Effect of vitamin D on skeletal muscle.

Beyond its traditional biological roles on bone health, extra-skeletal effects of vitamin D are currently under extensive research. The expression of the vitamin D receptor in most tissues has also strengthened the argument for its multiple functions. Among these, the effect of vitamin D on the mass and muscle performance has long been discussed. In ancient Greece, Herodotus recommended the sun as a cure for the "weak and soft muscles" and former Olympians exposed to sunlight to improve their physical performance. In 1952, Dr Spellerberg, a sports physiologist, has conducted an extensive study on the effects of UV irradiation on the performance of elite athletes. Following the significant results of this investigation, the scientist has informed the Olympic Committee that UV irradiation had a "persuasive" effect on physical performance and motor skills. These data are consistent with many subsequent studies reporting an improvement in physical activity, speed and endurance in young subjects treated with UV or with supplements containing vitamin D. Additional observation indicates a significant effect on muscle strength, particularly in the lower limbs. Concerning the mechanisms involved, some recent fundamental studies have shown that vitamin D exerts some molecular effects within the muscle cell. Specifically, a regulatory effect of vitamin D on calcium flux, mineral homeostasis and signaling pathways controlling protein anabolism has been reported in muscle tissue. Several epidemiological studies show that low vitamin D status is always associated with a decrease in muscle mass, strength and contractile capacity in older people. Vitamin D deficiency accelerates muscle loss with age (sarcopenia), and therefore leads to a reduction in physical capacity and to an increased risk of falls and fractures. In contrast, an additional intake of vitamin D in older people significantly improves muscle function and physical performance.