Physical performance and Vitamin D in elderly black women-the PODA randomized clinical trial

Context: There is limited information on the influence of vitamin D on physical performance in black Americans. Objective: To determine if maintenance of serum 25(OH)D>75 nmol/L prevents a decline in physical performance. Design: The Physical Performance, Osteoporosis and Vitamin D in African American Women (PODA) trial had a prospective, randomized, placebo controlled, double-dummy design with two arms: one of which is placebo vitamin D3 adjusted to maintain serum 25(OH)D >75 nmol/L. Patients: The target population was healthy elderly black women with serum 25(OH)D between 20 and 65 nmol/L. The trial was 3 years in duration with measurement of physical performance every 6 months: grip strength, Short Physical Performance Battery (SPPB), 10 chair rises, and 6-minute walk distance. A total of 260 women entered the study and 184 completed 3 years. Mean age was 68.2 years. Baseline 25(OH)D was 53 nmol/L; total SPPB was 11 (10 to 12). Setting: Research center in an academic health center. Main Outcomes Measure: Prevention of decline in physical performance measures. Intervention: Participants were randomly assigned to placebo or active vitamin D. Vitamin D3 dose was adjusted to maintain serum 25(OH)D >75 nmol/L. Results: There was a decline with time in grip strength and the 6-minute walk test. The SPBB increased with time. There were no substantial differences between the placebo and active vitamin D3 groups with respect to the temporal patterns observed for any of the performance measures. Conclusion: There is no benefit of maintaining serum 25(OH)D>75 nmol/L in preventing the decline in physical performance in healthy black American women. ; https://doi.org/10.1210/jc.2018-01418