem in this population of elderly patients who had recently suffered a hip fracture . This insufficiency was related only to serum calcium in multivariable controlled models but can not be reliably identified or excluded by measuring serum calcium alone . Physicians should be encouraged to check and monitor patients ' serum levels of 25-hydroxyvitamin Dexfenfluramine ( dF ) was compared to placebo as adjuvant to a very energy-restricted diet ( 1.6 - 4.2 MJ/24 h ) . The diet was continued as long as possible or until a satisfactory weight loss had been achieved , and dietary efforts were continued throughout the study . Of the 37 females and five males included , 71 per cent could be followed up for 12 months . Initial BMI ranged from 28 to 54 kg/m2 . The lowest body weight was reached 1 month earlier in the dF group ( P = 0.037 ) . Throughout the study , the reduction of excess weight ( REW ) was greater in dF patients ( P less than 0.05 only at 4 and 6 months ) . At 6 months , excess weight had declined by 15 per cent more in the dF group than in the placebo group ( 95 per cent confidence limits of the median being 1 - 31 per cent ) . Between 6 and 12 months , both groups regained weight significantly , the rates of regain differing only insignificantly . At 12 months , excess weight showed a net decrease of only 8 per cent more in the dF group than in the placebo group ( 95 per cent confidence limits being -7 to + 24 per cent ) . Therefore , REW showed no significant group difference after 12 months . Type of obesity ( and roid or gynoid ) as determined by waist to hip ratio had no significant impact on either weight loss , REW , reductions of waist and hip circumferences , or on waist to hip ratio changes . S-alkaline phosphatases and s-uric acid declined significantly in the dF group only . Side-effects were all mild and their prevalence showed no group difference . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND : A central distribution of adipose tissue is frequently associated with cardiovascular disease ( CVD ) and its risk factors . METHODS : Clinical usefulness of  waist-to-hip ratio ( WHR )  for predicting the risk of cardiovascular events , estimated with models based on data from the Framingham and Prospect i ve Cardiovascular Münster ( PROCAM ) studies was evaluated . SUBJECTS : These were 552 men and 160 women , asymptomatic and at risk for CVD , aged 30–74 y , recruited from an ongoing risk factor screening program conducted at worksites . RESULTS : Abdominal fatness was a strong predictor of cardiovascular complications in subjects whose WHR was in the top quintile ( > 0.98 for men and > ; 0.91 for women ) . The estimated percentage rate of coronary heart disease ( CHD , P<0.01 ) and death ( P<0.01 ) , myocardial infa rct ion ( P<0.01 ) , stroke ( P<0.01 ) , total CVD ( P<0.001 ) and death ( P<0.01 ) increased with increasing quintile of WHR in men and women . In the highest WHR , the number of subjects exceeding a 15 % risk of developing a coronary event over the next 10 y was more than two-fold greater ( odds ratio ( OR ) 2.60 ( confidence intervals ( CI ) 1.09–6.54 ) than in the lowest WHR quintiles . Similar six-year myocardial infa rct ion ( MI ) risks at each quintile of WHR were observed in men in both Framingham and PROCAM models . In the overall population , CHD estimates increased with increasing quintiles of WHR with the Framingham model and an adapted model for estimating probabilities of disease in the French population of the Prévention Cardiovasculaire en Médecine du Travail ( PCV-METRA ) group . CONCLUSION : Abdominal deposition of fat assessed by WHR may be of strong clinical value for predicting high risk of cardiovascular events OBJECTIVES Aging is associated with changes in resting energy expenditure ( REE ) and body composition . We investigated the association between age and changes in REE in men and women stratified by body mass index ( BMI ) categories ( normal weight , overweight and obesity ) . We also examined whether the age-related decline in REE was explained by concomitant changes in body composition and lifestyle factors . STUDY DESIGN Cross-sectional . MAIN OUTCOME MEASURES 3442 adult participants ( age range : 18 - 81 y ; men/women : 977/2465 ) were included . The BMI range was 18.5 - 60.2 kg/m(2 ) .  REE was measured by indirect calorimetry in fasting conditions and body composition by bioelectrical impedance . Regression models were used to evaluate age-related changes in REE in subjects stratified by sex and BMI . Models were adjusted for body composition ( fat mass , fat free mass ) , smoking , disease count and physical activity . RESULTS In unadjusted models , the rate of decline in REE was highest in obese men ( slope=-8.7±0.8 kcal/day/year ) whereas the lowest rate of decline was observed in normal weight women ( -2.9±0.3 kcal/day/year ) . Gender differences were observed for the age of onset of REE adaptive changes ( i.e. , not accounted by age related changes in body composition and lifestyle factors ) . In women , adaptive changes appeared to occur in middle-age ( ∼47 y ) across all BMI groups whereas changes seemed to be delayed in obese men ( ∼54 y ) compared to overweight ( ∼43 y ) and normal weight ( ∼39 y ) men . CONCLUSIONS Sex and BMI influenced the rate and degree of the age-related decline in REE . Critical age windows have been identified for the onset of putative mechanisms of energy adaptation . These findings require confirmation in prospect i ve studies BACKGROUND Fat accumulation in nonadipose tissue is linked to insulin resistance and metabolic diseases . Earlier studies have shown that hepatic lipid accumulation can occur after 4 d of a high-fat diet in humans , and this fat accumulation can be blunted by the ingestion of additional proteins . OBJECTIVES In this study , we explored whether a single high-fat meal increased the lipid content in liver and skeletal muscle as measured by using in vivo proton magnetic resonance spectroscopy ( ¹H-MRS ) and whether the addition of protein can modulate the postpr and ial ectopic lipid storage . DESIGN Intrahepatic lipid ( IHL ) and intramyocellular lipid ( IMCL ) concentrations were determined by using ¹H-MRS before and 3 and 5 h after a high-fat with added protein meal ( 61.5 % of energy from fat ) or a high-fat without added protein meal ( mean ± SEM : 51.1 ± 7.9 g of protein ; 191.9 ± 9.9 kcal added ) in a r and omized crossover study . IHL and IMCL concentrations were converted to absolute concentrations ( g/kg wet weight ) by using water as an internal reference . RESULTS Nine lean , healthy subjects [ 6 men and 3 women ; mean ( ±SD ) age : 22.7 ± 3.0 y ; mean body mass index ( in kg/m² ) : 21.8 ± 1.8 ] were included in this study . IHL concentrations increased ∼20 % ( P < 0.01 ) at 3 h after the meal and did not further increase after 5 h. In contrast , IMCL concentrations were not altered during the postpr and ial period ( P = 0.74 ) . The addition of protein to a single high-fat meal did not change the postpr and ial accumulation of fat in the liver ( P = 0.93 ) or skeletal muscle ( P = 0.84 ) . CONCLUSIONS In this study , we showed that a single energy-dense , high-fat meal induced net lipid accumulation in the liver , which was detected by using in vivo ¹H-MRS . This noninvasive approach might bring new opportunities to study postpr and ial hepatic lipid dynamics . The addition of protein did not change the ectopic lipid retention after a single high-fat meal The authors investigated the association of adherence to Mediterranean diet with  colorectal cancer ( CRC ) risk  in the European Prospect i ve Investigation into Cancer and nutrition study .  Adherence to Mediterranean diet was expressed through two 10-unit scales , the Modified Mediterranean diet score ( MMDS ) and the Centre-Specific MMDS ( CSMMDS ) . Both scales share the same dietary components but differ in the cut-off values that were used for these components in the construction of the scales . Adjusted hazard ratios ( HR ) for the associations of these scales with CRC incidence were estimated . After 5,296,617 person-years of follow-up , 4,355 incident CRC cases were identified . A decreased risk of CRC , of 8 and 11 % was estimated when comparing the highest ( scores 6–9 ) with the lowest ( scores 0–3 ) adherence to CSMMDS and MMDS respectively . For MMDS the HR was 0.89 ( 95 % confidence interval ( CI ) : 0.80 , 0.99 ) . A 2-unit increment in either Mediterranean scale was associated with a borderline statistically significant 3 to 4 % reduction in CRC risk ( HR for MMDS : 0.96 ; 95 % CI : 0.92 , 1.00 ) . These associations were somewhat more evident , among women , were mainly manifested for colon cancer risk and their magnitude was not altered when alcohol was excluded from MMDS . These findings suggest that following a Mediterranean diet may have a modest beneficial effect on CRC risk RATIONALE Although vitamin D is widely used to promote skeletal health , definitive data on benefits and risks of supplemental vitamin D alone on bone are lacking . Results from large , r and omized controlled trials in the general population are sparse . Data on the effects of supplemental omega-3 fatty acids ( FAs ) on bone are also limited . DESIGN The VITamin D and OmegA-3 TriaL ( VITAL ) is a double-blind , placebo-controlled trial assessing the role of vitamin D3 ( 2000 IU/d ) and omega-3 FA ( 1g/d ) supplements in reducing risks of cancer and cardiovascular disease among U.S. men aged ≥50 and women aged ≥55 . To comprehensively test effects of supplemental vitamin D and /or omega-3 FAs on skeletal health , the VITAL : Effects on Fractures ancillary study is determining the effects of these supplements on incident fractures among 25,875 participants enrolled in the parent trial . Study investigators adjudicate fractures through a detailed review of medical records and radiological images ( hip and femur ) . In a complementary ancillary , VITAL : Effects on Structure and Architecture is determining the effects of supplemental vitamin D and /or omega-3 FAs on bone with detailed phenotyping during in-person visits . Comprehensive assessment s of bone density , turnover , structure/architecture , body composition , and physical performance are being performed at baseline and 2 years post-r and omization . CONCLUSION Results from these studies will clarify the relationship between supplemental vitamin D and /or omega-3 FAs on bone health outcomes , and inform clinical care and public health guidelines on the use of supplemental vitamin D for the primary prevention of fractures in women and men African Americans have a disproportionate burden of inflammation-associated chronic diseases such as cancer and lower circulating levels of 25-hydroxyvitamin D [ 25(OH)D ] . The effect of vitamin D3 ( cholecalciferol ) supplementation on inflammatory markers is uncertain . We conducted a r and omized , double-blind , placebo-controlled trial of supplemental oral vitamin D ( placebo , 1,000 , 2,000 , or 4,000 IU/day of vitamin D3 orally for 3 months ) in 328 African Americans ( median age , 51 years ) of public housing communities in Boston , MA , who were enrolled over three consecutive winter periods ( 2007–2010 ) . Change from 0 to 3 months of plasma levels of 25(OH)D , high-sensitivity C-reactive protein ( CRP ) , interleukin (IL)-6 , IL-10 , and soluble TNF-α receptor type 2 ( sTNF-R2 ) in 292 ( 89 % ) participants were measured . Overall , no statistically significant changes in CRP , IL-6 , IL-10 , and sTNF-R2 were observed after the vitamin D supplementation period . Baseline CRP was significantly inversely associated with the baseline 25(OH)D level ( P < 0.001 ) in unadjusted and adjusted models . An interaction between baseline 25(OH)D and vitamin D supplementation was observed for outcome change in log CRP ( month 3–month 0 ; P for interaction = 0.04 ) . Within an unselected population of African Americans , short-term exposure to vitamin D supplementation produced no change in circulating inflammatory markers . This study confirms the strong independent association of CRP with 25(OH)D status even after adjusting for body mass index . Future studies of longer supplemental vitamin D3 duration are necessary to examine the complex influence of vitamin D3 on CRP and other chronic inflammatory cytokines for possible reduction of cancer health disparities in African Americans . Cancer Prev Res ; 7(2 ) ; 218–25 . © 2013 AACR BACKGROUND Inadequate dietary intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons . METHODS We studied the effects of three years of dietary supplementation with calcium and vitamin D on bone mineral density , biochemical measures of bone metabolism , and the incidence of nonvertebral fractures in 176 men and 213 women 65 years of age or older who were living at home . They received either 500 mg of calcium plus 700 IU of vitamin D3 ( cholecalciferol ) per day or placebo .  Bone mineral density was measured by dual-energy x-ray absorptiometry , blood and urine were analyzed every six months , and cases of nonvertebral fracture were ascertained by means of interviews and verified with use of hospital records . RESULTS The mean ( + /-SD ) changes in bone mineral density in the calcium-vitamin D and placebo groups were as follows : femoral neck , + 0.50+/-4.80 and -0.70+/-5.03 percent , respectively ( P=0.02 ) ; spine,+2.12+/-4.06 and + 1.22+/-4.25 percent ( P=0.04 ) ; and total body , + 0.06+/-1.83 and -1.09+/-1.71 percent ( P<0.001 ) . The difference between the calcium-vitamin D and placebo groups was significant at all skeletal sites after one year , but it was significant only for total-body bone mineral density in the second and third years . Of 37 subjects who had nonvertebral fractures , 26 were in the placebo group and 11 were in the calcium-vitamin D group ( P=0.02 ) . CONCLUSIONS In men and women 65 years of age or older who are living in the community , dietary supplementation with calcium and vitamin D moderately reduced bone loss measured in the femoral neck , spine , and total body over the three-year study period and reduced the incidence of nonvertebral fractures BACKGROUND Obesity in the United States has increased significantly during the past several decades . The role of calcium in the maintenance of a healthy body weight remains controversial . METHODS A r and omized , double-blinded , placebo-controlled trial was performed with 36 282 postmenopausal women , aged 50 to 79 years , who were already enrolled in the dietary modification and /or hormone therapy arms of the Women 's Health Initiative clinical trial . Women were r and omized at their first or second annual visit to receive a dose of 1000 mg of elemental calcium plus 400 IU of cholecalciferol ( vitamin D ) or placebo daily . Change in body weight was ascertained annually for an average of 7 years . RESULTS Women receiving calcium plus cholecalciferol supplements vs women receiving placebo had a minimal but consistent favorable difference in weight change ( mean difference , -0.13 kg ; 95 % confidence interval , -0.21 to -0.05 ; P = .001 ) . After 3 years of follow-up , women with daily calcium intakes less than 1200 mg at baseline who were r and omized to supplements were 11 % less likely to experience small weight gains ( 1 - 3 kg ) and 11 % less likely to gain more moderate amounts of weight ( > 3 kg ) ( P for interaction for baseline calcium intake = .008 ) . CONCLUSION Calcium plus cholecalciferol supplementation has a small effect on the prevention of weight gain , which was observed primarily in women who reported inadequate calcium intakes . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00000611 Experimental evidence suggests a specific role for the active metabolite of vitamin D ( 1,25(OH)2D3 ) in insulin secretion . In order to evaluate the possible clinical significance , 65 middle-aged men with impaired glucose tolerance , and normal serum levels of vitamin D metabolites , were enrolled in a three-month study where they were given either 0.75 micrograms alpha-calcidol ( 1 alpha(OH)D3 ) daily or placebo .  Indices of glucose and lipid metabolism were evaluated before and after treatment . There were no significant changes during the trial neither for fasting blood glucose , hemoglobin A1c or for the intravenous glucose tolerance between the treatment and the placebo groups , nor were there any consistent changes in insulin values during the glucose tolerance test . Subjects treated with alpha-calcidol displayed a significant reduction in body weight with an average of 1.1 kg , while those receiving placebo lost no weight . Treatment did not affect the serum lipoprotein values . Thus , a modest dose of active vitamin D , which did not cause elevation of serum calcium , did not provide general improvement of glucose tolerance or of insulin secretion when given to patients with impaired glucose tolerance , but without vitamin D deficiency , over a three-month period AIM To determine the short-term effect of vitamin D(3 ) supplementation on insulin sensitivity in apparently healthy , middle-aged , central ly obese men . SUBJECTS AND METHODS A double-blind r and omized controlled trial was conducted at a tertiary care facility in which 100 male volunteers aged > or = 35 years received three doses of vitamin D(3 ) ( 120,000 IU each ; supplemented group ) fortnightly or placebo ( control group ) . Hepatic fasting insulin sensitivity [ homeostasis model assessment ( HOMA ) , quantitative insulin-sensitivity check index , HOMA-2 ] , postpr and ial insulin sensitivity [ oral glucose insulin sensitivity ( OGIS ) ] , insulin secretion ( HOMA%B , HOMA2-%B ) , lipid profile and blood pressure were measured at baseline and at 6 weeks ' follow-up . RESULTS Seventy-one of the recruited subjects completed the study ( 35 in supplemented group , 36 in control group ) . There was an increase in OGIS with supplementation by per protocol analysis ( P = 0.038 ; intention-to-treat analysis P = 0.055 ) . The age- and baseline 25-hydroxyvitamin D level-adjusted difference in change in OGIS was highly significant ( mean difference 41.1 + /- 15.5 ; P = 0.01 ) . No changes in secondary outcome measures ( insulin secretion , basal indices of insulin sensitivity , blood pressure or lipid profile ) were found with supplementation . CONCLUSION The trial indicates that vitamin D(3 ) supplementation improves postpr and ial insulin sensitivity ( OGIS ) in apparently healthy men likely to have insulin resistance ( central ly obese but non-diabetic ) BACKGROUND Serum 25-hydroxyvitamin D ( 25-[OH]D ) is considered the best biomarker of clinical vitamin D status . OBJECTIVE To determine the effect of increasing oral doses of vitamin D(3 ) on serum 25-(OH)D and serum parathyroid hormone ( PTH ) levels in postmenopausal white women with vitamin D insufficiency ( defined as a 25-[OH]D level ≤50 nmol/L ) in the presence of adequate calcium intake . These results can be used as a guide to estimate the Recommended Dietary Allowance ( RDA ) ( defined as meeting the needs of 97.5 % of the population ) for vitamin D(3 ) . DESIGN R and omized , placebo-controlled trial . ( Clinical Trials.gov registration number : NCT00472823 ) SETTING Creighton University Medical Center , Omaha , Nebraska . PARTICIPANTS 163 healthy postmenopausal white women with vitamin D insufficiency enrolled in the winter or spring of 2007 to 2008 and followed for 1 year . INTERVENTION Participants were r and omly assigned to receive placebo or vitamin D(3 ) , 400 , 800 , 1600 , 2400 , 3200 , 4000 , or 4800 IU once daily . Daily calcium supplements were provided to increase the total daily calcium intake to 1200 to 1400 mg . MEASUREMENTS The primary outcomes were 25-(OH)D and PTH levels at 6 and 12 months . RESULTS The mean baseline 25-(OH)D level was 39 nmol/L. The dose response was curvilinear and tended to plateau at approximately 112 nmol/L in patients receiving more than 3200 IU/d of vitamin D(3 ) . The RDA of vitamin D(3 ) to achieve a 25-(OH)D level greater than 50 nmol/L was 800 IU/d . A mixed-effects model predicted that 600 IU of vitamin D(3 ) daily could also meet this goal . Compared with participants with a normal body mass index ( < 25 kg/m(2 ) ) , obese women ( ≥30 kg/m(2 ) ) had a 25-(OH)D level that was 17.8 nmol/L lower . Parathyroid hormone levels at 12 months decreased with an increasing dose of vitamin D(3 ) ( P = 0.012 ) . Depending on the criteria used , hypercalcemia occurred in 2.8 % to 9.0 % and hypercalciuria in 12.0 % to 33.0 % of participants ; events were unrelated to dose . LIMITATION Findings may not be generalizable to other age groups or persons with substantial comorbid conditions . CONCLUSION A vitamin D(3 ) dosage of 800 IU/d increased serum 25-(OH)D levels to greater than 50 nmol/L in 97.5 % of women ; however , a model predicted the same response with a vitamin D(3 ) dosage of 600 IU/d . These results can be used as a guide for the RDA of vitamin D(3 ) , but prospect i ve trials are needed to confirm the clinical significance of these results . PRIMARY FUNDING SOURCE National Institute on Aging BACKGROUND AND AIM Cross-sectional studies indicate vitamin D to be of importance for glucose tolerance , blood pressure and serum lipids , but whether supplementation with vitamin D would improve cardio-vascular risk factors is not known . DESIGN AND SETTING The study was a 1 year , double blind placebo-controlled intervention trial performed at the University Hospital of North Norway from November 2005 to October 2007 . Subjects . A total of 438 overweight or obese subjects , 21 - 70 years old , were included and 330 completed the study . INTERVENTIONS The subjects were r and omized to vitamin D ( cholecalciferol , vitamin D(3 ) ) 40 000 IU per week ( DD group ) , vitamin D 20 000 IU per week ( DP group ) , or placebo ( PP group ) . All subjects were given 500 mg calcium daily . MAIN OUTCOME MEASURES Fasting serum lipids and blood pressure were measured and an oral glucose tolerance test performed at start and end of the study . RESULTS At baseline the mean serum 25(OH)D levels were 58 nmol L(-1 ) ( all subjects ) and increased to 140 and 101 nmol L(-1 ) in the DD and DP groups , respectively . No significant differences were found between the three groups regarding change in measures of glucose metabolism or serum lipids . In the DP group , there was a slight but significant increase in systolic blood pressure compared with the placebo group . CONCLUSIONS Our results do not support a positive effect of vitamin D on glucose tolerance , blood pressure or serum lipids . Further studies in subjects with low serum 25(OH)D levels combined with impaired glucose tolerance , hypertension or dyslipidaemia are needed
target: CONCLUSIONS Supplementation with vitamin D showed no effect on adiposity measures in adults
background: CONTEXT The independent or interactive effects of vitamin D and calcium on adiposity remain inconclusive .
  OBJECTIVE The objective of this systematic review and meta- analysis was to assess whether vitamin D and calcium supplements cause changes in adiposity .