- Early studies suggest that vitamin D may reduce the risk of developing cardiovascular disease and cancer.
- However, there are few large, high-quality randomized controlled trials (RCTs) to support this.
- A recent RCT investigated the effects of vitamin D supplementation in Finland.
- No association was found between vitamin D supplementation and a reduced risk of cardiovascular disease or cancer.
Vitamin D helps the body
Many scientists have sought to understand how vitamin D deficiency and supplementation affect the disease.by
In the last two years
Two other areas of particular interest are the potential effects of vitamin D on the risk of cardiovascular disease and cancer. However, few RCTs have investigated this.These types of studies Gold standard To identify causal relationships in scientific research.
Recent research American Journal of Clinical Nutrition, Go some way to deal with this knowledge gap.
Talk to Today’s medical news, Vimal KaraniProfessors of nutritional genomics and nutritional genomics at the University of Reading, UK, have confirmed that there is a gap between early studies and clinical trial results.
Professor Karani has not been involved in recent research, but has collaborated with some of its authors.
He said in a large epidemiological study in the past, “Vitamin D deficiency [cardiovascular disease] Characteristics of various ethnic groups. This suggests that vitamin D supplements may reduce cardiovascular risk, he said.
“But clinical trials do not provide compelling evidence of the blood pressure-lowering effects of vitamin D supplementation,” he continued.
Professor Karani said, “There can be many reasons for this, including sample size, supplement duration, supplement dosage, participant age, geographic location, exposure to sunlight, and differences in resulting measurements. There is a need for further research to reproduce the findings in multiple ethnic groups. “
To provide further evidence of the relationship between vitamin D, cardiovascular disease, and cancer, the researchers behind this study Finnish Vitamin D Test..
This took place between 2012 and 2018 and was double-blind, randomized, and placebo-controlled.
“When we started planning our trials, there was a lot of evidence from observational studies that vitamin D deficiency was associated with almost all major chronic diseases, including: [cardiovascular disease], Cancer, type 2 diabetes, and mortality. ” Dr. Jyrki Virtanen In an interview with Today’s medical news..
Dr. Wiltanen is an associate professor of nutrition and public health at the University of Eastern Finland and a co-principal researcher in this study.
“Also, we [the] The population of eastern Finland, the body’s low vitamin D content, was associated with an increased risk of mortality and glucose metabolism disorders. However, these types of studies do not provide evidence of causality. “
“At that time, there was little evidence of improvement from RCTs. [the] The vitamin D status of the body supplemented with vitamin D reduced the risk of illness. “
“Therefore, our goal is to start a long-term vitamin D supplementation test in Finland, where vitamin D deficiency was quite prevalent due to the long winter, and vitamin D supplementation reduces the risk of major chronic illness and death. It was to investigate if it could be done. “
The researchers examined data from 2,495 people, including male participants over the age of 60 and female participants over the age of 65 after menopause. Participants also had no history of cardiovascular disease or cancer.
Participants took either placebo, a daily dose of 1,600 international units (IU) of vitamin D, or a daily dose of 3,200 IU of vitamin D.
The team determined that vitamin D doses did not reduce the incidence of cardiovascular disease or cancer in this cohort compared to placebo.
One factor that complicated this analysis was that participants tended to have high levels of vitamin D at the beginning of the study. The author believes this is due to the implementation of policies to fortify foods with vitamin D in Finland. 2003-2011..
“Vitamin D supplementation may not provide significant health benefits, especially in populations where vitamin D status is already good at the start of the study.”
-Dr. Zirki Birtanen
“The” problem “of most large vitamin D supplementation trials was that the starting levels of vitamin D were fairly high in most of the study population,” explained Dr. Virtanen.
“This may reflect the well-known fact that people participating in this type of study tend to be more health-conscious and interested in their own health. On average, he is healthier than the average population. ”
“They may be eating better, supplementing and exercising, all of which are also associated with elevated serum vitamin D levels,” he said. MNT..
“People who may benefit from vitamin D supplements, that is, those with low serum vitamin D levels, are a minority in the study. However, for ethical reasons, it is not possible to screen people and the study. It is difficult to target this deficient population because it cannot only recognize people with low vitamin D levels. It is unethical to keep the placebo group, which is part of the study population, deficient. [in] Vitamin D for several years. “
Despite the low recruitment level (the study author wanted to recruit 30,000 participants), the results showed some signs that vitamin D had health benefits. explained.
“Recruitment was difficult and did not live up to expectations, but there are some signs that the cohorts surveyed had low incidence of both. [cardiovascular disease] And cancer, compared to national statistics that would have been collected in advance. “
“This may indicate that improved national vitamin D status benefits the overall health of the population, in addition to the well-known effects on bone and muscle health. Due to the small number of adoptions, the cohort may not be nationally representative and care must be taken when interpreting these findings, “said scientists.
According to Professor Karani, “A unique feature of this RCT is that it used two different vitamin D doses to confirm a dose-response effect for 5 years. Despite the high doses, in this study, the supplements No effect was seen on the reduction in incidence. [cardiovascular disease] And cancer. “
“The findings have a significant impact on public health,” continued Professor Karani. “But the findings cannot be generalized to other populations. [the] Finland’s population
Dr. Wiltanen said there was some evidence of broader health benefits from vitamin D supplementation, but there were also conflicting findings.
“At this point, there is no consensus. [about] What is the optimal vitamin D intake? [whether it is] Same for all health consequences and all people. for example,
“And so far, there is no evidence that vitamin D supplementation can be prevented. [SARS-CoV-2] In the case of infectious diseases, especially patients with severe forms of COVID-19, low serum vitamin D levels are well documented. “
“this is, [SARS-CoV-2] Acute infections are known to lead to lower serum vitamin D levels, and many COVID-19 patients are overweight or obese, or have chronic illnesses such as type 2 diabetes, all of which. It is an infection, not a cause, as it is associated with a decrease in serum. Vitamin D levels, “explained Dr. Virtanen.
Professor Strain, Dr. McSorley, and Dr. Magee emphasized the possible role of vitamin D in a healthy immune system.
“Recently, there is strong evidence that vitamin D supports the immune system. Given the pandemic, people who are rich in vitamin D respond more seriously to COVID-19 than those who are deficient. Does not seem to show, recovers faster. “
“Vitamin D plays an important role in musculoskeletal health. Vitamin D can be obtained from sunlight and diet. However, vitamin D supplements are needed to meet the recommended dietary intake. In the United States, it’s 600 IU per day for people aged 1-70 and 800 IU per day for people over 70. That’s good status. “
“Supplement is especially relevant for people living in northern latitudes who cannot synthesize vitamin D from sunlight during the winter, and for people who spend little time outdoors and / or get limited amounts of vitamin D from food sources. There is likely to be.”
“Unless the food is fortified with vitamin D, it is very difficult to get vitamin D from food intake alone. In addition, people with illnesses that affect the absorption of vitamin D need vitamin D supplementation. It can happen, “says scientists.
Professor Strain, Dr. McSorley, and Dr. Magee suggested that the study could be developed by studying populations with low levels of vitamin D.
“This study needs to be done in the right population, where many people have low vitamin D status and can therefore benefit from vitamin D supplementation.”
“It’s important to investigate whether vitamin D supplementation can reduce the incidence. [cardiovascular disease] And cancer, it will be a powerful case of compulsory vitamin D fortification or promotion of population fortified foods. “
“The Finnish people [vitamin D] Enhancement programs are benefiting by reducing the incidence [cardiovascular disease] And the beneficial effects expected on cancer and bone health. “
“Another very important area that needs further investigation is the association between adequate vitamin D status and a fully functional immune system, especially in the light of the current COVID-19 pandemic.”
As Professor Karani points out, “Similar RCTs with long periods of vitamin D supplementation are highly justified in ethnically diverse populations to see if the results of this study can be generalized. . “
Dr. Wiltanen said MNT His current focus is on further analysis of the results of the Finnish vitamin D test.
“At this time, we have no plans to launch another Vitamin D trial, but of course we will publish some other results from the Finnish Vitamin D trial, such as the effects. [on] Arrhythmia, infection, type 2 diabetes, falls and fractures, pain, [and] I change my mood. “
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