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 Review author searched on PubMed, Medline, Embase, Scopus database (last search May 30, 2021), with the MeSH terms and keywords of vitamin D, (25(OH)D), elderly and obesity. This review article aims to support the rationale on the correct vitamin D supplementation in elderly people with obesity and overweight.

EVIDENCE SYNTHESIS 10 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 shows that the daily vitamin D supplementation from 2000 to 4000 UI is highly recommended in elderly people with obesity because 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. 5) Dosages equal at 1000 UI or lower do not show and important effect on vitamin d deficiency and 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.