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Nutrients
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Calcium, Vitamin D and Aging in Humans
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Calcium, Vitamin D and Aging in Humans

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (5 March 2024) | Viewed by 40844

Special Issue Editors

Prof. Dr. Stefano Gonnelli

E-Mail Website
Guest Editor
Department of Medicine Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
Interests: calcium; vitamin D; metabolic bone diseases; osteoporosis; atherosclerosis; fragility fractures; sarcopenia; aging
Special Issues, Collections and Topics in MDPI journals
Dr. Ligia J. Dominguez

E-Mail Website
Co-Guest Editor
Geriatric Unit, Department of Medicine, University of Palermo, Via del Vespro 141, 90127 Palermo, Italy
Interests: nutrition; aging; type 2 diabetes; Alzheimer; cardiovascular disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is currently a growing awareness that nutritional factors have major impacts on the risk of age-associated chronic non-communicable diseases and mortality. In fact, adult or elderly individuals with inadequate dietary calcium intake or insufficient vitamin D levels have an increased risk of sarcopenia and osteoporosis as a result of the deterioration of musculoskeletal health. Therefore, most older individuals should benefit from vitamin D and calcium supplementation. However, the supplementation with calcium alone produces only a slight reduction in fracture risk, particularly in the elderly. Instead, several studies have shown that vitamin D, when combined with calcium and an adequate compliance, significantly decreases the incidence of hip fractures and other fragility fractures, especially in subjects over the age of 70 and in institutionalized ones. In the elderly, vitamin D supplementations may improve muscle function and decrease the risks of falling. Moreover, Vitamin D may have biological effects well beyond the skeleton, and several studies support an association between low vitamin D concentrations and an increased risk of dementia, diabetes, cancer and infectious diseases. Further well-designed studies are needed to better define the role of vitamin D in the prevention and treatment of these diseases in the elderly.

Prof. Dr. Stefano Gonnelli
Dr. Ligia J. Dominguez
Guest Editors

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Keywords

  • calcium
  • vitamin D
  • micronutrients
  • vitamin
  • mineral
  • osteoporosis
  • bone
  • aging
  • sarcopenia
  • elderly
  • geriatric
  • old age
  • frailty

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Published Papers (9 papers)

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Editorial

Jump to: Research, Review, Other

5 pages, 182 KiB  
Editorial
Calcium, Vitamin D, and Aging in Humans
by Ligia J. Dominguez and Stefano Gonnelli
Nutrients 2024, 16(23), 3974; https://doi.org/10.3390/nu16233974 - 21 Nov 2024
Viewed by 278
Abstract
There is currently a growing awareness that nutritional factors have major impacts on the risk of age-associated chronic non-communicable diseases and mortality [...] Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)

Research

Jump to: Editorial, Review, Other

12 pages, 1702 KiB  
Article
Effect of 2 Years of Monthly Calcifediol Administration in Postmenopausal Women with Vitamin D Insufficiency
by Marco Occhiuto, Jessica Pepe, Luciano Colangelo, Marco Lucarelli, Antonio Angeloni, Luciano Nieddu, Viviana De Martino, Salvatore Minisola and Cristiana Cipriani
Nutrients 2024, 16(11), 1754; https://doi.org/10.3390/nu16111754 - 3 Jun 2024
Cited by 2 | Viewed by 904
Abstract
Background: We assessed the long-term (24 months) efficacy and safety of monthly calcifediol (0.266 mg) in the correction and maintenance of total 25(OH)D levels in postmenopausal women with basal values <30 ng/mL. Methods: We initially enrolled 45 consecutive patients during the period September [...] Read more.
Background: We assessed the long-term (24 months) efficacy and safety of monthly calcifediol (0.266 mg) in the correction and maintenance of total 25(OH)D levels in postmenopausal women with basal values <30 ng/mL. Methods: We initially enrolled 45 consecutive patients during the period September 2019–September 2020. After an initial visit, patients were instructed to return at 3, 6, 9, 12 and 24 months for measuring serum total 25(OH)D, ionised calcium, creatinine and isoenzyme of alkaline phosphatase (bALP). Here, we report only the per-protocol analysis, because the COVID-19 pandemic precluded adherence to the scheduled visits for some patients. Results: The patients’ mean age was 62.4 ± 9.0 years. Mean basal 25(OH)D levels were 20.5 ± 5.3 ng/mL. There was a continuous increase of mean 25(OH)D values (p for trend < 0.001). However, mean values at month 24 (36.7 ± 15.9) were not significantly different in respect to values at month 12 (41.2 ± 11.18). At 24 months, only 1 out 19 patients had a value <20 ng/mL. There was a significant decrease with time of mean values of bALP (p < 0.0216), with no significant changes between 12 and 24 months. No significant changes were observed as far as ionised calcium or creatinine were concerned. Conclusions: The long-term administration of calcifediol maintains stable and sustained 25(OH)D concentrations, with no safety concerns. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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12 pages, 1485 KiB  
Article
Comparative Study of Healthy Older and Younger Adults Shows They Have the Same Skin Concentration of Vitamin D3 Precursor, 7-Dehydrocholesterol, and Similar Response to UVR
by Oktawia Borecka, John J. Dutton, Jonathan C. Y. Tang, William D. Fraser, Ann R. Webb and Lesley E. Rhodes
Nutrients 2024, 16(8), 1147; https://doi.org/10.3390/nu16081147 - 12 Apr 2024
Cited by 2 | Viewed by 1970
Abstract
Vitamin D3 synthesis in human skin is initiated by solar ultraviolet radiation (UVR) exposure of precursor 7-dehydrocholesterol (7DHC), but influence of age on the early stage of vitamin D3 metabolism is uncertain. We performed a prospective standardised study in healthy ambulant [...] Read more.
Vitamin D3 synthesis in human skin is initiated by solar ultraviolet radiation (UVR) exposure of precursor 7-dehydrocholesterol (7DHC), but influence of age on the early stage of vitamin D3 metabolism is uncertain. We performed a prospective standardised study in healthy ambulant adults aged ≥65 and ≤40 years examining (1) if baseline skin 7DHC concentration differs between younger and older adults and (2) the impact of older age on serum vitamin D3 response to solar simulated UVR. Eleven younger (18–40 years) and 10 older (65–89 years) adults, phototype I–III, received low-dose UVR (95% UVA, 5% UVB, 1.3 SED) to ~35% of the body surface area. Biopsies were taken for 7DHC assay from unexposed skin, skin immediately and 24 h post-UVR, and blood sampled at baseline, 24 h and 7 d post-UVR for vitamin D3 assay. Samples were analysed by HPLC-MS/MS. Baseline skin 7DHC (mean ± SD) was 0.22 ± 0.07 and 0.25 ± 0.08 µg/mg in younger versus older adults (no significant difference). Baseline serum vitamin D3 concentration was 1.5 ± 1.5 and 1.5 ± 1.7 nmol/L in younger versus older adults, respectively, and showed a significant increase in both groups post-UVR (no significant differences between age groups). Thus, skin 7DHC concentration was not a limiting factor for vitamin D3 production in older relative to younger adults. This information assists public health guidance on sun exposure/vitamin D nutrition, with particular relevance to the growing populations of healthy ambulant adults ≥65 years. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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Graphical abstract

14 pages, 2188 KiB  
Article
Vitamin D Status among Patients Admitted to a Geriatric Ward—Are Recommendations for Preventing Its Deficiency Effective Enough?
by Maksymilian Adam Lech, Marcin Warpechowski, Aleksandra Wojszel, Justyna Rentflejsz, Marta Świętek and Zyta Beata Wojszel
Nutrients 2024, 16(2), 193; https://doi.org/10.3390/nu16020193 - 6 Jan 2024
Viewed by 3243
Abstract
Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it [...] Read more.
Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7–33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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10 pages, 825 KiB  
Article
Dietary Calcium Intake and Osteoporosis Risk in Arab Adults
by Nasser M. Al-Daghri, Syed Danish Hussain, Abdullah M. Alnaami, Naji Aljohani and Shaun Sabico
Nutrients 2023, 15(13), 2829; https://doi.org/10.3390/nu15132829 - 21 Jun 2023
Cited by 4 | Viewed by 2782
Abstract
Osteoporosis is a major public health concern in Saudi Arabia’s aging population. There is particularly limited information on how diet affects bone loss in this ethnic group. The purpose of this study was to examine the association between dietary calcium (Ca) intake and [...] Read more.
Osteoporosis is a major public health concern in Saudi Arabia’s aging population. There is particularly limited information on how diet affects bone loss in this ethnic group. The purpose of this study was to examine the association between dietary calcium (Ca) intake and osteoporosis risk in Saudi adults. A total of 1950 patients (416 males and 1534 females) with known risk factors for osteoporosis participated in this cross-sectional study. A short questionnaire (CaQ) was used to assess dietary Ca intakes in patients attending tertiary hospitals in Riyadh City. The prevalence of osteoporosis was 21.3% and was more common in females (93.5%). Patients with osteoporosis were older (p < 0.001) and had lower BMI (p < 0.001). Results showed that the overall mean Ca intake was only 445.1 mg/day (recommended dietary intake of 1300 mg/day). Tea intake (OR = 0.8 95%CI: 0.7–1.0; p = 0.02) and consumption of fish and eggs (OR = 0.9 95%CI: 0.8–1.0; p = 0.01) were significantly associated with a lower risk of osteoporosis. Furthermore, consumption of biscuits, cake and bread slices were significantly associated with higher incidence of osteoporosis (OR = 1.3 95%CI: 1.0–1.5; p = 0.02). In conclusion, extremely low dietary Ca intake was observed among Saudi adults already at risk of osteoporosis. A balanced diet including high amount of Ca, vitamin D and omega-3 fatty acids accompanied by limiting consumption of foods high in saturated fats and glycemic index may be helpful in reducing osteoporosis risk in the Saudi adult population. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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Review

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18 pages, 659 KiB  
Review
Nutrition, Vitamin D, and Calcium in Elderly Patients before and after a Hip Fracture and Their Impact on the Musculoskeletal System: A Narrative Review
by Luisella Cianferotti, Giuseppe Bifolco, Carla Caffarelli, Gherardo Mazziotti, Silvia Migliaccio, Nicola Napoli, Carmelinda Ruggiero and Cristiana Cipriani
Nutrients 2024, 16(11), 1773; https://doi.org/10.3390/nu16111773 - 5 Jun 2024
Cited by 1 | Viewed by 2466
Abstract
Hip fractures are a major health issue considerably impacting patients’ quality of life and well-being. This is particularly evident in elderly subjects, in which the decline in bone and muscle mass coexists and predisposes individuals to fall and fracture. Among interventions to be [...] Read more.
Hip fractures are a major health issue considerably impacting patients’ quality of life and well-being. This is particularly evident in elderly subjects, in which the decline in bone and muscle mass coexists and predisposes individuals to fall and fracture. Among interventions to be implemented in hip fractured patients, the assessment and management of nutritional status is pivotal, particularly in subjects older than 65. Nutrition plays a central role in both primary and secondary preventions of fracture. An adequate protein intake improves muscle mass and strength and the intestinal absorption of calcium. Other nutrients with recognized beneficial effects on bone health are calcium, vitamins D, K, and C, potassium, magnesium, folate, and carotenoids. With reference to calcium, results from longitudinal studies showed that the consumption of dairy foods has a protective role against fractures. Moreover, the most recent systematic reviews and meta-analyses and one umbrella review demonstrated that the combination of calcium and vitamin D supplementation significantly reduces hip fracture risk, with presumed higher efficacy in older and institutionalized subjects. Owing to these reasons, the adequate intake of calcium, vitamin D, protein, and other macro and micronutrients has been successfully implemented in the Fracture Liaison Services (FLSs) that represent the most reliable model of management for hip fracture patients. In this narrative review, papers (randomized controlled trials, prospective and intervention studies, and systematic reviews) retrieved by records from three different databases (PubMed, Embase, and Medline) have been analyzed, and the available information on the screening, assessment, and management of nutritional and vitamin D status and calcium intake in patients with hip fractures is presented along with specific prevention and treatment measures. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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20 pages, 1823 KiB  
Review
Vitamin D and Risk of Incident Type 2 Diabetes in Older Adults: An Updated Systematic Review and Meta-Analysis
by Ligia J. Dominguez, Nicola Veronese, Eliana Marrone, Carla Di Palermo, Candela Iommi, Rosaria Ruggirello, Carla Caffarelli, Stefano Gonnelli and Mario Barbagallo
Nutrients 2024, 16(11), 1561; https://doi.org/10.3390/nu16111561 - 22 May 2024
Cited by 2 | Viewed by 4283
Abstract
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin [...] Read more.
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50–60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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26 pages, 778 KiB  
Review
Targeting the Hallmarks of Aging with Vitamin D: Starting to Decode the Myth
by Carmelinda Ruggiero, Laura Tafaro, Luisella Cianferotti, Flavia Tramontana, Ilaria Giovanna Macchione, Carla Caffarelli, Agostino Virdis, Marika Ferracci, Giuseppe Rinonapoli, Patrizia Mecocci, Nicola Napoli and Valeria Calsolaro
Nutrients 2024, 16(6), 906; https://doi.org/10.3390/nu16060906 - 21 Mar 2024
Cited by 4 | Viewed by 22328
Abstract
Aging is the result of several complex and multifactorial processes, where several agents contribute to an increased intrinsic vulnerability and susceptibility to age-related diseases. The hallmarks of aging are a set of biological mechanisms that are finely regulated and strictly interconnected, initiating or [...] Read more.
Aging is the result of several complex and multifactorial processes, where several agents contribute to an increased intrinsic vulnerability and susceptibility to age-related diseases. The hallmarks of aging are a set of biological mechanisms that are finely regulated and strictly interconnected, initiating or contributing to biological changes and anticipating several age-related diseases. The complex network of cellular and intercellular connections between the hallmarks might represent a possible target for the research of agents with pleiotropic effects. Vitamin D (VitD) is known to have a positive impact not only on muscle and bone health but also on several extra-skeletal districts, due to the widespread presence of Vitamin D Receptors (VDRs). VitD and VDR could be molecules potentially targeting the hallmarks of the aging network. To date, evidence about the potential effects of VitD on the hallmarks of aging is scarce in humans and mainly based on preclinical models. Although underpowered and heterogeneous, in-human studies seem to confirm the modulatory effect of VitD on some hallmarks of aging and diseases. However, more investigations are needed to clarify the pleiotropic effects of VitD and its impact on the hallmark of aging, hopefully highlighting the courses for translational applications and potential clinical conclusions. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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Other

9 pages, 523 KiB  
Brief Report
Vitamin D Status in Belgian Children: A Regional Study
by Louise Van de Walle, Yvan Vandenplas, Jaan Toelen and Anke Raaijmakers
Nutrients 2024, 16(5), 657; https://doi.org/10.3390/nu16050657 - 26 Feb 2024
Cited by 2 | Viewed by 1552
Abstract
Background: Vitamin D deficiency is the most frequent cause of impaired skeletal growth, and can lead to the development of nutritional rickets. The aim of this study was to evaluate the vitamin D status in a large group of children aged 0–18 years. [...] Read more.
Background: Vitamin D deficiency is the most frequent cause of impaired skeletal growth, and can lead to the development of nutritional rickets. The aim of this study was to evaluate the vitamin D status in a large group of children aged 0–18 years. Methods: We collected laboratory data on vitamin D levels from children who underwent blood sampling between 2014 and 2021. Results: We included 14,887 samples. In this group, 17.7% were vitamin D severely deficient (<12 ng/mL), 25.2% were insufficient (12–20 ng/mL), and another large proportion (28.3%) was borderline (20–30 ng/mL). Sufficient levels (>30 ng/mL) were met in 28.8% of children. We observed no association between gender and vitamin D status (p = 0.132). Adolescents aged 13–18 years (n = 3342) had the highest prevalence of severe vitamin D deficiency (24.9%). Vitamin D levels were higher in summer/autumn compared to winter/spring. Conclusions: Vitamin D deficiency/insufficiency has a high prevalence in children, mostly in children above 7 years of age. Many of these children (over 80%) do not meet the 30 ng/mL sufficiency threshold. It is essential that Belgian Health Authorities are aware of this high prevalence, as the current Belgian recommendation suggests ceasing vitamin D supplementation at the age of six. Additional research is required to investigate the consequences of our findings, and what specific approach is needed to achieve normal vitamin D levels in children aged 0 to 18 years. Full article
(This article belongs to the Special Issue Calcium, Vitamin D and Aging in Humans)
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