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Soldiers need vitamin D, but levels cut in half in 18 years – March 2014

Clinical relevance of optimizing vitamin d status in soldiers to enhance physical and cognitive performance

J Spec Oper Med. 2014 Spring;14(1):58-66.
Wentz LM, Eldred JD, Henry MD, Berry-Caban CS.

Vitamin D deficiency initiates a loss of combat effectiveness by impairing physical and cognitive functioning of combat Operators.
Synthesized in response to sunlight and consumed in the diet, vitamin D functions as a hormone and regulates gene expression for nearly 300 genes throughout the human body.
These target genes are involved processes essential to combat operations, such as

  • immune function,
  • response to stress,
  • inflammation, and
  • regulation of calcium movement.

Since widespread vitamin D deficiency is observed across the U.S. population, poor vitamin D status is expected in Servicemembers.

Physical conditions linked to vitamin D deficiency include increased risk for muscle or bone injury, muscle weakness, and reduced neuromuscular function.

Hormonally, vitamin D levels have been positively correlated with testosterone levels.

Vitamin D deficiency is also associated with

  • cognitive decline,
  • depression, and
  • may prolong recovery following mild traumatic brain injury (mTBI).

Since vitamin D deficiency elevates systemic inflammation, poor vitamin D status at the time of brain injury may prolong the inflammatory response and exacerbate postconcussive symptoms.

Furthermore, veterans with mTBI experience chronic endocrine dysfunction.

While vitamin D status has not been assessed post-mTBI, it is plausible that vitamin D levels are altered along with testosterone and growth hormone, raising the question of whether vitamin D deficiency results from trauma-related hormonal abnormalities or whether vitamin D deficiency increases the risk for endocrine dysfunction.

Through its association with testosterone production, vitamin D deficiency may increase the risk for posttraumatic stress disorder (PTSD) since testosterone levels are altered in veterans with PTSD. Therefore, vitamin D status has a significant impact on Operator health and performance. Supplementing vitamin D to deficient Operators provides a noninvasive and low-cost intervention to maintain combat force.

PMID: 24604440    Download the PDF from ResearchGate via Vitamin D Life

Vitamin D levels dropped by half in just 18 years in the same area

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Cited by 10 publications as of Jan 2020

  • Prevalence of Vitamin D Deficiency and Its Effects on Military Forces' Performance-A Review Study - in Farsi not English
  • Correlations between Vitamin D Concentrations and Lipid Panels in Active Duty and Veteran Military Personnel - 2016
  • Vitamin D correlation with testosterone concentration in male US soldiers and veterans - 2016
  • Fatty Acid Blood Levels, Vitamin D Status, Physical Performance, Activity, and Resiliency: A Novel Potential Screening Tool for Depressed Mood in Active Duty. . . - 2016, free PDF
  • Vitamin D Clinical Relevance in the Recovery From Traumatic Brain Injury Among the Military Population
  • Significance of vitamin D to tactical athletes - 2014

Need for Routine Vitamin D Screening in Military Personnel - letter to Editor 2016

MILITARY MEDICINE, 181, 9:1163, 2016
COL Albert F. DiNicola, MC USAR (Ret.)*; Peter J. DiNicola, BS f; Lucia Sanchez*
*Pinnacle Medical Group, 8110 Mango Avenue, Fontana, CA 92335.
f University of California, Riverside, 900 University Avenue, Riverside, CA 92521.
Dear Editor:

Vitamin D is a necessary component in repairing bone damage, decreasing predisposition to bone injury, and strengthening the immune system. Vitamin D deficiency plays a key role in the etiology of bone pathologies such as rickets, osteoporosis, and osteomalacia. In military personnel, as noted by the Deployment Health Clinical Center, low vitamin D blood levels have been associated with

  • musculoskeletal injuries and stress fractures

as well as implicated in increased susceptibility to

  • chronic musculoskeletal pain,
  • autoimmune disease,
  • cancer,
  • immune system dysfunction,
  • diabetes, and
  • post-traumatic stress disorder-mild traumatic brain injury symptoms.

Deployed Operation Iraqi Freedom/Operation Enduring Freedom military personnel have a predisposition to low vitamin D levels as a result of lack of sun exposure due to uniform sleeve worn down, shade-cover-seeking behaviors, nighttime operational requirements, use of sunblock, and lack of fortified dairy products in MREs (Meals Ready to Eat). Heavy field loads, carried by Service Members and weighing 60-100 plus pounds, also increase the risk of musculoskeletal injuries.
The intent in our study is to demonstrate the suboptimal blood vitamin D levels in apparently well-appearing adolescents and thus support the need for the military to routinely screen for and treat vitamin D deficiency and insufficiency so as to optimize bone health, reduce the risk of musculoskeletal injuries, and enhance immune system function. In our study, 120 adolescents were randomly screened during routine adolescent well checks for vitamin D deficiency (25-hydroxy blood vitamin D levels 0-19.9 ng/mL) and vitamin D insufficiency (25-hydroxy blood vitamin D levels 20.0-29.9 ng/mL). Age ranges were 11-18 years with a mean age of 14.6 years with 53% males (63/120) and 47% females (57/120). Ethnicities, in this predominantly low middle-income class population, were 95% Hispanic, 4% Caucasian, and 1% Middle Eastern with vitamin D levels obtained from May 2015 to February 2016.
Results were as follows:

  • total number of patients with vitamin D deficiency and insufficiency 80% (95/120),
  • total number with vitamin D deficiency 32% (38/120),
  • total number with vitamin D insufficiency 48% (57/120),
  • total number of males with vitamin D insufficiency 56% (35/63) and deficiency 17% (11/63), and
  • total number of females with vitamin D insufficiency 39% (22/57) and deficiency 47% (27/57).

The average 25-hydroxy vitamin D deficiency and insufficiency levels were 14.7 ng/mL and 23.4 ng/mL, respectively. Our results demonstrate a high incidence of vitamin D deficiency and insufficiency levels in both adolescent males and females with the percentage of vitamin D deficiency and insufficiency in females (86%, 49/57) greater than in males (73%, 46/63).

In conclusion, more studies are needed to determine the prevalence of suboptimal vitamin D levels among military personnel and the general population, and possible links to other medical conditions, such as

  • nonhealing fractures,
  • chronic pain,
  • anxiety,
  • depression, and
  • post-traumatic stress disorder-mild traumatic brain injury.

Mandatory vitamin D levels should be routinely obtained on all military personnel especially those in pre- and postdeployment mobilization phases. Obtaining blood vitamin D levels are widely available, rapid, inexpensive, and reliable.


See also Vitamin D Life

Ginde 2009 - see also the journal article
Military

Drop in Vitamin D levels VDW#10189
Brain and trauma

Bone and Muscle


Overview Sports and vitamin D has the following summary

Athletes are helped by vitamin D by:

  1. Faster reaction time
  2. Far fewer colds/flus during the winter
  3. Less sore/tired after a workout
  4. Fewer micro-cracks and broken bones
  5. Bones which do break heal much more quickly
  6. Increased VO2 and exercise endurance Feb 2011
  7. Indoor athletes especially need vitamin D
  8. Professional indoor athletes are starting to take vitamin D and/or use UV beds
  9. Olympic athletes have used UV/vitamin D since the 1930's
  10. The biggest gain from the use of vitamin D is by those who exercise less than 2 hours per day.
  11. Reduced muscle fatigue with 10,000 IU vitamin D daily
  12. Muscle strength improved when vitamin D added: 3 Meta-analysis
  13. Reduced Concussions
    See also: Sports and Vitamin D category 231 items

See also web

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Soldiers need vitamin D, but levels cut in half in 18 years – March 2014        
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ID Name Comment Uploaded Size Downloads
13304 Vitamin D correlation with testosterone concentration in male US soldiers and veterans.pdf admin 09 Jan, 2020 16:53 239.35 Kb 273
9493 Military 25 weeks.jpg admin 12 Mar, 2018 14:25 17.78 Kb 2965
9491 Anabolic Adaptations.pdf admin 12 Mar, 2018 14:19 540.74 Kb 541
9490 Clinical relevance of optimizing vitamin D status in soldiers.pdf admin 12 Mar, 2018 13:30 1,013.12 Kb 531
4487 SOF vit D decrease.jpg admin 14 Oct, 2014 01:52 38.91 Kb 3865
4484 JSOM.jpg admin 13 Oct, 2014 21:51 71.66 Kb 3974
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