Ultramarathons: Can vitamin D protect your bones?

What this episode covers

Ultramarathoners push their bodies to the limit, but can a giant pre-race dose of vitamin D really keep their bones from breaking down? In this episode, we dig into a trial that tested this claim – and found  a statistical endurance event of its own: six highly interchangeable papers sliced from one small study.  Expect missing runners, recycled figures, and a peer-review that reads like stand-up comedy, plus a quick lesson in using degrees of freedom as your statistical breadcrumbs.Statistical topicsData cleaning and validationDegrees of freedomExploratory vs confirmatory analysisFalse positives and Type I errorIntention-to-treat principleMultiple testingOpen data and transparencyP-hackingSalami slicingParametric vs non-parametric testsPeer review qualityRandomized controlled trialsResearch reproducibilityStatistical sleuthingMethodological morals“Degrees of freedom are the breadcrumbs in statistical sleuthing. They reveal the sample size even when the authors do not.”“Publishing the same study again and again with only the outcomes swapped is Mad Libs Science, better known as salami slicing.”ReferencesBoswell, Rachel. Pre-race vitamin D could do wonders for ultrarunners’ bone health, according to science. Runner’s World. September 25, 2025. Mieszkowski J, Stankiewicz B, Kochanowicz A, et al. Ultra-Marathon-Induced Increase in Serum Levels of Vitamin D Metabolites: A Double-Blind Randomized Controlled Trial. Nutrients. 2020;12(12):3629. Published 2020 Nov 25. doi:10.3390/nu12123629Mieszkowski J, Borkowska A, Stankiewicz B, et al. Single High-Dose Vitamin D Supplementation as an Approach for Reducing Ultramarathon-Induced Inflammation: A Double-Blind Randomized Controlled Trial. Nutrients. 2021;13(4):1280. Published 2021 Apr 13. doi:10.3390/nu13041280Mieszkowski J, Brzezińska P, Stankiewicz B, et al. Direct Effects of Vitamin D Supplementation on Ultramarathon-Induced Changes in Kynurenine Metabolism. Nutrients. 2022;14(21):4485. Published 2022 Oct 25. doi:10.3390/nu14214485Mieszkowski J, Brzezińska P, Stankiewicz B, et al. Vitamin D Supplementation Influences Ultramarathon-Induced Changes in Serum Amino Acid Levels, Tryptophan/Branched-Chain Amino Acid Ratio, and Arginine/Asymmetric Dimethylarginine Ratio. Nutrients. 2023;15(16):3536. Published 2023 Aug 11. doi:10.3390/nu15163536Stankiewicz B, Mieszkowski J, Kochanowicz A, et al. Effect of Single High-Dose Vitamin D3 Supplementation on Post-Ultra Mountain Running Heart Damage and Iron Metabolism Changes: A Double-Blind Randomized Controlled Trial. Nutrients. 2024;16(15):2479. Published 2024 Jul 31. doi:10.3390/nu16152479Stankiewicz B, Kochanowicz A, et al. Single high-dose vitamin D supplementation impacts ultramarathon-induced changes in serum levels of bone turnover markers: a double-blind randomized controlled trial. J Int Soc Sports Nutr. 2025 Dec;22(1):2561661. doi: 10.1080/15502783.2025.2561661.Kristin and Regina’s online courses: Demystifying Data: A Modern Approach to Statistical Understanding  Clinical Trials: Design, Strategy, and Analysis Medical Statistics Certificate Program  Writing in the Sciences Epidemiology and Clinical Research Graduate Certificate Program Programs that we teach in:Epidemiology and Clinical Research Graduate Certificate Program Find us on:Kristin -  LinkedIn & Twitter/XRegina - LinkedIn & ReginaNuzzo.com 00:00 Intro & claim of the episode 00:44 Runner’s World headline: Vitamin D for ultramarathoners 02:03 Kristin’s connection to running and vitamin D skepticism 03:32 Ultramarathon world—Regina’s stories and Death Valley race 06:29 What ultramarathons do to your bones 08:02 Boy story: four stress fractures in one race 10:00 Study design—40 male runners in Poland 11:33 Missing flow diagram and violated intention-to-treat 13:02 The intervention: 150,000 IU megadose 15:09 Blinding details and missing randomization info 17:13 Measuring bone biomarkers—no primary outcome specified 19:12 The wrong clinicaltrials.gov registration 20:35 Discovery of six papers from one dataset (salami slicing) 23:02 Why salami slicing misleads readers 25:42 Inconsistent reporting across papers 29:11 Changing inclusion criteria and sloppy methods 31:06 Typos, Polish notes, and misnumbered references 32:39 Peer review comedy gold—“Please define vitamin D” 36:06 Reviewer laziness and p-hacking admission 39:13 Results: implausible bone growth mid-race 41:16 Degrees of freedom sleuthing reveals hidden sample sizes 47:07 Open data? Kristin emails the authors 48:42 Lessons from Kristin’s own ultramarathon dataset 51:22 Fishing expeditions and misuse of parametric tests 53:07 Strength of evidence: one smooch each 54:44 Methodologic morals—Mad Libs Science & degrees of freedom breadcrumbs 56:12 Anyone can spot red flags—trust your eyes 57:34 Outro: skip the vitamin D shot before your next run

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