The enigma of vitamin D supplementation in aging with obesity

INTRODUCTION: The american Geriatrics Society recommends a minimum daily supplement of 1,000 IU and underlines that a dosage lower than 600 IU do not prevent falls in elderly people. EVIDENCE aCQUISITION: The author searched on PubMed, Medline, Embase, Scopus database the MeSH terms and keywords of “vitamin D,” “(25(OH)D),” “elderly” and “obesity.” The aim of this study was to support the rationale on the correct vitamin D supplementation in elderly people with obesity and overweight. EVIDENCE SYNTHESIS: Ten studies were found suitable for consideration in writing this comprehensive evidence-based rapid review. The supplementation of vitamin D included 1500 elderly subjects with Body Mass Index (BMI) over 25 kg/m2. This article proved that the daily vitamin D supplementation from 2000 to 4000 UI is highly recommended in elderly people with obesity because of: 1) sequestration of vitamin D by the adipose tissue; 2) increased catabolism of vita-in D in the adipose tissue; 3) decreased synthesis of serum 25 hydroxyvitamin D (25(OH)D) in the liver; 4) reduced sun-exposure; and 5) dosages equal at 1000 UI or lower that did not show any important effect on vitamin D deficiency and on related comorbidities in elderly people with obesity. CONClUSIONS: Gender, baseline levels of serum (25(OH)D) concentration, ethnicity and severity of BMI should be accounted for the correct supplementation of vitamin D in elderly population for the precision medicine goal.