Table 1

Summary of Scientific Advisory Committee on Nutrition’s findings for musculoskeletal health outcomes reviewed up until 2014

Rickets
  • A distinct threshold 25OHD concentration above which there is no risk of rickets could not be identified. Data suggested risk increased <25 nmol/L

  • <25nmol/L is not diagnostic of the disease

  • Evidence was mainly from cross-sectional observational studies and case reports and may have been influenced by confounding

  • It was not clear whether the cause of rickets was vitamin D deficiency and/or calcium deficiency

Osteomalacia
  • No clear serum 25OHD threshold concentration below which risk of osteomalacia increased but <20 nmol/L and ≤15 nmol/L in cross-sectional analyses

Bone health indices (bone mineral content, bone mineral density, biochemical markers of bone turnover)
  • Evidence suggested beneficial effects of vitamin D supplementation on bone health indices in adults aged ≥50 years. The evidence base for adults aged <50 years was insufficient to draw conclusions

Fracture prevention
  • Data in adults aged ≥50 years were mixed but suggested vitamin D supplementation did not reduce fracture risk

  • The effect of vitamin D supplementation on stress fracture risk in adults aged <50 years was insufficient to draw conclusions

Muscle strength and function
  • Limited evidence suggested a beneficial effect of vitamin D supplementation on muscle strength and function in adults aged <50 years with 25OHD <30 nmol/L

  • For adults aged ≥50 years with a range of 25OHD concentrations, evidence was mixed but overall suggested vitamin D supplementation improved muscle strength and function

Falls
  • Evidence mixed but suggested vitamin D supplementation reduced fall risk in community dwelling adults aged ≥50 years with mean baseline serum 25OHD concentrations across a range of values

  • Two studies reported increased fall risk with vitamin D supplementation; however, doses were very high and administered annually or monthly which may produce different effects from daily supplementation at lower doses

  • 25OHD, 25-hydroxyvitamin D.