Vitamin D supplementation and total mortality - A meta-analysis of randomized controlled trials

International Agency for Research on Cancer, 150 cours Albert Thomas, F-69372 Lyon, France.
Archives of Internal Medicine (Impact Factor: 13.25). 10/2007; 167(16):1730-7. DOI: 10.1001/archinte.167.16.1730
Source: PubMed

ABSTRACT Ecological and observational studies suggest that low vitamin D status could be associated with higher mortality from life-threatening conditions including cancer, cardiovascular disease, and diabetes mellitus that account for 60% to 70% of total mortality in high-income countries. We examined the risk of dying from any cause in subjects who participated in randomized trials testing the impact of vitamin D supplementation (ergocalciferol [vitamin D(2)] or cholecalciferol [vitamin D(3)]) on any health condition.
The literature up to November 2006 was searched without language restriction using the following databases: PubMed, ISI Web of Science (Science Citation Index Expanded), EMBASE, and the Cochrane Library.
We identified 18 independent randomized controlled trials, including 57 311 participants. A total of 4777 deaths from any cause occurred during a trial size-adjusted mean of 5.7 years. Daily doses of vitamin D supplements varied from 300 to 2000 IU. The trial size-adjusted mean daily vitamin D dose was 528 IU. In 9 trials, there was a 1.4- to 5.2-fold difference in serum 25-hydroxyvitamin D between the intervention and control groups. The summary relative risk for mortality from any cause was 0.93 (95% confidence interval, 0.87-0.99). There was neither indication for heterogeneity nor indication for publication biases. The summary relative risk did not change according to the addition of calcium supplements in the intervention.
Intake of ordinary doses of vitamin D supplements seems to be associated with decreases in total mortality rates. 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 with total mortality as the main end point should be organized for confirming these findings.


Available from: Sara Gandini, Jun 03, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT Introduction Vitamin D3 (cholecalciferol) is unique in nutritional science for its impressive safety, low cost, and wide range of clinical applications. The breadth of its clinical applications provides evidence of the importance of this nutrient/hormone in a wide range of physiologic functions, including calcium absorption and bone health, maintenance of gut mucosal integrity, maintenance of muscle strength, anti-inflammatory benefits, modulation of NFkB, antirheumatic and anti-autoimmune benefits, immunosupportive and anti-infection benefits, anti-cancer benefits, cardioprotection, neuroprotection, and ability to prevent deficiency-induced musculoskeletal pain, weakness, and seizures. In 2004, the current author lead the writing of an important review paper for the integrative medicine and functional medicine communities in Alternative Therapies in Health and Medicine, and this paper sought to effect a "paradigm shift" in the way vitamin D is perceived by clinicians with the hope that more clinicians would embrace its use for the benefit of their practices and patients. The purpose of this article is to briefly outline the arguments for and against and to invite proponents of "medically endorsed/promoted nutritional deficiency" to clearly articulate their position, its mechanisms, and to provide a risk/cost-benefit ratio substantiating what is otherwise contrary to the bulk of science and clinical practice on this topic. Vasquez A. Iatrogenic induction of vitamin D deficiency: The position against this potentially harmful practice and open invitation for its proponents to articulate substantiation. Int J Hum Nutr Funct Med 2015;v3(q1):p1
  • [Show abstract] [Hide abstract]
    ABSTRACT: Observational data on the association between circulating 25(OH)D and colorectal cancer risk are limited in women. To determine whether prediagnostic levels of 25(OH)D were associated with risk of incident colorectal cancer in the Women's Health Study (WHS), we conducted a nested case-control study using 274 colorectal cases and 274 controls. Each case was matched to a control by age, ethnicity, fasting status at the time of blood collection, time of day when blood was drawn, and month of blood draw. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for colorectal cancer by 25(OH)D quartiles. Mean plasma 25(OH)D was lower in cases versus controls (21.9 vs 23.9 ng/mL, p=0.01). In multivariable-adjusted logistic regression models, plasma 25(OH)D was significantly and inversely associated with odds of colorectal cancer (quartile 4 [Q4] versus quartile 1 [Q1]: OR (95% CI): 0.45 (0.25-0.81), ptrend 0.02). Additionally, we observed a somewhat lower risk of colorectal cancer mortality after adjustment for matching variables, randomization treatment and other risk factors (Q4:Q1 OR[95%CI]: 0.40(0.17-0.97); ptrend 0.05). In this cohort of healthy women, we found a significant inverse association between prediagnostic 25(OH)D levels and risk of incident colorectal cancer, and a borderline significant inverse association between prediagnostic 25(OH)D levels and colorectal cancer mortality. These results support a possible association between plasma 25(OH)D and risk of colorectal cancer in women. Received December 29, 2014. Revision received March 17, 2015. Accepted March 23, 2015.
    Cancer Prevention Research 03/2015; DOI:10.1158/1940-6207.CAPR-14-0470 · 5.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The current standard regimens for the treatment of acute myeloid leukemia (AML) are curative in less than half of patients; therefore, there is a great need for innovative new approaches to this problem. One approach is to target new treatments to the pathways that are instrumental to cell growth and survival with drugs that are less harmful to normal cells than to neoplastic cells. In this review, we focus on the MAPK family of signaling pathways and those that are known to, or potentially can, interact with MAPKs, such as PI3K/AKT/FOXO and JAK/STAT. We exemplify the recent studies in this field with specific relevance to vitamin D and its derivatives, since they have featured prominently in recent scientific literature as having anti-cancer properties. Since microRNAs also are known to be regulated by activated vitamin D, this is also briefly discussed here, as are the implications of the emerging acquisition of transcriptosome data and potentiation of the biological effects of vitamin D by other compounds. While there are ongoing clinical trials of various compounds that affect signaling pathways, more studies are needed to establish the clinical utility of vitamin D in the treatment of cancer.
    03/2015; 2015(4):504-534. DOI:10.3390/jcm4040504