Ultramarathons: Can vitamin D protect your bones?

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 topics

• Data cleaning and validation
• Degrees of freedom
• Exploratory vs confirmatory analysis
• False positives and Type I error
• Intention-to-treat principle
• Multiple testing
• Open data and transparency
• P-hacking
• Salami slicing
• Parametric vs non-parametric tests
• Peer review quality
• Randomized controlled trials
• Research reproducibility
• Statistical sleuthing

Methodological 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.”
  
  

References

• Boswell, 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/nu12123629
• Mieszkowski 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/nu13041280
• Mieszkowski 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/nu14214485
• Mieszkowski 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/nu15163536
• Stankiewicz 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/nu16152479
• Stankiewicz 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/X

Regina - 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