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Vitamin D Supplements Appear to Be Associated With Lower Mortality
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Gastroenterology Nov 2007
Les Lang
Richard Peek and K. Rajender Reddy, Section Editors
Individuals who take vitamin D supplements appear to have a lower risk of death from any cause over an average follow-up time of 6 years, according to a meta-analysis of 18 previously published studies in the September 10, 2007, issue of Archives of Internal Medicine.
Past studies have suggested that deficiencies in vitamin D might be associated with a higher risk of death from cancer, heart disease, and diabetes-illnesses that account for 60%-70% of deaths in high-income nations, according to background information in the article. "If the associations made between vitamin D and these conditions were consistent, then interventions effectively strengthening vitamin D status should result in reduced total mortality," the authors write.
Dr Philippe Autier, of the International Agency for Research on Cancer, Lyon, France, and Dr Sara Gandini, of the European Institute of Oncology, Milano, Italy, searched for randomized controlled trials of vitamin D supplements published before November 2006. They analyzed 18 separate trials that included 57,311 participants and evaluated doses of vitamin D ranging from 300-2000 IU, with an average dose of 528 IU. Most commercially available supplements contain between 400 and 600 IU.
Over an average follow-up period of 5.7 years, 4777 participants died. Individuals who took vitamin D had a 7% lower risk of death than those who did not. In the 9 trials that collected blood samples, those who took supplements had an average 1.4- to 5.2-fold higher blood level of vitamin D than those who did not.
"Mechanisms by which vitamin D supplementation would decrease all-cause mortality are not clear," the authors write. Vitamin D could inhibit some mechanisms by which cancer cells proliferate, or it may boost the function of blood vessels or the immune system, they note. "In conclusion, the intake of ordinary doses of vitamin D supplements seems to be associated with decreases in total mortality rates," the authors write. "The relationship between baseline vitamin D status, dose of vitamin D supplements and total mortality rates remains to be investigated. Population-based, placebo-controlled randomized trials in people 50 years or older for at least 6 years with total mortality as the main end point should be organized to confirm these findings."
The meta-analysis "adds a new chapter in the accumulating evidence for a beneficial role of vitamin D on health," writes Dr Edward Giovannucci of the Harvard School of Public Health, Boston, in an accompanying editorial. "Research on vitamin D should be continued to clearly elucidate the specific benefits and optimal intakes and levels of vitamin D," Dr Giovannucci continues. "Nonetheless, based on the total body of evidence of health conditions associated with vitamin D deficiency, abetted with the results from this meta-analysis, a more proactive attitude to identify, prevent and treat vitamin D deficiency should be part of standard medical care. From a broader public health perspective, the roles of moderate sun exposure, food fortification with vitamin D and higher-dose vitamin D supplements for adults need to be debated."
For more details, see "Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials," Arch Intern Med 2007;167:1730-1737; 1709-1710.
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