UPFRONT | Roundup NUTRITION Low vitamin D may increase risk of stress factures: study Experts recommend active individuals who participate in higher impact activities may need to maintain higher vita-min D levels, reports The Journal of Foot & Ankle Surgery. Investigators tested the se-rum concentration of 25(OH) D, which is used to determine vitamin D status, in patients with confirmed stress frac-tures. “By assessing the average serum vitamin D concentra-tions of people with stress fractures and comparing these with the current guidelines, we wanted to encourage a discus-sion regarding whether a higher concentration of serum vitamin D should be recommended for active indi-viduals,” explained lead inves-tigator Jason R. Miller, fellow-ship director of the Pennsylvania Intensive Lower Extremity Fellowship. The investigators reviewed the medical records of patients who experienced lower ex-tremity pain, with a suspected stress fracture, over a three-year period from August 2011 to July 2014. All patients had x-rays of the affected extrem-ity and were then sent for magnetic resonance imaging (MRI) if no acute fracture had been seen, yet concern for the presence of a stress fracture remained based on the physi-cal examination findings. Musculoskeletal radiologists independently reviewed all the MRI scans, and the investiga-tors then confirmed the diag-nosis of a stress fracture after a review of the images. The serum vitamin D level was recorded within three months of diagnosis for 53 (42.74 per cent) of these pa-tients. Using the standards recommended by the Vitamin D Council (sufficient range 40 to 80 ng/mL), more than 80 per cent of these patients would have been classified as having insufficient or deficient vitamin D levels. According to the standards set by the Endo-crine Society (sufficient range 30 to 100 ng/mL), over 50 per cent had insufficient levels. “Based on these findings, we recommend a serum vita-min D level of at least 40 ng/ mL to protect against stress fractures, especially for active individuals who enjoy partici-pating in higher impact activ-ities,” explained Miller. “However, vitamin D is not the sole predictor of a stress fracture and we recommend that individuals who regularly exercise or enjoy participating in higher impact activities should be advised on proper and gradual training regimens to reduce the risk of develop-ing a stress fracture,” he con-cluded. – Newswise www.canadianchiropractor.ca February 2016 Canadian Chiropractor 13
Chiropractic + Naturopathic Doctor February 2016: Page 13
