Sports Medicine

, Volume 43, Issue 7, pp 601–611 | Cite as

Vitamin D and Physical Performance

  • Daniel S. Moran
  • James P. McClung
  • Tal Kohen
  • Harris R. Lieberman
Review Article

Abstract

Vitamin D is an essential nutrient obtained from the diet and exposure to sunlight. Roles for vitamin D have been established in the function of the cardiovascular, immune, and musculoskeletal systems. An electronic database search was conducted using EMBASE (1967 to August 2012), MEDLINE (1966 to August 2012), SPORTDiscus™ (1975 to August 2012), and the Scientific Electronic Library Online (SciELO) (1998 to August 2012) with no limits of language of publication. Articles that described vitamin D and performance were considered eligible for this review. Recent studies suggest that vitamin D maintains physical performance in athletes and other active populations, e.g., maximal oxygen consumption may be related to vitamin D status. Poor vitamin D status affects muscle strength, and vitamin D may participate in protein synthesis through the actions of the vitamin D receptor in muscle tissue. Vitamin D may protect against overuse injuries, such as stress fracture, through its well-documented role in calcium metabolism. The objective of this manuscript is to review recent evidence regarding the importance of vitamin D for maintaining physical performance, and includes specific examples of how vitamin D supports the cardiovascular, immune, and musculoskeletal systems.

Notes

Acknowledgments

This research was supported in part by an appointment to the Research Participation Program at the US Army Medical Research Institute of Environmental Medicine administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and US Army Medical Research and Materiel Command. The authors are aware of no conflicts of interest that are directly relevant to the content of this review.

References

  1. 1.
    Udowenko M, Trojian T. Vitamin D: extent of deficiency, effect on muscle function, bone health, performance, and injury prevention. Conn Med. 2010;74(8):477–80.PubMedGoogle Scholar
  2. 2.
    Hamilton B. Vitamin D: and human skeletal muscle. Scand J Med Sci Sports. 2010;20(2):182–90.PubMedGoogle Scholar
  3. 3.
    Cannell JJ, Hollis BW, Zasloff M, et al. Diagnosis and treatment of vitamin D deficiency. Expert Opin Pharmacother. 2008;9:107–18.PubMedGoogle Scholar
  4. 4.
    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.PubMedGoogle Scholar
  5. 5.
    Cannell JJ, Hollis BW, Sorenson MB, et al. Athletic performance and vitamin D. Med Sci Sports Exerc. 2009;41(5):1102–10.PubMedGoogle Scholar
  6. 6.
    Halliday TM, Peterson NJ, Thomas JJ, et al. Vitamin D status relative to diet, lifestyle, injury, and illness in college athletes. Med Sci Sports Exerc. 2011;43(2):335–43.PubMedGoogle Scholar
  7. 7.
    Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S–88S.PubMedGoogle Scholar
  8. 8.
    Matsuoka LY, Ide L, Wortsman J, et al. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab. 1987;64(6):1165–8.PubMedGoogle Scholar
  9. 9.
    Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab. 2004;89(3):1196–9.PubMedGoogle Scholar
  10. 10.
    Snijder MB, van Dam RM, Visser M, et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population based study in older men and women. J Clin Endocrinol Metab. 2005;90(7):4119–23.PubMedGoogle Scholar
  11. 11.
    Webb AR. Who, what, where and when-influences on cutaneous vitamin D synthesis. Prog Biophys Mol Biol. 2006;92(1):17–25.PubMedGoogle Scholar
  12. 12.
    Houston DK, Cesari M, Ferrucci L, et al. Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2007;62(4):440–6.PubMedGoogle Scholar
  13. 13.
    Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr. 2003;89(5):552–72.PubMedGoogle Scholar
  14. 14.
    Bartoszewska M, Kamboj M, Patel DR. Vitamin D, muscle function, and exercise performance. Pediatri Clin North Am. 2010;57(3):849–61.Google Scholar
  15. 15.
    Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med. 2008;29(6):361–8.PubMedGoogle Scholar
  16. 16.
    Hutchinson MS, Grimnes G, Joakimsen RM, et al. Low serum 25-hydroxyvitamin D levels are associated with increased all-cause mortality risk in a general population: the Tromso study. Eur J Endocrinol. 2010;162(5):935–42.PubMedGoogle Scholar
  17. 17.
    Melamed ML, Michos ED, Post W, et al. 25-Hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008;168(15):1629–37.PubMedGoogle Scholar
  18. 18.
    Verstuyf A, Carmeliet G, Bouillon R, et al. Vitamin D: a pleiotropic hormone. Kidney Int. 2010;78(2):140–5.PubMedGoogle Scholar
  19. 19.
    Ceglia L. Vitamin D and skeletal muscle tissue and function. Mol Aspects Med. 2008;29(6):407–14.PubMedGoogle Scholar
  20. 20.
    Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Larsen PR, Kronenberg HM, Melmed S, et al., editors. Williams textbook of endocrinology. 10th ed. Philadelphia: Saunders; 2003. p. 1317–20.Google Scholar
  21. 21.
    McClung JP, Karl JP. Vitamin D and stress fracture: the contribution of vitamin D receptor gene polymorphisms. Nutr Rev. 2010;68(6):365–9.PubMedGoogle Scholar
  22. 22.
    Norman AW. Intestinal calcium absorption: a vitamin D-hormone-mediated adaptive response. Am J Clin Nutr. 1990;51:290–300.PubMedGoogle Scholar
  23. 23.
    Fleet JC, Eksir F, Hance KW, et al. Vitamin D-inducible calcium transport and gene expression in three Caco-2 cell lines. Am J Physiol Gastrointest Liver Physiol. 2002;283:G618–25.PubMedGoogle Scholar
  24. 24.
    Heaney RP. Vitamin D and calcium interactions: functional outcomes. Am J Clin Nutr. 2008;88(2):S541–4.Google Scholar
  25. 25.
    Larson-Meyer DE, Willis KS. Vitamin D and athletes. Curr Sports Med Rep. 2010;9(4):220–6.PubMedGoogle Scholar
  26. 26.
    Need AG, Horowitz M, Morris HA, et al. Vitamin D status: effects on parathyroid hormone and 1,25-dihydroxyvitamin D in postmenopausal women. Am J Clin Nutr. 2000;71:1577–81.PubMedGoogle Scholar
  27. 27.
    Cranney A, Weiler HA, O’Donnell S, et al. Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health. Am J Clin Nutr. 2008;88(2):S513–9.Google Scholar
  28. 28.
    Pfeifer M, Begerow B, Minne HW. Vitamin D and muscle function. Osteoporos Int. 2002;13(3):187–94.PubMedGoogle Scholar
  29. 29.
    Hopkinson NS, Li KW, Kehoe A, et al. Vitamin D receptor genotypes influence quadriceps strength in chronic obstructive pulmonary disease. Am J Clin Nutr. 2008;87:385–90.PubMedGoogle Scholar
  30. 30.
    Berchtold M, Brinkmeirer H, Muntener M. Calcium ion in skeletal muscle: its crucial role for muscle function, plasticity, and disease. Physiol Rev. 2000;80:1215–65.PubMedGoogle Scholar
  31. 31.
    Berg U, Gustafsson T, Sundberg C, et al. Interstitial IGF-1 in exercising skeletal muscle in women. Eur J Endocrinol. 2007;157:427–35.PubMedGoogle Scholar
  32. 32.
    Baxter RC. Insulin-like growth factor (IGF)-binding proteins: interactions with IGF’s and intrinsic bioactivities. Am J Physiol Endocrinol Metab. 2000;278:E967–76.PubMedGoogle Scholar
  33. 33.
    Peng L, Malloy P, Feldman D. Identification of a functional vitamin d response element in the human insulin-like growth factor binding protein-3 promoter. Mol Endocrinol. 2004;18:1109–19.PubMedGoogle Scholar
  34. 34.
    Liao L, Chen X, Wang S, et al. Steroid receptor coactivator 3 maintains circulating insulin-like growth factor 1 (IGF-1) by controlling IGF-binding protein 3 expression. Mol Cell Biol. 2008;28:2460–9.PubMedGoogle Scholar
  35. 35.
    Malabanan A, Veronikis I, Holick M. Redefining vitamin D insufficiency. Lancet. 1998;351:805–6.PubMedGoogle Scholar
  36. 36.
    Dawson-Hughes B, Heaney R, Holick M, et al. Estimates of optimal vitamin D status. Osteoporos Int. 2005;16:713–6.PubMedGoogle Scholar
  37. 37.
    Bischoff-Ferrari H, Giovannucci E, Willett W, et al. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMedGoogle Scholar
  38. 38.
    Bischoff-Ferrari H, Dawson-Hughes B. Where do we stand on vitamin D? Bone. 2007;41:S13–9.PubMedGoogle Scholar
  39. 39.
    Hansen K, Jones A, Lindstrom M, et al. Vitamin D insufficiency: disease or no disease? J Bone Miner Res. 2008;23:1052–60.PubMedGoogle Scholar
  40. 40.
    Holick M. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79:362–71.PubMedGoogle Scholar
  41. 41.
    Binkley N, Novotny R, Krueger D, et al. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. 2007;92:2130–5.PubMedGoogle Scholar
  42. 42.
    Nowson CA, Margerison C. Vitamin D intake and vitamin D status of Australians. Med J Aust. 2002;177:149–52.PubMedGoogle Scholar
  43. 43.
    Gordon C, DePeter K, Feldman H, et al. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 2004;158:531–7.PubMedGoogle Scholar
  44. 44.
    Hashemipour S, Larijani B, Adibi H, et al. Vitamin D deficiency and causative factors in the population of Tehran. BMC Publ Health. 2004;4:38–44.Google Scholar
  45. 45.
    Andersen R, Molgaard C, Skovgaard L, et al. Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr. 2005;59(4):533–41.PubMedGoogle Scholar
  46. 46.
    Rockell J, Green T, Skeaff C, et al. Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5–15 y. J Nutr. 2005;135:2602–8.PubMedGoogle Scholar
  47. 47.
    Hannan MT, Litman HJ, Araujo AB, et al. Serum 25-hydroxyvitamin D and bone mineral density in a racially and ethnically diverse group of men. J Clin Endocrinol Met. 2008;93:40–6.Google Scholar
  48. 48.
    Fonseca V, Tongia R, El-Hazmi M, et al. Exposure to sunlight and vitamin D deficiency in Saudi Arabian women. Postgrad Med J. 1984;60:589–91.PubMedGoogle Scholar
  49. 49.
    Hatun S, Islam O, Cizmecioglu F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 2005;135:218–22.PubMedGoogle Scholar
  50. 50.
    Allali F, El Aichaoui S, Saoud B, et al. The impact of clothing style on bone mineral density among post menopausal women in Morocco: a case-control study. Biomed Central Publ Health. 2006;6:1–6.Google Scholar
  51. 51.
    Zadshir A, Tareen N, Pan D, et al. The prevalence of hypovitaminosis D among US adults: data from the NHANES III. Ethn Dis. 2005;15(4 Suppl 5):S97–S101.Google Scholar
  52. 52.
    Van Demark RE 3rd, Allard B, Van Demark RE Jr. Nonunion of a distal tibial stress fracture associated with vitamin D deficiency: a case report. S D Med. 2010;63(3):87–93.Google Scholar
  53. 53.
    Glerup H, Mikkelsen K, Poulsen L, et al. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Intl. 2000;66:419–24.Google Scholar
  54. 54.
    Bischoff HA, Stahelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003;18(2):343–51.Google Scholar
  55. 55.
    Bischoff-Ferrari HA, Dietrich T, Orav EJ, et al. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr. 2004;80(3):752–8.PubMedGoogle Scholar
  56. 56.
    Wicherts IS, van Schoor NM, Boeke AJ, et al. Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007;92(6):2058–65.PubMedGoogle Scholar
  57. 57.
    Bartali B, Frongillo EA, Guralnik JM, et al. Serum micronutrient concentrations and decline in physical function among older persons. JAMA. 2008;299(3):308–15.PubMedGoogle Scholar
  58. 58.
    Ardestani A, Parker B, Mathur S, et al. Relation of vitamin D level to maximal oxygen uptake in adults. Am J Cardiol. 2011;107(8):1246–9.PubMedGoogle Scholar
  59. 59.
    Giovannucci E, Liu Y, Hollis BW, et al. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174–80.PubMedGoogle Scholar
  60. 60.
    Dobnig H, Pilz S, Scharnagl H, et al. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168:1340–9.PubMedGoogle Scholar
  61. 61.
    Autier P, Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167:1730–7.PubMedGoogle Scholar
  62. 62.
    Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2007;167:1159–65.PubMedGoogle Scholar
  63. 63.
    Gouni-Berthold I, Krone W, Berthold HK. Vitamin D and cardiovascular disease. Curr Vasc Pharmacol. 2009;7:414–22.PubMedGoogle Scholar
  64. 64.
    Bruce RA, Kusumi F, Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J. 1973;85:546–62.PubMedGoogle Scholar
  65. 65.
    Lyerly GW, Sui X, Lavie CJ, et al. The association between cardiorespiratory fitness and risk of all-cause mortality among women with impaired fasting glucose or undiagnosed diabetes mellitus. Mayo Clin Proc. 2009;84:780–6.PubMedGoogle Scholar
  66. 66.
    Mowry DA, Costello MM, Heelan KA. Association among cardiorespiratory fitness, body fat, and bone marker measurements in healthy young females. J Am Osteopath Assoc. 2009;109:534–9.PubMedGoogle Scholar
  67. 67.
    Lovell G, Vitamin D. Status of females in an elite gymnastics program. Clinical J Sport Med. 2008;18:159–61.Google Scholar
  68. 68.
    Gannagé-Yared MH, Chemali R, Sfeir C, et al. Dietary calcium and vitamin D intake in an adult Middle Eastern population: food sources and relation to lifestyle and PTH. Int J Vitam Nutr Res. 2005;75(4):281–9.PubMedGoogle Scholar
  69. 69.
    Glerup H, Mikkelsen K, Poulsen L, et al. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Int. 2000;66:419–24.PubMedGoogle Scholar
  70. 70.
    Bischoff-Ferrari HA, Borchers M, Gudat F, et al. Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res. 2004;19:265–9.Google Scholar
  71. 71.
    Maimoun L, Manetta J, Couret I, et al. The intensity level of physical exercise and the bone metabolism response. Int J Sports Med. 2006;27(2):105–11.PubMedGoogle Scholar
  72. 72.
    Bischoff-Ferrari HA. Vitamin D and fracture prevention. Endocrinol Metab Clin North Am. 2010;39(2):347–53.Google Scholar
  73. 73.
    Mingrone G, Greco A, Castagneto M, et al. A woman who left her wheelchair. Lancet. 1999;353:806.PubMedGoogle Scholar
  74. 74.
    Prabhala A, Garg R, Dandona P. Severe myopathy associated with vitamin D deficiency in Western New York. Arch Intern Med. 2000;160:1199–203.PubMedGoogle Scholar
  75. 75.
    Wang Y, Deluca HF. Is the vitamin D receptor found in muscle? Endocrinology. 2011;152(2):354–63.Google Scholar
  76. 76.
    Marantes I, Achenbach SJ, Atkinson EJ, et al. Is vitamin D a determinant of muscle mass and strength? J Bone Miner Res. 2011;26(12):2860–71.PubMedGoogle Scholar
  77. 77.
    McGrath JJ, Feron FP, Burne TH, et al. Vitamin D3-implications for brain development. J Steroid Biochem Mol Biol. 2004;89–90(1–5):557–60.PubMedGoogle Scholar
  78. 78.
    Eyles DW, Smith S, Kinobe R, et al. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat. 2005;29(1):21–30.PubMedGoogle Scholar
  79. 79.
    Dhesi JK, Jackson SH, Bearne LM, et al. Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing. 2004;33(6):589–95.PubMedGoogle Scholar
  80. 80.
    Dusso AS, Brown AJ, Slatopolsky E. Vitamin D. Am J Physiol Renal Physiol. 2005;289(1):F8–28.PubMedGoogle Scholar
  81. 81.
    Andersen NE, Karl JP, Cable SJ, et al. Vitamin D status in female military personnel during combat training. J Int Soc Sports Nutr. 2010;7:38.PubMedGoogle Scholar
  82. 82.
    Ruohola J, Laaksi I, Ylikomi T, et al. Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. J Bone Miner Res. 2006;21:1483–8.PubMedGoogle Scholar
  83. 83.
    Lappe J, Cullen D, Haynatzki G, et al. Calcium and vitamin D supplementation decreases incidence of stress fractures in female navy recruits. J Bone Miner Res. 2008;23:741–9.PubMedGoogle Scholar
  84. 84.
    Court-Brown CM. Fractures of the tibia and fibula. In: Bucholz RW, Heckman JD, editors. Rockwood and Green’s fractures in adults. 5th ed, vol. 2. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 1939–2000.Google Scholar
  85. 85.
    Trafton PG. Tibial shaft fractures. In: Browner BD, Levine AM, Jupiter JB, Trafton PG, editors. Skeletal trauma. 3rd ed. Philadelphia: Elsevier Saunders; 2003. p. 2131–255.Google Scholar
  86. 86.
    Moran DS, Finestone A, Arbel Y, et al. Simplified model to predict stress fracture in young elite combat recruits. J Strength Cond Res. 2012;26:2585–92.PubMedGoogle Scholar
  87. 87.
    Daffner RH, Pavlov H. Stress fractures: current concepts. AJR. 1992;159:245–52.PubMedGoogle Scholar
  88. 88.
    Devas MB. Stress fractures of the tibia in athletes or “shin soreness”. J Bone Joint Surg Br. 1958;40B(2):227–39.Google Scholar
  89. 89.
    Moran DS, Evans R, Arbel Y, et al. Physical and psychological stressors linked with stress fractures in recruit training. Scand J Med Sci Sports. 2011. doi:10.1111/j.1600-0838.2011.01420.x.PubMedGoogle Scholar
  90. 90.
    Hoffman JR, Chapnik L, Shamiss A, et al. The effect of strength and endurance on the incidence of lower extremity overuse injuries during military training. Mil Med. 1999;164:153–6.PubMedGoogle Scholar
  91. 91.
    Devas MB. Stress fractures. London: Churchill Livingstone; 1975.Google Scholar
  92. 92.
    Jones BH, Thacker SB, Gilchrist J, et al. Prevention of lower extremity stress fractures in athletes and soldiers: a systematic review. Epidemiol Rev. 2002;24:228–47.PubMedGoogle Scholar
  93. 93.
    Friedl KE, Evans RK, Moran DS. Stress fracture and military medical readiness: bridging basic and applied research. Med Sci Sports Exerc. 2008;40(11 Suppl):S609–22.PubMedGoogle Scholar
  94. 94.
    Willis KS, Vitamin D. Status and immune system biomarkers in athletes. Laramie: University of Wyoming; 2008. p. 85.Google Scholar
  95. 95.
    Laaksi I, Ruohola JP, Tuohimaa P, et al. An association of serum vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr. 2007;86:714–7.PubMedGoogle Scholar
  96. 96.
    Cox AJ, Gleeson M, Pyne DB, et al. Clinical and laboratory evaluation of upper respiratory symptoms on elite athletes. Clin J Sport Med. 2008;18(5):438–45.PubMedGoogle Scholar
  97. 97.
    Reis JP, Mühlen D, Miller ER III, et al. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics. 2009;124(3):e371–9.PubMedGoogle Scholar
  98. 98.
    Allen R, Cureton T. Effects of ultraviolet radiation on physical fitness. Arch Phys Med. 1945;26:641–4.PubMedGoogle Scholar
  99. 99.
    Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142–52.PubMedGoogle Scholar
  100. 100.
    Lehmann G. Significance of certain wave lengths for increased efficacy of ultraviolet irradiation (in German). Strahlentherapie. 1954;95(3):447–53.PubMedGoogle Scholar
  101. 101.
    McKinney K, Breitkopft CR, Berenson AB. Association of race, body fat, and season with vitamin D status among young women: a cross sectional study. Clin Endocrinol. 2008;69:535–41.Google Scholar
  102. 102.
    Erikssen J, Rodahl K. Seasonal variation in work performance and heart rate response to exercise: a study of 1,835 middle-aged men. Eur J Appl Physiol Occup Physiol. 1979;42:133–40.PubMedGoogle Scholar
  103. 103.
    Svedenhag J, Sjodin B. Physiological characteristics of elite male runners in and off-season. Can J Appl Sport Sci. 1985;10(3):127–33.PubMedGoogle Scholar
  104. 104.
    Svartberg J, Jorde R, Sundsfjord J, et al. Seasonal variation of testosterone and waist to hip ratio in men: the Tromso study. J Clin Endocrinol Metab. 2003;88(7):3099–104.PubMedGoogle Scholar
  105. 105.
    Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–64.Google Scholar
  106. 106.
    Izaks GJ. Fracture prevention with vitamin D supplementation: considering the inconsistent results. BMC Musculoskelet Disord. 2007;8:26.PubMedGoogle Scholar
  107. 107.
    Tenforde AS, Sayres LC, Sainani KL, et al. Evaluating the relationship of calcium and vitamin D in the prevention of stress fracture injuries in the young athlete: a review of the literature. PM R. 2010;2(10):945–9.Google Scholar
  108. 108.
    Valimaki VV, Alfthan H, Lehmuskallio E, et al. Vitamin D status as a determinant of peak bone mass in young Finnish men. J Clin Endocrinol Metab. 2004;89(1):76–80.PubMedGoogle Scholar
  109. 109.
    Priemel M, von Domarus C, Klatte TO, et al. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res. 2010;25(2):305–12.PubMedGoogle Scholar
  110. 110.
    El-Hajj G, Nabulsi M, Tamim H, et al. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. J Clin Endocrinol Metab. 2006;91:405–12.Google Scholar
  111. 111.
    Bischoff-Ferrari HA, Dietrich T, Orav EJ, et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004;116:634–9.PubMedGoogle Scholar
  112. 112.
    Givon U, Friedman E, Reiner A, et al. Stress fractures in the Israeli defense forces from 1995 to 1996. Clin Orthop Relat Res. 2000;373:227–32.Google Scholar
  113. 113.
    Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington: National Academy Press; 1997.Google Scholar
  114. 114.
    Ruffing J, Cosman F, Zion M, et al. Determinants of bone mass and bone size in a large cohort of physically active young adult men. Nutr Metab (Lond). 2006;3:14.Google Scholar
  115. 115.
    Turkbey EB, Jorgensen NW, Johnson WC, et al. Physical activity and physiological cardiac remodelling in a community setting: the Multi-Ethnic Study of Atherosclerosis (MESA). Heart. 2010;96:42–8.PubMedGoogle Scholar
  116. 116.
    Haggmark T, Eriksson E. Hypotrophy of the soleus muscle in man after Achilles tendon rupture. Discussion of findings obtained by computed tomography and morphologic studies. Am J Sports Med. 1979;7:121–6.PubMedGoogle Scholar
  117. 117.
    Whaley MH, Kampert JB, Kohl HW III, et al. Physical fitness and clustering of risk factors associated with the metabolic syndrome. Med Sci Sports Exerc. 1999;31:287–93.PubMedGoogle Scholar
  118. 118.
    Aloia JF, Li-Ng M. Re: epidemic influenza and vitamin D. Epidemiol Infect. 2007;135(7):1095–6.PubMedGoogle Scholar
  119. 119.
    Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134:1129–40.PubMedGoogle Scholar
  120. 120.
    Sabetta JR, DePetrillo P, Cipriani RJ, et al. Serum 25-hydroxyvitamin D and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010;5(6):e11088.PubMedGoogle Scholar
  121. 121.
    Ross AC, Taylor CL, Yaktine AL, et al. editors. Dietary reference intakes for calcium and vitamin D. Washington (DC): Food and Nutrition Board, Institutes of Medicine; 2010. p. 483.Google Scholar
  122. 122.
    Lenville J. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr. 2008;88(Suppl):582S–6S.Google Scholar
  123. 123.
    Barrueto F Jr, Wang-Flores HH, Howland MA, et al. Acute vitamin D intoxication in a child. Pediatrics. 2005;116:e453–6.PubMedGoogle Scholar
  124. 124.
    Klontz KC, Acheson DW. Dietary supplement-induced vitamin D intoxication. N Engl J Med. 2007;357:308–9.Google Scholar
  125. 125.
    Kobylinski S, Häfer B, Kohde G. Correlative pathologic studies on the role of vitamin D in vascular calcinosis in childhood (In German). Zentralbl Allg Pathol. 1984;129:137–47.PubMedGoogle Scholar
  126. 126.
    Bolland MJ, Grey A, Avenell A, et al. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011;342:d2040.PubMedGoogle Scholar
  127. 127.
    Zittermann A, Pilz S, Börgmann J, et al. Calcium supplementation and vitamin D: a trigger for adverse cardiovascular events? Future Cardiol. 2011;7(6):725–7.Google Scholar
  128. 128.
    Tryfonidou MA, Oosterlaken-Dijksterhuis MA, Mol JA, et al. 24-Hydroxylase: potential key regulator in hypervitaminosis D3 in growing dogs. Am J Physiol Endocrinol Metab. 2003;284:E505–13.PubMedGoogle Scholar
  129. 129.
    Harmeyer J, Schlumbohm C. Effects of pharmacological doses of vitaminD3 on mineral balance and profiles of plasma vitaminD3 metabolites in horses. J Steroid Biochem Mol Biol. 2004;89–90:595–600.PubMedGoogle Scholar
  130. 130.
    Ross AC, Manson JE, Abrams SA, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–8.Google Scholar
  131. 131.
    Zittermann A, Grant WB. 25-hydroxyvitamin D levels and all-cause mortality. Arch Intern Med. 2009;169:1075–6.PubMedGoogle Scholar
  132. 132.
    Bischoff-Ferrari HA, Willett WC, Oray EJ, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med. 2012;367:40–9.PubMedGoogle Scholar
  133. 133.
    Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev. 2008;13:6–20.PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Daniel S. Moran
    • 1
    • 2
    • 3
  • James P. McClung
    • 4
  • Tal Kohen
    • 2
  • Harris R. Lieberman
    • 4
  1. 1.Oak Ridge Institute for Science and Education ProgramUnited States Army Research Institute of Environmental MedicineNatickUSA
  2. 2.Heller Institute of Medical Research, Sheba Medical CenterTel HashomerIsrael
  3. 3.Ariel UniversityArielIsrael
  4. 4.Military Nutrition DivisionUnited States Army Research Institute of Environmental MedicineNatickUSA

Personalised recommendations