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The Effect of Vitamin D in the Elderly Population
- Benefits and Requirements of Vitamin D for Optimal Health: A Review

The elderly have a particularly strong need to maintain vitamin D sufficiency. Not only are they likely to produce less vitamin D from solar UVB irradiation because they generally spend less time in sunlight than do younger people,118,119 but their efficiency of photoproduction is less.119-121 In addition, diseases such as cancer and osteoporotic fractures are most likely among the elderly. A study from Turkey reported it was possible to identify risk of vitamin D insufficiency in elderly subjects simply by asking about clothing habits and exposure to sunlight.122 In countries where some foods are fortified (such as milk, breakfast cereals, orange juice,123 and some breads124 in the United States, and milk and margarine in Canada36), and where many take vitamin supplements, dietary patterns and supplement consumption would have to be questioned as well.125 However, in high-latitude countries, serum 25(OH)D levels in winter tend to be low.126

Cancer is a disease for which incidence and mortality rates generally increase with age and there is generally a time lag between dietary effects and discovery of cancer. A 23-year lag between the introduction of Western dietary factors, reduced total dietary fiber, and colon cancer was found for Japan after 1947.127 Exercise is associated with reduced risk for cancer,128,129 and the elderly generally exercise less than their younger counterparts. The most important reason, however, for increased risk of cancer with increasing age is likely chromosomal changes, such as aneuploidy (having an abnormal number of chromosomes) and telomere erosion.130 Telomeres, the end caps of chromosomes, are thought to shorten with each instance of cell division, and the rate of division increases with energy consumption and body mass index. Also involved are advanced glycation end products and reactive oxygen species.131 Active vitamin D induces ovarian cell apoptosis through down-regulation of telomerase.132 Telomerase activity is inversely correlated with telomere length.133

Osteoporotic fractures are of significant concern for the elderly. Several factors contribute to the risk of such fractures, including low BMD, muscle weakness, and neurological control of balance/neuro-muscular function.134,135 Vitamin D sufficiency, adequate dietary calcium and related minerals, and exercise help reduce the risk of falls and fractures.85,136-138 An added benefit is reduced tooth loss.139

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