Winter warmth from Cochrane
At this time of year, when the sun makes its briefest appearance, maintaining vitamin D intake is a priority, but what evidence is there that vitamin D helps prevent fractures? An updated review now includes 53 studies involving more than 90 000 men and women aged over 65 years from community, hospital and nursing home settings. It found that taking vitamin D on its own is unlikely to prevent fractures, but when taken with calcium supplements it slightly reduces the likelihood of hip and other types of fracture (doi: 10.1002/14651858.CD000227.pub4).
A small chink of sunshine for people with osteoarthritis comes with an updated review of oral herbal therapies. Forty-five new studies have been added to the original four, involving nearly 6000 participants. With over 30 medicinal plant products included, the results focus on the two with multiple studies: Boswellia serrata and avocado-soyabean unsaponifiables. For both, the evidence points towards slight reductions in pain and improvements in function, with more definitive evidence in favour of B. serrata. Evidence on side effects is uncertain (doi: 10.1002/14651858.CD002947.pub2).
The outlook is patchier in a new review of interventions to improve control of modifiable risk factors in the secondary prevention of stroke. The review included 26 studies, most lasting between 3 and 12 months, and looked at patient-level…