Insufficient Vitamin D Intake and Low Vitamin D Status in Men Over 80 Y of Age: Intervention is Required To Meet Dietary Targets in Long-Term Care Facilities

Vitamin D is important to bone health. This study examined vitamin D intake and status in institutionalized elderly men in relation to biomarkers of bone metabolism and functional indicators. Materials and Methods: Elderly male veterans were studied in Phase I (n=40) for 16 weeks (April, June, August 2008) and Phase II (n=30) for another 16 weeks (October and December 2008 and February 2009) for dietary vitamin D using 5 day menu selection (Phase I) and using 3×3-d weighed food records (Phase II). Anthropometric data, Mini-Mental State Evaluation (MMSE) scores and sun exposure were collected. Functional capacity was assessed using the Frail Elderly Functional Assessment Tool (FEFA) and handgrip strength. Biochemistry included serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin (OC) and C-terminal telopeptides of Type 1 collagen (CTX). Mixed model ANOVA and Pearson correlations analyses were used. Results: Participants were relatively healthy (Age: 85 ± 3 years (Mean ± SD), BMI: 26.1 ± 4.3 kg/m2, MMSE: 25 ± 5, FEFA: 13 ± 8, grip strength: 22 ± 8 kg). Sixty-six percent (280 ± 120 IU) of the planned dietary vitamin D was consumed. Vitamin D came mainly from fortified milk and meal supplements and 33% took pill supplements (400-800 IU/d). Serum 25(OH) D concentration rose by summer (Phase I: 60.9 ± 24.4, 68.2 ± 24.6 and 76.1 ± 22.4 nmol/L, respectively) and declined thereafter (Phase II: 57.7 ± 24.1, 62.9 ± 30.7 and 61.3 ± 29.2 nmol/L). PTH was lower in spring compared to late summer through winter whereas CTX and OC did not change. Serum 25(OH) D was correlated to BMI, but not to indicators of functional status. Conclusions: In long-term care, vitamin D from foods and supplements fails to meet recommendations of 800 IU (20 μg) for those over 70 y.