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the mean baseline dietary calcium intake was 495 mg/day, and the mean serum 25OHD concentration was 12 nmol/L. For men, the mean baseline dietary calcium intake was 548 mg/day, and the mean serum 25OHD concentration was 21 nmol/L. At the end of the study, in both women and men, there were no significant differences in lumbar spine BMD changes between the groups receiving the two doses of vitamin D3 (400 or 800 IU/day) and the placebo group.

Pregnant or lactating women Overall, from AHRQ-Ottawa, there was insufficient evidence on the association between 25OHD concentration and change in bone density during pregnancy. Four studies (no RCTs, three cohort studies, one before-and-after study) assessed vitamin D nutriture at various time points in pregnancy, with vitamin D deficiency being observed in 0 to 50 percent of subjects, but only one cohort study (n = 115) rated

BOX 4-3

AHRQ Findings by Life Stage for Serum 25OHD Measures and BMC/BMD*

0–6 months: Inconsistent evidence for an association between a specific serum 25OHD concentration and the bone health outcome BMC in infants.


7 months–2 years: Fair evidence of an association between 25OHD concentrations and baseline BMD and change in BMD or BMC indexes from the studies in older children and adolescents.


3–8 years: Fair evidence of an association between 25OHD concentrations and baseline BMD and change in BMD or BMC indexes from the studies in older children and adolescents.


9–18 years: Fair evidence of an association between 25OHD concentrations and baseline BMD and change in BMD or BMC indexes from the studies in older children and adolescents. Two new RCTs identified by AHRQ-Tufts enrolled only girls in this life stage. The results showed no significant differences in whole-body BMC changes between groups receiving either lower doses of vitamin D (200 or 400 IU/day) or higher doses of vitamin D (800 or 2,000 IU/day) and the placebo group.


19–50 years: Discordance between the results from RCTs and the majority of observational studies in postmenopausal women and elderly men. Based on results of the observational studies, there is fair evidence to support an association between serum 25OHD concentration and BMD or changes in BMD at the femoral neck. One new RCT identified by AHRQ-Tufts enrolled primarily men and women in this life stage. The



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