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Insufficient vitamin D levels tied to earlier death in older men
Insufficient vitamin D levels were linked to earlier death in older men living in Thailand, according to findings published in Geriatrics and Gerontology International.
“A body of evidence has been accumulating about vitamin D status and multiple health outcomes, including falls, fractures, cancer, cardiometabolic diseases and mortality. The literature on the effect of vitamin D on mortality, however, remains inconsistent,” Varalak Srinonprasert, MD, an associate professor in the department of medicine at Siriraj Hospital, Mahidol University in Bangkok, and colleagues wrote.
Researchers analyzed survey data from 2008 in 1,268 older adults (median age, 74 years) from a national database in Thailand, then linked the information to a 2015 vital registry.
They found 24.5% of the men and 43.9% of the women had insufficient vitamin D levels, but the low levels were only significantly associated with all-cause mortality in men (adjusted HR = 1.77; 95% CI, 1.25-2.51). In addition, diabetes was a modifier effect in men with diabetes who had insufficient vitamin D levels (HR = 3.34; 95% CI, 1.76-6.33).
“Most [previous] studies focused on [vitamin D insufficiency] and diabetic control or the risk of having concurrent cardiovascular diseases, whereas limited study explored the risk of death among diabetes patients with [vitamin D insufficiency],” Srinonprasert and colleagues wrote.
“Unfortunately, data on the specific cause of death were not available in the analysis of the present study. It was, thus, impossible to prove whether the increased mortality with vitamin D deficiency was related to cardiovascular mortality or not. Although the present study reported a fairly low prevalence of self-reported cardiovascular diseases, it is likely to be a reporting bias.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.
Perspective
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This is another study that shows a likely relationship between low blood levels of vitamin D and earlier death. Srinonprasert and colleagues specifically showed a correlation between elderly men in Thailand who had insufficient vitamin D blood levels and how they were more likely to die of any cause. As vitamin D levels were lower, the increase of dying increased. Interestingly, it did not show the same results for elderly Thai women.
While this study has some limitations and was specific to elderly men and women in Thailand, it adds to our knowledge that vitamin D is an important vitamin, or more accurately a pre-hormone. Vitamin D has been prominent in health news the past several years for good reason. It is needed for us to absorb calcium. It also plays an important role in our immune systems. In fact, research points to a lower risk of some solid tumors, notably of the breast, prostate and colon, with adequate vitamin D levels. I have had dozens of patients tell me they no longer get colds like they used to in the winter or their muscles don’t ache like they did before they found out they were very low in vitamin D and then started to a D3 supplement.
My take on all this is that, yes, vitamin D is important and that many people are deficient for various reasons, including living in a cold climate, not getting enough sensible sun exposure, wearing sunscreen (which blocks our body’s ability to make this pre-hormone) and being overweight or obese, since these lead to lower D levels. With overweight and obesity, which is now almost 70% of the U.S. population, the vitamin D gets stored in our fat cells leaving less circulating in the blood. I regularly see patients who have insufficient vitamin D levels and then are placed on vitamin D supplementation. Vitamin D supplements are usually recommended since it is very hard to get enough from food alone, even with fortified foods. We don’t want to increase our exposure of skin cancer either, so sunblock is prudent, but this too can contribute to lower than desired vitamin D levels.
The flip side of this is vitamin D has not exactly turned out to be the cure-all that it has been portrayed or perhaps hoped it would be. It is important to remember that vitamin D is just one of 13 essential vitamins our bodies need for optimal health. If we are deficient in any one of these, our bodies can’t run well. It is like a car with plenty of gasoline or electricity but not enough oil. It can run, but how long before problems arise? Surely vitamin D is important and, yes, we should look at our blood levels if we suspect a deficiency. It can make a difference in our health, just like so many other nutrients can too.