Extraskeletal outcomes such as cancer and cardiovascular disease have what level of evidence according to the IOM review?

• A. Sufficient for all extraskeletal outcomes
• B. Inconsistent
• C. Strong and consistent
• D. No evidence

Answer: (B)

The main idea is that the evidence linking supplementation to extraskeletal outcomes like cancer and cardiovascular disease is inconsistent. The IOM review looked beyond bone health and found that study results do not converge on a clear effect of vitamin D or calcium on these outcomes. Some studies suggested possible benefits, others found no effect, and results varied depending on dose, baseline vitamin D status, population, duration, and how outcomes were defined. Because of this variability and the limitations of the data, the level of evidence is not strong or conclusive, and it’s not accurate to say there is consistent or sufficient evidence for these outcomes.