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Skin photosynthesis is the main source of vitamin D. Limited sun exposure and insufficient dietary vitamin D supply justify vitamin D supplementation in certain age groups. In older adults, recommended doses for vitamin D supplementation vary between 200 and 2000\u00a0IU\/day, to achieve a goal of circulating 25-hydroxyvitamin D (calcifediol) of at least 50\u00a0nmol\/L. The target level depends on the population being supplemented, the assessed system, and the outcome. Several recent large randomized trials with oral vitamin D regimens varying between 2000 and 100,000\u00a0IU\/month and mostly conducted in vitamin D-replete and healthy individuals have failed to detect any efficacy of these approaches for the prevention of fracture and falls. Considering the well-recognized major musculoskeletal disorders associated with severe vitamin D deficiency and taking into account a possible biphasic effects of vitamin D on fracture and fall risks, an European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group convened, carefully reviewed, and analyzed the meta-analyses of randomized controlled trials on the effects of vitamin D on fracture risk, falls or osteoarthritis, and came to the conclusion that 1000\u00a0IU daily should be recommended in patients at increased risk of vitamin D deficiency. The group also addressed the identification of patients possibly benefitting from a vitamin D loading dose to achieve early 25-hydroxyvitamin D therapeutic level or from calcifediol administration.<\/jats:p>","DOI":"10.1007\/s40520-022-02279-6","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T06:03:15Z","timestamp":1666764195000},"page":"2603-2623","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working 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EC is consultant for DiaSorin, Fujirebio, IDS, Menarini, Nittobo and bioM\u00e9rieux. NCH has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, UCB, Shire, Consilient Healthcare, Kyowa Kirin and Internis Pharma. SM reports grants from Sanofi, MSD, GSK, Pfizer, Takeda, Mylan through institution as organizer of meetings\/congresses and as principal investigator of epidemiological studies, for taking part to advisory boards and expert meetings. CC has received consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic and Roche. OBr reports consulting or lecture fees for AMGEN, Aptissen, Biophytis, IBSA, MEDA, Mylan, Novartis, Sanofi, TRB Chemedica, UCB, Viatris outside this manuscript subject. BC has received fees for lectures or scientific advisory boards from Alexion, AMGEN Aptissen, BMS, Expanscience, Ferring, Lilly, Kyowa-Kirin, MSD, Novartis, Roche diagnostics, Sublimed, Theramex, UCB, Viatris. ACJ has received fees for performing educational activities from Abbott Nutrition, Nutricia\/Danone, Nestl\u00e9 Medical Nutrition and Fresenius Kabi and consulting fees from Rejuvenate Biomed, Reneo Pharmaceuticals and Akros Pharma. AC has received fees for lectures or scientific advisory boards from Bristol Myers Squibb and Nestle. BD-H has received grants through her institution for research from DSM and Pfizer, for Data Safety and Monitoring board membership from AgNovos, and a lecture fee from Grupo Italfarmaco. RAF reports stock options from Inside Tracker and Axcella Health and consultancy from Nestle\u2019, Biophytis, Pfizer, Rejuvenate Biomed, and Chugai. TT has received consultancy\/speaker\u2019s fees from AMGEN, Arrow, Biogen, Chugai, Expanscience, Grunenthal, Jansen, LCA, Lilly, MSD, Nordic, Novartis, Pfizer, Sanofi, Thuasne, Theramex, TEVA and UCB and financial support or fees for research activities from: Bone Therapeutics, Chugai, UCB. NV reports personal fees from IBSA, Mylan, Viatris, Fidia, MSD outside of the submitted work. JYR reports consulting fees or advisory board participation for IBSA-Genevrier, Mylan, Radius Health, Pierre Fabre, Faes Pharma, Rejuvenate Biomed, Samumed, TEVA, Theramex, Pfizer, Mithra Pharmaceuticals, lecturing fees for IBSA-Genevrier, Mylan, Cniel, Dairy Research Council (DRC), Nutricia, Danone, Agnovos and grant support from IBSA-Genevrier, Mylan, Cniel, Radius Health and TRB. RR has received fees for lectures or scientific advisory boards from Abiogen, Danone, Echolight, European Milk Forum, Nestl\u00e9, ObsEva, Pfizer Consumer Health and Theramex. TC, KDC, NAD, OB, MR, NF, JAK, PH, JMK, OL, AL, MPY, RPR, JAT, MW have no conflict of interest or disclosures with regard to this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval from the institutional review board was not required for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This article does not contain any studies with human participants or animals not previously published. All procedures performed in the previously published by the author were in accordance with ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of human and animal rights"}},{"value":"For this review, formal consent was not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}