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Early in the clinical trials testing the ability of vitamin D to prevent fractures, a surprising observation was made. Not only did modest dose vitamin D (700–800 IU D3 daily) dramatically reduce fracture incidence, but amazingly, within a few months of starting the vitamin D the researchers saw a reduction of fracture incidence. The researchers had expected that over time, vitamin D would increase intestinal calcium absorption, reduce bone-depleting parathyroid hormone, and thus reduce fractures — but why did the fracture incidence fall so quickly? This question led to the discovery that vitamin D, the “sunshine vitamin,” has a direct action on muscles. Vitamin D, we now know, directly and quickly enhances muscle mass, strength, and coordination, and it reduces body sway — all of which increase stability and balance. Vitamin D deficiency, on other hand, leads to impaired musculoskeletal functioning and poor coordination, and thus increased falls.
Many studies support the finding that vitamin D supplementation significantly reduces falls. One recent study, in fact, reported a 72% reduction in falls in an elderly population after five months of treatment with 800 IU of vitamin D. Another study observed a 49% reduction in falls among women in geriatric-care facilities using a combination of 800 IU vitamin D3 and 1,200 mg calcium carbonate in comparison to those given just 1,200 mg calcium carbonate alone.
But simply adding vitamin D isn’t the sole factor in preventing falls — muscles that aren’t used won’t grow stronger. And muscle mass and bone mass change together — if your muscles strengthen, so do your bones, but if you lose muscle, you also lose bone. Several studies show that in just ten weeks, weight training undertaken by sedentary elders can increase their muscle mass by 15–20% and can double their muscle strength. Even more, Dr. William Evans working at the Knool Laboratory for Human Performance Research at Penn State University reported that their exercise program has shown that a ninety-five-year-old can become as physically fit as a healthy fifty-year-old, and a sixty-five-year-old as physically fit as a healthy thirty-year-old. This bone–muscle link is made even stronger by data showing that the anti-fracture benefits of strength training persist over time.
But does all this exercise and strength training actually prevent people from falling? Several clinical trials and large meta-analyses document that it does. For example, a New Zealand study of older women and men found that a nurse-delivered home exercise program reduced falls by 46%. In fact, programs developed by physical therapists that targeted fall reduction using strength training in combination with balance enhancement and gait training were perhaps the most effective in significantly reducing falls.
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