Athletic Performance Is Physical Performance

Why is athletic performance medically important? If you think for a minute, you'd realize that athletic performance is the same as physical performance. What happens when physical performance is impaired? People fall and break their hip, resulting in death, disability, or nursing home admission. Many people don't realize how fatal falls can be in the elderly. In 2003, the CDC reported that 13,700 persons over 65 died from falls in the USA, with 1.8 million ending up in emergency rooms for treatment of nonfatal injuries from falls. Falls cause the majority of hip fractures which, if they don't result in death, often result in admission to a nursing home. That's 13,700 deaths, hundreds of thousands of surgeries, countless nursing home admissions, and tens of billions in health care costs every year—all from impaired athletic performance. That's why it matters.  Centers for Disease Control (CDC)Fatalities and injuries from falls among older adults—United States, 1993–2003 and 2001–2005.MMWR Morb Mortal Wkly Rep. 2006 Nov 17;55(45):1221–4.

"Gold Standard" Evidence

The scientific evidence that vitamin D reduces falls in the elderly is quite strong. Despite this, some physicians say they must wait for randomized, placebo controlled, interventional trials. They say they need such "gold standard" evidence before they will act to prevent falls. Here it is:

Four "gold standard" vitamin D studies

1. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. link to study
2. Vitamin D supplementation improves neuromuscular function in older people who fall. link to study
3. Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. link to study
4. A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. link to study

Some say they require a meta-analysis of such "gold standard" studies, from a top-flight university, published in a respected journal. Here it is:

Harvard Meta-analysis published in JAMA

Effect of Vitamin D on falls: a meta-analysis. link to study

Doctors Do What Drug Companies Tell Them

Will these "gold standard" studies prompt physicians to act? Will older patients finally get their vitamin D blood level tested and appropriate treatment of their vitamin D deficiency? No, most will not. I wish physicians acted on scientific studies, but they do not—no matter how many people are dying. Vitamin D scientists conducting such trials are in for a rude surprise. Because no matter how good, well-designed, or meticulously-conducted their studies are, no matter how good the journal, practicing physicians will continue to ignore them. Practicing physicians do what they learned in medical school, what their colleagues do, and what the drug company salespersons tell them. Very few keep abreast of medical research, unless a drug company representative puts that research under their nose.

That's why I wrote about athletic performance. Falling is a failure of athletic performance—anything that improves athletic performance will also reduce deaths from falls.

As far as athletic performance in younger people goes, I certainly got some interesting letters. One guy from Tennessee agreed to list his phone number, in case the press wants to call or come by and watch him do chin-ups.

Reader Response

I hope that's 2,000 units, not 2,000 mg. 2,000 mg would be 80 million units (80,000 1,000 IU tablets). 2,000 IU (.05 mg) per day is enough if you are a small woman who gets some sunlight in the sunnier months. Tell your friends, it might save their lives and that's a better feeling than beating them in tennis.