<p>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.</p><p><br><strong>Statistical topics</strong></p><ul><li>Data cleaning and validation</li><li>Degrees of freedom</li><li>Exploratory vs confirmatory analysis</li><li>False positives and Type I error</li><li>Intention-to-treat principle</li><li>Multiple testing</li><li>Open data and transparency</li><li>P-hacking</li><li>Salami slicing</li><li>Parametric vs non-parametric tests</li><li>Peer review quality</li><li>Randomized controlled trials</li><li>Research reproducibility</li><li>Statistical sleuthing<p></p></li></ul><p><strong>Methodological morals</strong></p><ul><li><em>“Degrees of freedom are the breadcrumbs in statistical sleuthing. They reveal the sample size even when the authors do not.”</em></li><li><em>“Publishing the same study again and again with only the outcomes swapped is Mad Libs Science, better known as salami slicing.”<br></em><br></li></ul><p><br><strong>References<br></strong><br></p><ul><li>Boswell, Rachel. <a href="https://www.runnersworld.com/uk/health/injury/a68056833/vitamin-d-ultramarathon-study/">Pre-race vitamin D could do wonders for ultrarunners’ bone health, according to science.</a> Runner’s World. September 25, 2025. </li><li>Mieszkowski J, Stankiewicz B, Kochanowicz A, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/33255807/">Ultra-Marathon-Induced Increase in Serum Levels of Vitamin D Metabolites: A Double-Blind Randomized Controlled Trial. </a><em>Nutrients</em>. 2020;12(12):3629. Published 2020 Nov 25. doi:10.3390/nu12123629</li><li>Mieszkowski J, Borkowska A, Stankiewicz B, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/33924645/">Single High-Dose Vitamin D Supplementation as an Approach for Reducing Ultramarathon-Induced Inflammation: A Double-Blind Randomized Controlled Trial.</a> <em>Nutrients</em>. 2021;13(4):1280. Published 2021 Apr 13. doi:10.3390/nu13041280</li><li>Mieszkowski J, Brzezińska P, Stankiewicz B, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/36364748/">Direct Effects of Vitamin D Supplementation on Ultramarathon-Induced Changes in Kynurenine Metabolism.</a><em> Nutrients</em>. 2022;14(21):4485. Published 2022 Oct 25. doi:10.3390/nu14214485</li><li>Mieszkowski J, Brzezińska P, Stankiewicz B, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/37630726/">Vitamin D Supplementation Influences Ultramarathon-Induced Changes in Serum Amino Acid Levels, Tryptophan/Branched-Chain Amino Acid Ratio, and Arginine/Asymmetric Dimethylarginine Ratio.</a> <em>Nutrients</em>. 2023;15(16):3536. Published 2023 Aug 11. doi:10.3390/nu15163536</li><li>Stankiewicz B, Mieszkowski J, Kochanowicz A, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/39125358/">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.</a> <em>Nutrients</em>. 2024;16(15):2479. Published 2024 Jul 31. doi:10.3390/nu16152479</li><li>Stankiewicz B, Kochanowicz A, et al. <a href="https://pubmed.ncbi.nlm.nih.gov/40963202/">Single high-dose vitamin D supplementation impacts ultramarathon-induced changes in serum levels of bone turnover markers: a double-blind randomized controlled trial.</a> J Int Soc Sports Nutr. 2025 Dec;22(1):2561661. doi: 10.1080/15502783.2025.2561661.</li></ul><p><strong>Kristin and Regina’s online courses: <br></strong><br></p><p><a href="https://online.stanford.edu/courses/som-xche0033-demystifying-data-modern-approach-statistical-understanding">Demystifying Data: A Modern Approach to Statistical Understanding</a>  </p><p><a href="https://online.stanford.edu/courses/som-xche0030-clinical-trials-design-strategy-and-analysis">Clinical Trials: Design, Strategy, and Analysis</a> </p><p><a href="https://online.stanford.edu/programs/medical-statistics-program">Medical Statistics Certificate Program</a>  </p><p><a href="https://www.coursera.org/learn/sciwrite">Writing in the Sciences</a> </p><p><a href="https://online.stanford.edu/programs/epidemiology-and-clinical-research-graduate-certificate">Epidemiology and Clinical Research Graduate Certificate Program</a> </p><p><strong>Programs that we teach in:</strong></p><p><a href="https://online.stanford.edu/programs/epidemiology-and-clinical-research-graduate-certificate">Epidemiology and Clinical Research Graduate Certificate Program</a> </p><p><br></p><p><strong>Find us on:</strong></p><p>Kristin - <a href="https://www.linkedin.com/in/kristin-sainani-642b5914/"> LinkedIn</a> &amp;<a href="https://x.com/KristinSainani"> Twitter/X</a></p><p>Regina -<a href="https://www.linkedin.com/in/reginanuzzo/"> LinkedIn</a> &amp;<a href="https://www.reginanuzzo.com/"> </a><a href="http://reginanuzzo.com">ReginaNuzzo.com</a></p><p><br> 00:00 Intro &amp; claim of the episode<br> 00:44 Runner’s World headline: Vitamin D for ultramarathoners<br> 02:03 Kristin’s connection to running and vitamin D skepticism<br> 03:32 Ultramarathon world—Regina’s stories and Death Valley race<br> 06:29 What ultramarathons do to your bones<br> 08:02 Boy story: four stress fractures in one race<br> 10:00 Study design—40 male runners in Poland<br> 11:33 Missing flow diagram and violated intention-to-treat<br> 13:02 The intervention: 150,000 IU megadose<br> 15:09 Blinding details and missing randomization info<br> 17:13 Measuring bone biomarkers—no primary outcome specified<br> 19:12 The wrong clinicaltrials.gov registration<br> 20:35 Discovery of six papers from one dataset (salami slicing)<br> 23:02 Why salami slicing misleads readers<br> 25:42 Inconsistent reporting across papers<br> 29:11 Changing inclusion criteria and sloppy methods<br> 31:06 Typos, Polish notes, and misnumbered references<br> 32:39 Peer review comedy gold—“Please define vitamin D”<br> 36:06 Reviewer laziness and p-hacking admission<br> 39:13 Results: implausible bone growth mid-race<br> 41:16 Degrees of freedom sleuthing reveals hidden sample sizes<br> 47:07 Open data? Kristin emails the authors<br> 48:42 Lessons from Kristin’s own ultramarathon dataset<br> 51:22 Fishing expeditions and misuse of parametric tests<br> 53:07 Strength of evidence: one smooch each<br> 54:44 Methodologic morals—Mad Libs Science &amp; degrees of freedom breadcrumbs<br> 56:12 Anyone can spot red flags—trust your eyes<br> 57:34 Outro: skip the vitamin D shot before your next run </p><p><br></p>

Normal Curves: Sexy Science, Serious Statistics

Regina Nuzzo and Kristin Sainani

Ultramarathons: Can vitamin D protect your bones?

OCT 6, 202558 MIN
Normal Curves: Sexy Science, Serious Statistics

Ultramarathons: Can vitamin D protect your bones?

OCT 6, 202558 MIN

Description

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

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