The role of vitamin D, either alone or in combination with calcium, in reducing fractures is a contentious issue.. Some studies have shown a reduction in the risk of fractures, others have shown no effect, and one recent study found an increased risk of hip fracture.
In the linked study, the DIPART (vitamin D Individual Patient Analysis of Randomized Trials) group reports an individual patient data analysis aimed at identifying factors that influence the efficacy of vitamin D or vitamin D plus calcium in reducing fractures. The study also assessed the influence of dosing regimens and the co-administration of calcium.
Trials using vita¬min D (low or high dose) combined with calcium reduced the overall risk of fracture (hazard ratio 0.92, 9S% confi¬dence interval 0.86 to 0.99), but that only low dose (10 ug) vitamin D combined with calcium reduced the risk of hip fracture (0.74, 0.60 to 0.91). They found no association between fracture history and treatment response, or any association with age, sex, or hormone replacement therapy. Vitamin D alone, irrespective of dose, had no effect on fracture risk.
Whether vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) are equi-potent is not yet established. Recent consensus has suggested that serum concentrations of 70•80 nmol/l are needed for normal health.
Vitamin D has direct effects on muscle strength modulated by specific vitamin D receptors in human muscle tissue. Supplementation may increase muscle strength, thereby reducing the risk of falls and subsequent non-verte¬bral fractures. In combination with calcium, vitamin D reduced first falls by 27% at 12 months and 39% at 20 months, with a decrease in body sway.
So vitamin D ( 10-20 µg / day ) and calcium ( 1000 mg calcium / day ) supplementation appears to have merit.Sahota 2009 Reducing the risk of fractures with calcium and vitamin D BMJ vol 340 p 109-110 The DIPART group 2009 Patient level pooled analyses of 68500 patients from seven major vitamin D fracture trials in US and Europe. BMJ vol 340, pp 139-140
Whole Wheat grain cereals —
This review is a comprehensive overview of the benefits of whole grain cereals.
Epidemiological studies have shown that whole-grain cereals can protect against obesity, diabetes, cardio vascular disease and cancers.
The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are well-recognised mechanisms in this protection.
Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses.
The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection.
Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as a-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid are important.
Any seed is a start up pack for the new plant and must contain all that is required for a new life. All seeds must be nutritionally of value.
Finally, benefits of nutrigenomics to study complex physiological effects of the ‘whole-grain package’, and the most promising ways for improving the nutritional quality of cereal products are _discussed.
Fardet (2010 ) New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutrition research Reviews vol 23 65-134