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. 2006 Nov;11(6):271–276. doi: 10.1007/BF02898016

Vitamin D and prevention of osteoporosis: Japanese perspective

Kazutoshi Nakamura 1,
PMCID: PMC2723451  PMID: 21432355

Abstract

Vitamin D insufficiency or a low vitamin D status, is a prevalent condition worldwide. However, there have been no studies addressing this public health issue until recently. In this review article, a summary of a series of studies conducted by the author and his colleagues to determine whether the vitamin D status of Japanese people is adequate and how their vitamin D status affects bone mass and bone metabolism is presented. The observational studies conducted by our group revealed that vitamin D insufficiency does not seem to be a serious problem among active elderly people, but that elderly people with a low level of activities of daily living (ADL) are at a very high risk of vitamin D insufficiency. In young adults, a high intact PTH concentration due to vitamin D insufficiency, which adversely affects their bone mass, is common, suggesting that vitamin D nutrition, as well as dietary calcium intake, should be improved. However, the effects of vitamin D insufficiency among elderly Japanese on bone metabolism, bone mass, and fractures have not been clarified, and should be studied further to determine whether specific preventive strategies, such as vitamin D supplementation, are required for this high-risk group. Intervention studies targeting Japanese populations are required to further address this issue.

Key words: 25-hydroxyvitamin D, Japanese, osteoporosis, prevention, vitamin D

Footnotes

This article is based upon the research that was given Encouragement Award at the 76th Annual Meeting of the Japanese Society for Hygiene held in Yamaguchi, Japan on March 25–28, 2006.

References

  • (1).Marcus R, Majumder S. The nature of osteoporosis. In: Marcus R, Feldman D, Kelsey J, editors. Osteoporosis, 2nd ed., San Diego: Academic Press; 2001. p. 3–17.
  • (2).Morita Y, Endo N, Iga T, Tokunaga K, Ohkawa Y. The incidence of cervical and trochanteric fractures of the proximal femur in 1999 in Niigata Prefecture, Japan. J Bone Miner Metab. 2002;20:311–318. [DOI] [PubMed]
  • (3).Van der Wielen RPJ, Löwik MRH, van der Berg H, de Groot LC, Haller J, Moreiras O, et al. Serum vitamin D concentrations among elderly people in Europe. Lancet. 1995;346:207–210. [DOI] [PubMed]
  • (4).Holick MF. Evolution, biologic functions, and recommended dietary allowances for vitamin D. In: Holick MF editor. Vitamin D: Physiology, Molecular Biology, and Clinical Applications. Totowa NJ, USA: Human Press; 1995. p. 1–16.
  • (5).Devine A, Wilson SG, Dick JM, Prince RL. Effects of vitamin D metabolites on intestinal calcium absorption and bone turnover in elderly women. Am J Clin Nutr. 2002;75:283–288. [DOI] [PubMed]
  • (6).Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing. 2000;29:301–304. [DOI] [PubMed]
  • (7).Nakamura K. Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis. J Bone Miner Metab. 2006;24:1–6. [DOI] [PubMed]
  • (8).Nakamura K, Nashimoto M, Tsuchiya Y, Saito T, Nishiwaki T, Ueno K, et al. The threshold value of serum 25-hydroxyvitamin D concentration in relation to elevated serum parathyroid hormone concentrations in elderly Japanese women. J Bone Miner Metab. 2006;24:395–400. [DOI] [PubMed]
  • (9).Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr. 2004;80(6 Suppl):1706S-1709S. [DOI] [PubMed]
  • (10).Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–2264. [DOI] [PubMed]
  • (11).Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hereberg S, et al. Prevalence of vitamin D insufficiency in adult normal population. Osteoporos Int. 1997;7:439–443. [DOI] [PubMed]
  • (12).Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: base-line data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86:1212–1221. [DOI] [PubMed]
  • (13).Gloth III FM, Gundberg CM, Hollis BW, Haddad Jr JG, Tobin JD, Vitamin D deficiency in homebound elderly persons. JAMA 1995;274:1683–1686. [DOI] [PubMed]
  • (14).Nakamura K, Nashimoto M, Hori Y, Muto K, Yamamoto M. Serum 25-hydroxyvitamin D levels in active women of middle and advanced age in a rural community in Japan. Nutrition. 1999;15:870–873. [DOI] [PubMed]
  • (15).Nakamura K, Nashimoto M, Hori Y, Yamamoto M. Serum 25-hydroxyvitamin D concentrations and related dietary factors in peri- and postmenopausal Japanese women. Am J Clin Nutr. 2000;71:1161–1165. [DOI] [PubMed]
  • (16).Nakamura K, Nashimoto M, Endoh K, Yamamoto M. Vitamin D nutritional status of women living on a solitary island in Japan: a population-based study. Environ Health Prev Med. 2000;5:49–52. [DOI] [PMC free article] [PubMed]
  • (17).Jacques PF, Felson DT, Tucker KL, Mahnken B, Wilson PW, Rosenberg IH, et al. Plasma 25-hydroxyvitamin D and its determinants in an elderly population sample. Am J Clin Nutr. 1997;66:929–936. [DOI] [PubMed]
  • (18).Nakamura K, Nishiwaki T, Ueno K, Yamamoto M. Serum 25-hydroxyvitamin D and activities of daily living in noninstitutionalized elderly Japanese requiring care. J Bone Miner Metab. 2005;23:488–494. [DOI] [PubMed]
  • (19).Nashimoto M, Nakamura K, Matsuyama S, Hatakeyama M, Yamamoto M. Hypovitaminosis D and hyperparathyroidism in physically inactive elderly Japanese living in nursing homes: relationship with age, sunlight exposure, and activities of daily living. Aging Clin Exp Res. 2002;14:5–12. [DOI] [PubMed]
  • (20).Nakamura K, Nashimoto M, Okuda Y, Ota T, Yamamoto M. Fish as a major source of vitamin D in the Japanese diet. Nutrition. 2002;18:415–416. [DOI] [PubMed]
  • (21).Nakamura K, Hori Y, Nashimoto M, Okuda Y, Miyazaki H, Kasai Y, et al. Nutritional covariates of dietary calcium in elderly Japanese women: results of a study using the duplicate portion sampling method. Nutrition. 2003;19:922–925. [DOI] [PubMed]
  • (22).Resources Council, Science and Technology Agency, Japan. Standard Tables of Food Composition in Japan: Vitamin D. Tokyo: Printing Bureau, Ministry of Finance, 1993. (in Japanese).
  • (23).Nakamura K, Nashimoto M, Tsuchiya Y, Obata A, Miyanishi K, Yamamoto M. Vitamin D insufficiency in Japanese female college students: a preliminary report. Int J Vitam Nutr Res. 2001;71:302–305. [DOI] [PubMed]
  • (24).Nakamura K, Nashimoto M, Matsuyama S, Yamamoto M. Low concentrations of the serum 25-hydroxyvitamin D in young Japanese women: a cross sectional study. Nutrition. 2001;17:921–925. [DOI] [PubMed]
  • (25).Kenko-Eiyo-Joho-Kenkyukai (Society for Information on Health and Nutrition). The National Health and Nutrition Survey in Japan, 2003 (Ministry of Health, Labour and Welfare of Japan). Tokyo: Dai-ichi Shuppan; 2006. (in Japanese)
  • (26).Nakamura K, Ueno K, Nishiwaki T, Okuda Y, Saito T, Tsuchiya Y, et al. Nutrition, mild hyperparathyroidism, and bone mineral density in young women. Am J Clin Nutr. 2005;82:1127–1133. [DOI] [PubMed]
  • (27).Nakamura K, Iki M. Efficacy of optimization of vitamin D in preventing osteoporosis and osteoporotic fractures: a systematic review. Environ Health Prev Med. 2006;11:155–170. [DOI] [PMC free article] [PubMed]
  • (28).Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004;291:1999–2006. [DOI] [PubMed]
  • (29).Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005;16:713–716. [DOI] [PubMed]
  • (30).Nakamura K. Oshiki R, Hatakeyama K, Nishiwaki T, Ueno K, Nashimoto M, et al. Vitamin D status, postural sway, and the incidence of falls in elderly community-dwelling Japanese women. Arch Osteoporos. (in press)

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