scholarly journals Assessment of the Methods Used to Develop Vitamin D and Calcium Recommendations—A Systematic Review of Bone Health Guidelines

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2423
Author(s):  
Zhaoli Dai ◽  
Joanne E. McKenzie ◽  
Sally McDonald ◽  
Liora Baram ◽  
Matthew J. Page ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Bone Health ◽  
Calcium Intake ◽  
Guideline Development ◽  
World Health ◽  
Osteoporosis Prevention ◽  
Supplement Use ◽  
Daily Vitamin ◽  
Development Methods

Background: There are numerous guidelines developed for bone health. Yet, it is unclear whether the differences in guideline development methods explain the variability in the recommendations for vitamin D and calcium intake. The objective of this systematic review was to collate and compare recommendations for vitamin D and calcium across bone health guidelines, assess the methods used to form the recommendations, and explore which methodological factors were associated with these guideline recommendations. Methods: We searched MEDLINE, EMBASE, CINAHL, and other databases indexing guidelines to identify records in English between 2009 and 2019. Guidelines or policy statements on bone health or osteoporosis prevention for generally healthy adults aged ≥40 years were eligible for inclusion. Two reviewers independently extracted recommendations on daily vitamin D and calcium intake, supplement use, serum 25 hydroxyvitamin D [25(OH)D] level, and sunlight exposure. They assessed guideline development methods against 25 recommended criteria in the World Health Organization (WHO) handbook for guideline development. Additionally, they identified types of evidence underpinning the recommendations. Results: we included 47 eligible guidelines from 733 records: 74% of the guidelines provided vitamin D (200~600–4000 IU/day) and 70% provided calcium (600–1200 mg/day) recommendations, 96% and 88% recommended vitamin D and calcium supplements, respectively, and 70% recommended a specific 25(OH)D concentration. On average, each guideline met 10 (95% CI: 9–12) of the total of 25 methodological criteria for guideline development recommended by the WHO Handbook. There was uncertainty in the association between the methodological criteria and the proportion of guidelines that provided recommendations on daily vitamin D or calcium. Various types of evidence, including previous bone guidelines, nutrient reference reports, systematic reviews, observational studies, and perspectives/editorials were used to underpin the recommendations. Conclusions: There is considerable variability in vitamin D and calcium recommendations and in guideline development methods in bone health guidelines. Effort is required to strengthen the methodological rigor of guideline development and utilize the best available evidence to underpin nutrition recommendations in evidence-based guidelines on bone health.

scholarly journals Methodological quality of public health guideline recommendations on vitamin D and calcium : a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031840 ◽  
Author(s):  
Zhaoli Dai ◽  
Cynthia M Kroeger ◽  
Sally McDonald ◽  
Matthew J Page ◽  
Joanne E McKenzie ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Vitamin D ◽  
Bone Health ◽  
Methodological Quality ◽  
Guideline Development ◽  
Grey Literature ◽  
Dietary Guidelines ◽  
Published Data

IntroductionCurrent recommendations for vitamin D and calcium in dietary guidelines and bone health guidelines vary significantly among countries and professional organisations. It is unknown whether the methods used to develop these recommendations followed a rigourous process and how the differences in methods used may affect the recommended intakes of vitamin D and calcium. The objectives of this study are (1) collate and compare recommendations for vitamin D and calcium across guidelines, (2) appraise methodological quality of the guideline recommendations and (3) identify methodological factors that may affect the recommended intakes for vitamin D and calcium. This study will make a significant contribution to enhancing the methodological rigour in public health guidelines for vitamin D and calcium recommendations.Methods and analysesWe will conduct a systematic review to evaluate vitamin D and calcium recommendations for osteoporosis prevention in generally healthy middle-aged and older adults. Methodological assessment will be performed for each guideline against those outlined in the 2014 WHO handbook for guideline development. A systematic search strategy will be applied to locate food-based dietary guidelines and bone health guidelines indexed in various electronic databases, guideline repositories and grey literature from 1 January 2009 to 28 February 2019. Descriptive statistics will be used to summarise the data on intake recommendation and on proportion of guidelines consistent with the WHO criteria. Logistic regression, if feasible, will be used to assess the relationships between the methodological factors and the recommendation intakes.Ethics and disseminationEthics approval is not required as we will only extract published data or information from the published guidelines. Results of this review will be disseminated through conference presentations and peer-reviewed publications.PROSPERO registration numberCRD42019126452

scholarly journals A living WHO guideline on drugs to prevent covid-19

BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Meta Analysis ◽  
World Health ◽  
Policy And Practice ◽  
Assessment Development ◽  
Research Priority ◽  
Health Organization ◽  
Almost All ◽  
Drug Interventions

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.

Vitamin D in Basketball Players: Current Evidence and Future Directions

2021 ◽  
pp. 194173812110193
Author(s):  
Emilija Stojanović ◽  
Dragan Radovanović ◽  
Tamara Hew-Butler ◽  
Dušan Hamar ◽  
Vladimir Jakovljević
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Body Composition ◽  
Physical Performance ◽  
Bone Health ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Basketball Players ◽  
Level Of Evidence

Context: Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. Objective: To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. Data Sources: PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. Study Selection: After screening, 15 studies were included in the systematic review and meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. Results: The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% ( P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat ( r = −0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. Conclusion: The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.

scholarly journals Systematic review: associations of calcium intake, vitamin D intake, and physical activity with skeletal outcomes in people with Type 1 diabetes mellitus

2019 ◽  
Vol 56 (10) ◽  
pp. 1091-1102 ◽  
Author(s):  
María Cristina Gil-Díaz ◽  
Jennifer Raynor ◽  
Kimberly O. O’Brien ◽  
George J. Schwartz ◽  
David R. Weber
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Systematic Review ◽  
Vitamin D ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Calcium Intake ◽  
Vitamin D Intake

Vitamin D supplementation for bone health in adults with epilepsy: A systematic review

Epilepsia ◽  
2018 ◽  
Vol 59 (4) ◽  
pp. 885-896 ◽  
Author(s):  
Haya Fernandez ◽  
Heba Tallah Mohammed ◽  
Tejal Patel
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Bone Health ◽  
Vitamin D Supplementation

scholarly journals Bone Health in Athletes

2016 ◽  
Vol 9 (2) ◽  
pp. 108-117 ◽  
Author(s):  
Marci A. Goolsby ◽  
Nicole Boniquit
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Female Athlete ◽  
Early Recognition ◽  
Critical Factor ◽  
Female Athlete Triad ◽  
Osteoporosis Prevention ◽  
Level Of Evidence ◽  
Bone Stress ◽  
Prevention And Treatment

Context: The health of the skeletal system is important for athletes young and old. From the early benefits of exercise on bones to the importance of osteoporosis prevention and treatment, bone health affects the ability to be active throughout life. Evidence Acquisition: PubMed articles dating from 1986 to 2016 were used for the review. Relevant terms such as keywords and section titles of the article were searched and articles identified were reviewed for relevance to this article. Study Design: Clinical review. Level of Evidence: Levels 1 through 4 evidence included. Results: There is strong evidence that exercise benefits bone health at every age and is a critical factor in osteoporosis prevention and treatment. Vitamin D, calcium, and hormones play vital roles in ensuring optimal bone health. When there is an imbalance between exercise and nutrition, as seen in the female athlete triad, bone health is compromised and can lead to bone stress injuries and early osteoporosis. Both of these can lead to morbidity and lost time from training and competition. Thus, early recognition and appropriate treatment of the female athlete triad and other stress fracture risk factors are vital to preventing long-term bone health problems. Conclusion: To optimize bone health, adequate nutrition, appropriate weightbearing exercise, strength training, and adequate calcium and vitamin D are necessary throughout life.

scholarly journals Dietary Calcium Intake, Vitamin D Status, and Bone Health in Postmenopausal Women in Rural Pakistan

2011 ◽  
Vol 29 (5) ◽  
Author(s):  
Nicola M Lowe ◽  
Basma Ellahi ◽  
Qudsia Bano ◽  
Sonia Ali Bangash ◽  
Soma R Mitra ◽  
...  
Keyword(s):  
Vitamin D ◽  
Postmenopausal Women ◽  
Bone Health ◽  
Calcium Intake ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
Vitamin D Status ◽  
Rural Pakistan

scholarly journals The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Leila Nikniaz ◽  
Mohammad Amin Akbarzadeh ◽  
Hossein Hosseinifard ◽  
Mohammad-Salar Hosseini
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
World Health ◽  
Ordinal Scale ◽  
Cochrane Library

Background: Several studies have suggested the positive impact of vitamin D on patients infected with SARS-CoV-2. This systematic review aims to evaluate the effects of vitamin D supplementation on clinical outcomes and mortality rate of COVID-19 patients. Methods: A comprehensive search was conducted through the databases of PubMed, Scopus, Web of Knowledge, Embase, Ovid, and The Cochrane Library without time and language limitation, until December 16, 2020. The results were screened, and the outcomes of interest were extracted. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, the remaining results were appraised critically. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA) software version 2.0. Results: Of the 2311 results, four studies and 259 patients were enrolled, including 139 patients in vitamin D intervention groups. The pooled analysis of three studies, reporting the patients’ survival and mortality rate, showed a significantly lower mortality rate among the intervention groups compared with the control groups (OR=0.264, 95% CI=0.099–0.708, p-value=0.008). Two of the studies reported the clinical outcomes based on the World Health Organization’s Ordinal Scale for Clinical Improvement (OSCI) score for COVID-19, where both of them showed a significant decrease in OSCI score in the vitamin D intervention groups. One study reported a lower rate of intensive care unit (ICU) admission, and one study reported a significant decrease in serum levels of Fibrinogen. Conclusion: Prescribing vitamin D supplementation to patients with COVID-19 infection seems to decrease the mortality rate, the severity of the disease, and serum levels of the inflammatory markers. Further studies are needed to determine the ideal type, dosage, and duration of supplementation.

scholarly journals Nutrition and osteoporosis prevention and treatment

2020 ◽  
Vol 7 (4) ◽  
pp. 3709-3720
Author(s):  
Jalal Hejazi ◽  
Ali Davoodi ◽  
Mohammadreza Khosravi ◽  
Meghdad Sedaghat ◽  
Vahideh Abedi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Mass ◽  
Vitamin K ◽  
Significant Role ◽  
Bone Health ◽  
The Elderly ◽  
Calcium Deficiency ◽  
Osteoporosis Prevention ◽  
Prevention And Treatment ◽  
Good Nutrition

Introduction: Osteoporosis falls among the major general health issues, specifically in the elderly, and is a widespread disease these days. According to various studies, good nutrition plays a significant role in osteoporosis prevention and treatment. The aim of this study was to conduct an extensive literature review on the effects of different nutrients to understand how macronutrients, micronutrients, and non-nutritive substances affect bone health. Methodology: To find relevant studies, the main keyword “osteoporosis” was searched in combination with “zinc,” “vitamin K,” “phosphorus,” “vitamin D,” “calcium,” “lipid,” “protein,” and “phytoestrogens” in PubMed (MEDLINE), Web of Science, SID, and Iran Medex databases. Findings: The most important element for bone health is calcium, which has a direct link to the bone mass density (BMD). In the case of calcium deficiency, high phosphorus content can damage bone tissue. The acceptable ratio of phosphorus to calcium is 0.5-1.5:1. Vitamin D is another important nutrient for bones; serum levels of vitamin D less than 20 ng/ml reduce bone density and increase the risk of fracture. High protein intake results in calcium excretion and loss of bone mass. In addition, calcium deficiency increases the risk of osteoporosis, specifically in the elderly. According to the literature, there is an inverse correlation between saturated fats and BMD. Vitamin K and magnesium deficiencies are correlated with BMD reduction and increased risk of osteoporosis. Copper and zinc are used as co-factors in the formation of collagen and elastin, and in mineralization of bone. As a result, deficiency of these elements may disrupt the process of incorporating minerals into the bone matrix. Conclusion: Good nutrition may play a significant role in osteoporosis prevention and treatment. Indeed, a healthy diet containing calcium (1,200 mg/day); vitamin D (600 IU); and certain amounts of protein, magnesium, and vitamin K can contribute greatly to bone health.

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