scholarly journals Potential of Vitamin D Food Fortification in Prevention of Cancer Deaths—A Modeling Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3986
Author(s):  
Tobias Niedermaier ◽  
Thomas Gredner ◽  
Sabine Kuznia ◽  
Ben Schöttker ◽  
Ute Mons ◽  
...  

Meta-analyses of randomized controlled trials (RCTs) have estimated a 13% reduction of cancer mortality by vitamin D supplementation among older adults. We evaluated if and to what extent similar effects might be expected from vitamin D fortification of foods. We reviewed the literature on RCTs assessing the impact of vitamin D supplementation on cancer mortality, on increases of vitamin D levels by either supplementation or food fortification, and on costs of supplementation or fortification. Then, we derived expected effects on total cancer mortality and related costs and savings from potential implementation of vitamin D food fortification in Germany and compared the results to those for supplementation. In RCTs with vitamin D supplementation in average doses of 820–2000 IU per day, serum concentrations of 25-hydroxy-vitamin D increased by 15–30 nmol/L, respectively. Studies on food fortification found increases by 10–42 nmol/L, thus largely in the range of increases previously demonstrated by supplementation. Fortification is estimated to be considerably less expensive than supplementation. It might be similarly effective as supplementation in reducing cancer mortality and might even achieve such reduction at substantially larger net savings. Although vitamin D overdoses are unlikely in food fortification programs, implementation should be accompanied by a study monitoring the frequency of potentially occurring adverse effects by overdoses, such as hypercalcemia. Future studies on effectiveness of vitamin D supplementation and fortification are warranted.

2021 ◽  
pp. 1-7
Author(s):  
S.D. Anton ◽  
R.T. Mankowski ◽  
P. Qiu ◽  
L. You ◽  
B.A. Bensadon ◽  
...  

Background: Vitamin D insufficiency contributes to muscle weakness and a higher risk of falls in older adults. Objectives: This study explored the impact of vitamin D supplementation on self-reported falls and physical function in older adults with low vitamin D levels and a recent fall history. Materials and Methods: Twenty-five older adults ≥ 70 years with two or more falls during the past year, low vitamin D blood levels (≥10 ng/ml and < 30 ng/mL), and slow gait speed (1.2 m/s) participated in a 6-month vitamin D supplementation (800 IU/day) study. A modified version of the Morse Fall Scale questionnaire was used to assess frequency of falls over one-year prior to study enrollment. Functional outcomes (short physical performance battery, handgrip strength, gait Timed Up and Go, and six-minute walk), and vitamin D levels were assessed at baseline and 6-month follow-up. Results: Based on diaries and pill counts, participants were generally adherent to the intervention (6 of 7 days per week). Supplementation with 800 IU/day of vitamin D for 6 months increased blood vitamin D levels from 23.25±4.8 ng/ml to 29.13±6.9 ng/ml (p<0.001). Self-reported number of falls decreased from an average of 3.76 ± 2.2 falls in one-year to 0.76 ± 1.4 falls (p <0.0001) over the 6-month intervention. No changes in functional outcome measures were observed. Conclusions: Vitamin D supplementation at the currently recommended dose of 800 IU/day increased blood vitamin D levels and reduced frequency of falls in older adults with low vitamin D levels and a recent fall history.


Author(s):  
Paul Zajic ◽  
Stefan Heschl ◽  
Michael Schörghuber ◽  
Petra Srekl-Filzmaier ◽  
Tatjana Stojakovic ◽  
...  

Summary Background There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. Methods In this prospective observational pilot study in adult patients undergoing cardiovascular surgery on cardiopulmonary bypass (CPB), blood samples drawn at preoperative baseline (t1), after weaning from CPB (t2), on intensive care unit (ICU) admission (t3) and on the first (t4) and second (t5) postoperative days were analyzed. Results A total of 26 patients (130 samples) were included in this study. Fluid loading by CPB led to a median reduction of 25(OH)D by −22.6% (range −54.5% to −19.5%) between t1 and t2. Cohen’s kappa (κ) for method agreement for vitamin D deficiency (tested cut-off values 20 ng/ml and 12 ng/ml), was κ = 0.291 (p < 0.001) and κ = 0.469 (p < 0.001), respectively. The mean difference between measurements by ECLIA and LC-MS/MS was 4.8 ng/ml (±5.7), Pearson’s r for correlation was 0.73 (p < 0.001). The biologically inactive C3-epimer did not contribute to 25(OH)D levels assessed by LC-MS/MS. Conclusion The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate. Trial Registration DRKS00009216, German Clinical Trials Registry (www.drks.de)


2020 ◽  
Vol 93 (5) ◽  
pp. 304-312
Author(s):  
Claire Flot ◽  
Valérie Porquet-Bordes ◽  
Justine Bacchetta ◽  
Anya Rothenbuhler ◽  
Anne Lienhardt-Roussie ◽  
...  

<b><i>Aim:</i></b> To describe the demographic characteristics, risk factors, and presenting features of children with symptomatic nutritional rickets in France. <b><i>Methods:</i></b> This is a retrospective study of 38 children diagnosed with nutritional rickets from 1998 to 2019. <b><i>Results:</i></b> We observed a higher frequency of rickets in males (74 vs. 26%), in young children (median age at diagnosis: 23 months; 82% were younger than 5 years), and in children with a non-Caucasian ethnic background (89%). Most children were exclusively breastfed (78%) without adequate vitamin D supplementation (89%). The most common presentations were bowed legs (63%), hypocalcemic seizures (21%), and growth retardation (11%). Approximately half (62%) of the children were hypocalcemic. The children presenting with hypocalcemic seizures were significantly younger (0.8 vs. 2.2 years; <i>p</i> = 0.041) and had lower total serum calcium levels (1.44 vs. 2.17 mmol/L; <i>p</i> &#x3c; 0.0001), higher phosphatemia (1.43 vs. 1.23 mmol/L; <i>p</i> = 0.020), and lower 25-hydroxy vitamin D levels (3 vs. 7 ng/mL; <i>p</i> = 0.020) but similar parathyroid hormone levels (357 vs. 289 ng/mL; <i>p</i> = 0.940) compared to rickets cases who did not experience hypocalcemic seizures. A dilated cardiomyopathy was detected in 14% of the children who had undergone echocardiography. <b><i>Conclusion:</i></b> Nutritional rickets remains endemic in the pediatric population and its most severe forms can have life-threatening sequelae. Health practitioners need to be cognizant of these facts to raise awareness and screen high-risk populations.


2021 ◽  
Vol 14 (1) ◽  
pp. 303-309
Author(s):  
Mostafa Hassan Ragab ◽  
Eman Monir Sherif ◽  
Nadia Badawy Abd- El Gawad ◽  
Safaa Mohamed Elserougy ◽  
Eman Essam Shaban ◽  
...  

Diabetes is one of the commonest chronic diseases worldwide. Vitamin D deficiency showed to be increasing, and have a potential role in autoimmune diseases among which in type 1 diabetes. The aim The aim of the study was to assess the impact of oral vitamin D supplementation on blood glucose (HbA1C) in T1DM patients and to find out the role of vitamin D as a biomarker for follow of T1DM patients compared to HbA1C. Subjects and methods: A randomized interventional clinical study was designed. The study enrolled 60 children patients with T1DM. Only 45 children continued to the end of study. Initial (pre-intake) assessment included history taking, clinical examination, and measurement of serum 25-OH vitamin D3 and serum HbA1C. These children received oral vitamin D supplements for 3 months then post-intake assessment were done again. Results: The study showed that serum vitamin D was deficient among Egyptian children and adolescents with T1DM (mean 11.4±3.4 ng/ml). , 53.33% of the patients had vitamin D deficiency with a 35.6% had insufficiency and 11.11% were VD sufficient. Patients received oral vitamin D supplementation for 3 months after which marked improvement in the levels of serum vitamin D levels and HA1C, 87.5% and 86.5% respectively.


2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982659 ◽  
Author(s):  
Johan Linden ◽  
Gabriel Granåsen ◽  
Jonatan Salzer ◽  
Anders Svenningsson ◽  
Peter Sundström

Background Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed. Objective To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels. Methods Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health. Results In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects. Conclusion The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.


2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jonathan D. Adachi ◽  
Jacques P. Brown ◽  
George Ioannidis

Though vitamin D is important for bone health, little is known about the monitoring and management of vitamin D levels in patients with osteoporosis in clinical practice—a deficit this chart review initiative aimed to remedy. A total of 52 physicians completed profiles for 983 patients being treated for osteoporosis between November 2008 and April 2009. Information collected included demographics; fracture risk factors; availability and level of serum vitamin D measurements; and information on osteoporosis medications and calcium and vitamin D supplementation. Physicians also evaluated patients’ current regimens and detailed proposed changes, if applicable. Nearly 85% of patients were prescribed calcium and vitamin D supplements. Serum 25-hydroxy vitamin D levels were available for 73% of patients. Of these patients, approximately 50% had levels less than 80 nmol/L, which contrasts with the 37% thought to have “unsatisfactory” vitamin D levels based on physician perceptions. Physicians felt 26% of patients would benefit from additional vitamin D supplementation. However, no changes to the osteoporosis regimen were suggested for 48% of patients perceived to have “unsatisfactory” vitamin D levels. The results underscore the importance of considering vitamin D status when looking to optimize bone health.


Author(s):  
Devi Dayal

<p>Vitamin D deficiency (VDD) is presumed to play a role in several infective and non-infective conditions such as acute respiratory infections, tuberculosis, diabetes, hypertension, stroke etc. Most of the respiratory viral infections occur during winter season when the vitamin D levels in most individuals are generally low. The current pandemic of coronavirus disease 2019 (COVID-19) which began during winter season similar to the previous epidemics due to coronaviruses, has again stirred a debate on the role of VDD in the initiation and spread of the pandemic. The data on vitamin D status in patients with COVID-19 is however lacking. Different vitamin D supplementation strategies have recently been suggested as part of several countermeasures aimed at reducing the impact of COVID-19 pandemic. This brief narrative review discusses the evidence for the link between VDD and COVID-19 and the approaches suggested for vitamin D supplementation.</p>


2018 ◽  
Author(s):  
Omowunmi Aibana ◽  
Chuan-Chin Huang ◽  
Said Aboud ◽  
Alberto Arnedo-Pena ◽  
Mercedes C. Becerra ◽  
...  

ABSTRACTBackgroundFew studies have evaluated the association between pre-existing vitamin D deficiency (VDD) and incident TB. We assessed the impact of baseline vitamin D on TB risk.MethodsWe assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6751 household contacts of TB patients in Peru. We also conducted a one-stage individual participant data meta-analysis searching PubMed and Embase for studies of vitamin D and TB until December 31, 2017. We included studies that assessed vitamin D before TB diagnosis. We defined VDD as 25–(OH)D <50 nmol/L, insufficiency as 50–75 nmol/L and sufficiency as >75nmol/L. We estimated the association between vitamin D and incident TB using conditional logistic regression in the Peru cohort and generalized linear mixed models in the meta-analysis.FindingsIn Peru, baseline VDD was associated with a statistically insignificant increase in incident TB (aOR 1·70, 95% CI 0·84–3·46; p=0·14). We identified seven studies for the meta-analysis and analyzed 3544 participants. Individuals with VDD and very low vitamin D (<25nmol/L) had increased TB risk (aOR 1·48, 95% CI 1·04–210;p=0· 03 and aOR 2 08, 95% CI 0·88–4·92; p trend=002 respectively). Among HIV-positive patients, VDD and very low vitamin D conferred a 2-fold (aOR 2.18, 95% CI 1· 22–3·90; p=0· 01) and 4-fold (aOR 4·28, 95% CI 0·85–21·44; p trend=0·01) increased risk of TB respectively.InterpretationOur findings suggest vitamin D predicts TB risk in a dose-dependent manner and vitamin D supplementation may play a role in TB prevention.FundingNational Institute of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse (NIDA), National Institute of Mental Health (NIMH), International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Dental and Craniofacial Research (NIDCR), Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Foundation, Ujala Foundation, Wyncote Foundation, NIH - Fogarty International Center Program of International Training Grants in Epidemiology Related to AIDS, NIAID Byramjee Jeejeebhoy Medical College HIV Clinical Trials Unit, NIAID’s Baltimore-Washington-India Clinical Trials Unit, National Commission on Biotechnology, the Higher Education Commission, International Research Support Initiative Program of the Higher Education Commission Government of Pakistan, the Bill and Melinda Gates Foundation, and the NIH Fogarty International Center.Research in ContextEvidence before this studyNumerous studies have found lower serum vitamin D levels among patients with active TB disease compared to healthy controls. However, research has not clarified whether low vitamin D increases TB risk or whether TB disease leads to decreased vitamin D levels. We conducted PubMed and Medline searches for all studies available through December 31, 2017 on the association between vitamin D status and TB disease. We included the following keywords: “vitamin D,” “vitamin D deficiency,” “hypovitaminosis D,” “25-hydroxyvitamin D,” “1,25-dihydroxyvitamin D,” “vitamin D2,” “vitamin D3,” “ergocalciferol,” “cholecalciferol,” and “tuberculosis.” We found only seven studies had prospectively evaluated the impact of baseline vitamin D levels on risk of progression to TB disease.We report here the results of a case control study nested within a large prospective longitudinal cohort study of household contacts of TB cases and the results of an individual participant data (IPD) metaanalysis of available evidence on the association between vitamin D levels and incident TB disease.Added value of this studyWe demonstrated that low vitamin D levels predicts risk of future progression to TB disease in a dose-dependent manner.Implications of all the available evidenceThese findings suggest the possibility that vitamin D supplementation among individuals at high risk for developing TB disease might play a role in TB prevention efforts.


2012 ◽  
Vol 52 (1) ◽  
pp. 16
Author(s):  
Ayi Dilla Septarini ◽  
Taralan Tambunan ◽  
Pustika Amalia

Background Children with frequently relapsing and steroiddependentnephrotic syndrome (FRNS/SDNS) are at riskfor osteoporosis due to impaired metabolism of calcium andvitamin D.Objective To determine the effect of calcium and vitamin Dsupplementation on bone mineral density, serum ionized calciumlevels and serum 25-hydroxy-vitamin D levels in children withFRNS and SDNS.Methods A clinical trial with a before and after design wasperformed. Subjects were SDNS or FRNS pediatric patients 2: 5years of age. Subjects received 800 mg elemental calcium and 400IU vitamin D supplementation for 8 weeks. Serum ionized calcium,serum 25-hydroxy-vitamin D [25(0H)D], and bone mineral density(BMD) were determined before and after the supplementation.Results Of the 30 subjects, 28 completed the study. However,only 20 subjects underwent BMD determination before and aftersupplementation. Of the 28 subjects, 22 had hypocalcemia and 26had low vitamin D levels. Osteopenia was found in 14/20 subjects andosteoporosis was in 2/20 subjects. After 8 weeks of supplementation,mean serum ionized calcium increased from low [1.15 mmol/L (SDO.oJ)] to normal [1.18 mmol/L (SD 0.04)] (P< 0.001) levels, butmean serum 25(0H)D only increased from vitamin D deficiencycategory [20 ng/mL (SD 7 .7)] to vitamin D insufficiency category[25.5 ng/mL (7.7)] (P=0.010). Mean z-score BMD increased from-1.1 (SD 0.9) to -0.7 (SD 0.2) after supplementation (P<0.001).Conclusion Calcium vitamin D supplementation effectively increasedserum ionized calcium, serum 25 (OH)D, and BMD in subjectswith FRNS and SDNS. [Paediatr lndones. 2012;52:16-21].


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