Exercise May Be More Effective Than Vitamin D In Reducing Falls

MedicalResearch.com Interview with:
Kirsti Uusi-Rasi, PhD, Adjunct Professor
Senior Researcher
UKK Institute for Health Promotion Research
Tampere Finland

Medical Research: What is the background for this study? What are the main findings?

Dr. Kirsti Uusi-Rasi: Falls are the leading cause of unintentional injuries and fractures in
older adults, head injuries and fractures being the most severe
consequences. Therefore, falls prevention is important when trying to
prevent injuries. There is strong high-quality evidence from previous
studies that exercise that includes strength and balance training can
reduce the risk of falling in older adults. However, there are also
studies that have reported no benefit in reducing the actual incidence
of falls. Effects of vitamin D have also been studied widely, and
vitamin D is known to be vital for bone metabolism and health.
However, results regarding effects on falls and fractures are
inconsistent. Furthermore, persons with low vitamin D levels (serum
25OHD) have been associated with lower physical performance and
greater decline in physical functioning, but clinical trials exploring
the role of vitamin D in reducing falls and fractures and in improving
physical functioning are inconclusive. Because there is hardly any
evidence about exercise and vitamin D together, we investigated the
separate and combined effects of multimodal exercise training and
vitamin D supplementation in reducing falls and injurious falls among
older women at risk for falling.

We assigned 409 participants randomly to one of four groups with:
1)vitamin D 800 IU/day and exercise
2) placebo and exercise
3) vitamin D 800 IU/day without exercise
4) placebo without exercise.

Exercise consisted of strength, balance, mobility and agility group training.

At the end of two years, exercise seemed to be more effective in
reducing injurious falls in this age group, with or without vitamin D.
Exercise also improved physical functioning (strength, balance and
mobility). In general, the training program was well tolerated with no
severe adverse effects or injuries. Vitamin D helped maintain femoral
neck BMD and increased trabecular bone density at the tibia. Our study
also suggests that the current vitamin D recommendation (800 IU/d for
older people) is adequate.

Medical Research: What should clinicians and patients take away from your report?

Dr. Kirsti Uusi-Rasi: Good physical functioning is important in preventing falls and
injuries in older women. Multimodal exercise including strength and
balance training is essential for improving/maintaining physical
functioning. The current vitamin D recommendation (800 IU/d for older
people) seems to be adequate for maintaining optimal serum vitamin D
levels (25OHD). However, exercise seemed to be more effective in
reducing injurious falls in this age group, with or without vitamin D.
The study strengthens the evidence in favor of the benefits of
exercise. That is why we highly recommend people to keep physically
active.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Kirsti Uusi-Rasi: Effects of vitamin D may be more pronounced in vitamin D deplete
individuals or in institutionalized people. Also, though the effect of
exercise has been reported, there is hardly any evidence on the
effects of vitamin D on falls prevention in men. Future research
could also evaluate the genetic variation in vitamin D modulating genes.

Citation:

 

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MedicalResearch.com Interview with:, & Kirsti Uusi-Rasi, PhD, Adjunct Professo (2015). Exercise May Be More Effective Than Vitamin D In Reducing Falls MedicalResearch.com

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