Intervention to reduce vitamin testing in primary care: a randomized controlled trial

BackgroundAlthough vitamin tests are increasingly ordered by GPs, an evidence-based indication is often lacking.AimTo rationalise and reduce ordering of vitamin D and B12 tests by educating GPs and their patients about the merits and pitfalls of performing vitamin tests.MethodA two-armed cluster randomised study assessing the effectiveness of two separate interventions on the number of vitamin tests ordered. In total 26 health centres in the Netherlands participated (200 000 patients). De-implementation group 1 received education and a 3-monthly benchmarking of their own vitamin test ordering behaviour. De-implementation group 2 received the same intervention, but supplemented with educational material for patients. The primary study endpoint was the total reduction in vitamin D and B12 tests ordered at the end of the study as compared to a 1-year pre-intervention period. Secondary outcomes were the number of deficient test results, the number of (high dose) vitamin prescriptions, and the direct cost savings.ResultsThe number of vitamin D tests ordered at the end of the 1-year study period as compared to a 1-year pre-intervention period decreased with 23%. For vitamin B12 tests an overall reduction of 20% was found. Adding patient information had additional value over training and benchmarking of GPs, which was significant for vitamin D (−29% with and −19% without patient information), compared to respectively −22% and −18% for vitamin B12.ConclusionA structured intervention programme, including training of GPs and benchmarking their ordering of diagnostic tests, resulted in a significant reduction in ordered vitamin tests.

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Faculty Opinions recommendation of High-dose vitamin D(3) during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.7746956.8077054 ◽

2011 ◽

Cited By ~ 1

Author(s):

Willem J Wiersinga ◽

Gavin Koh

Keyword(s):

Vitamin D ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Antimicrobial Treatment ◽

High Dose ◽

Double Blind ◽

Intensive Phase ◽

Vitamin D 3 ◽

Randomised Controlled ◽

High Dose Vitamin

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Single High-Dose Vitamin D Supplementation as an Approach for Reducing Ultramarathon-Induced Inflammation: A Double-Blind Randomized Controlled Trial

Nutrients ◽

10.3390/nu13041280 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1280

Author(s):

Jan Mieszkowski ◽

Andżelika Borkowska ◽

Błażej Stankiewicz ◽

Andrzej Kochanowicz ◽

Bartłomiej Niespodziński ◽

...

Keyword(s):

Vitamin D ◽

Inflammatory Marker ◽

Controlled Trial ◽

Vitamin D Supplementation ◽

Oncostatin M ◽

Control Group ◽

High Dose ◽

Double Blind ◽

Single High Dose ◽

High Dose Vitamin

Purpose: A growing number of studies indicate the importance of vitamin D supplementation for sports performance. However, the effects of a single high-dose vitamin D supplementation on ultramarathon-induced inflammation have not been investigated. We here analyzed the effect of a single high-dose vitamin D supplementation on the inflammatory marker levels in ultramarathon runners after an ultramarathon run (maximal run 240 km). Methods: In the study, 35 runners (amateurs) were assigned into two groups: single high-dose vitamin D supplementation group, administered vitamin D (150,000 IU) in vegetable oil 24 h before the start of the run (n = 16); and placebo group (n = 19). Blood was collected for analysis 24 h before, immediately after, and 24 h after the run. Results: Serum 25(OH)D levels were significantly increased after the ultramarathon in both groups. The increase was greater in the vitamin D group than in the control group. Based on post-hoc and other analyses, the increase in interleukin 6 and 10, and resistin levels immediately after the run was significantly higher in runners in the control group than that in those in the supplementation group. Leptin, oncostatin M, and metalloproteinase tissue inhibitor levels were significantly decreased in both groups after the run, regardless of the supplementation. Conclusions: Ultramarathon significantly increases the serum 25(OH)D levels. Attenuation of changes in interleukin levels upon vitamin D supplementation confirmed that vitamin D has anti-inflammatory effect on exercise-induced inflammation.

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Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy378 ◽

2019 ◽

Vol 109 (6) ◽

pp. 1578-1587 ◽

Cited By ~ 16

Author(s):

Zarintaj Malihi ◽

Carlene M M Lawes ◽

Zhenqiang Wu ◽

Ying Huang ◽

Debbie Waayer ◽

...

Keyword(s):

Vitamin D ◽

Randomized Controlled Trial ◽

Serum Calcium ◽

Kidney Stone ◽

Controlled Trial ◽

Vitamin D Supplementation ◽

High Dose ◽

Randomized Controlled ◽

High Dose Vitamin

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Effect of Monthly, High-Dose, Long-Term Vitamin D on Lung Function: A Randomized Controlled Trial

Nutrients ◽

10.3390/nu9121353 ◽

2017 ◽

Vol 9 (12) ◽

pp. 1353 ◽

Cited By ~ 23

Author(s):

John Sluyter ◽

Carlos Camargo ◽

Debbie Waayer ◽

Carlene Lawes ◽

Les Toop ◽

...

Keyword(s):

Vitamin D ◽

Randomized Controlled Trial ◽

Lung Function ◽

Controlled Trial ◽

High Dose ◽

Randomized Controlled

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Long-term vitamin D and high-dose n-3 fatty acids’ supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD

British Journal Of Nutrition ◽

10.1017/s0007114519001132 ◽

2019 ◽

Vol 122 (04) ◽

pp. 423-430 ◽

Cited By ~ 1

Author(s):

Hamid Reza Talari ◽

Vahid Najafi ◽

Fariba Raygan ◽

Naghmeh Mirhosseini ◽

Vahidreza Ostadmohammadi ◽

...

Keyword(s):

Fatty Acids ◽

Vitamin D ◽

Cardiometabolic Risk ◽

Controlled Trial ◽

Hdl Cholesterol ◽

High Sensitivity ◽

Intima Media Thickness ◽

Diabetic Patients ◽

High Dose ◽

Type 2 Diabetic Patients

AbstractThis study was performed to evaluate the effects of vitamin D and n-3 fatty acids’ co-supplementation on markers of cardiometabolic risk in diabetic patients with CHD. This randomised, double-blinded, placebo-controlled trial was conducted among sixty-one vitamin D-deficient diabetic patients with CHD. At baseline, the range of serum 25-hydroxyvitamin D levels in study participants was 6·3–19·9 ng/ml. Subjects were randomly assigned into two groups either taking 50 000 IU vitamin D supplements every 2 weeks plus 2× 1000 mg/d n-3 fatty acids from flaxseed oil (n 30) or placebo (n 31) for 6 months. Vitamin D and n-3 fatty acids’ co-supplementation significantly reduced mean (P = 0·01) and maximum levels of left carotid intima–media thickness (CIMT) (P = 0·004), and mean (P = 0·02) and maximum levels of right CIMT (P = 0·003) compared with the placebo. In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β −0·40 mmol/l; 95 % CI −0·77, −0·03; P = 0·03), insulin (β −1·66 μIU/ml; 95 % CI −2·43, −0·89; P < 0·001), insulin resistance (β −0·49; 95 % CI −0·72, −0·25; P < 0·001) and LDL-cholesterol (β −0·21 mmol/l; 95 % CI −0·41, −0·01; P = 0·04), and a significant increase in insulin sensitivity (β +0·008; 95 % CI 0·004, 0·01; P = 0·001) and HDL-cholesterol (β +0·09 mmol/l; 95 % CI 0·01, 0·17; P = 0·02) compared with the placebo. Additionally, high-sensitivity C-reactive protein (β −1·56 mg/l; 95 % CI −2·65, −0·48; P = 0·005) was reduced in the supplemented group compared with the placebo group. Overall, vitamin D and n-3 fatty acids’ co-supplementation had beneficial effects on markers of cardiometabolic risk.

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Bioavailability and Safety of Vitamin D3 from Pizza Baked with Fortified Mozzarella Cheese: A Randomized Controlled Trial

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2015-015 ◽

2015 ◽

Vol 76 (3) ◽

pp. 109-116 ◽

Cited By ~ 2

Author(s):

Banaz Al-Khalidi ◽

Winnie Chiu ◽

Dérick Rousseau ◽

Reinhold Vieth

Keyword(s):

Vitamin D ◽

Dose Group ◽

Controlled Trial ◽

High Dose Group ◽

Secondary Outcome ◽

High Dose ◽

Mozzarella Cheese ◽

Double Blind ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Purpose: To assess the bioavailability and safety of vitamin D3 from fortified mozzarella cheese baked on pizza. Methods: In a randomized, double-blind trial, 96 apparently healthy, ethnically diverse adults were randomized to consume 200 IU or 28 000 IU vitamin D3 fortified mozzarella cheese with pizza once weekly for a total of 8 weeks. Blood and urine samples were collected at baseline (week 1) and final (week 10) visits for serum 25-hydroxyvitamin D and other biochemical measures. The primary outcome compared serum 25-hydroxyvitamin D between groups at 10 weeks. The secondary outcome evaluated the safety of vitamin D dosing protocol as measured by serum and urine calcium, phosphate, creatinine, and serum parathyroid hormone (PTH). Results: Serum 25-hydroxyvitamin D increased by 5.1 ± 11 nmol/L in the low-dose group (n = 47; P = 0.003), and by 73 ± 22 nmol/L in the high-dose group (n = 49; P < 0.0001). None of the subjects in either group developed any adverse events during the supplementation protocol. Serum PTH significantly decreased in the high-dose group only (P < 0.05). Conclusions: Vitamin D3 is safe and bioavailable from fortified mozzarella cheese baked on pizza.

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Genetic Variation of the Vitamin D Binding Protein Affects Vitamin D Status and Response to Supplementation in Infants

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-00630 ◽

2019 ◽

Vol 104 (11) ◽

pp. 5483-5498 ◽

Cited By ~ 5

Author(s):

Maria Enlund-Cerullo ◽

Laura Koljonen ◽

Elisa Holmlund-Suila ◽

Helena Hauta-alus ◽

Jenni Rosendahl ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D3 ◽

Binding Protein ◽

Controlled Trial ◽

Minor Allele ◽

Analysis Of Covariance ◽

High Dose ◽

Vitamin D Status ◽

Vitamin D Binding Protein ◽

Term Infants

Abstract Context Single nucleotide polymorphisms (SNPs) of the vitamin D binding protein encoding the GC (group component) gene affect 25-hydroxyvitamin D (25OHD) concentrations, but their influence on vitamin D status and response to vitamin D supplementation in infants is unknown. Objective To study GC genotype–related differences in 25OHD concentrations and the response to supplementation during a vitamin D intervention study in infants. Design In this randomized controlled trial, healthy term infants received vitamin D3 (10 or 30 μg/d) from 2 weeks to 24 months of age. GC SNPs rs2282679, rs4588, rs7041, and rs1155563 were genotyped. rs4588/7041 diplotype and haplotypes of rs2282679, rs4588, and rs7041 (Haplo3SNP) and of all four SNPs (Haplo4SNP) were determined. Main Outcome Measures 25OHD measured in cord blood at birth and at 12 and 24 months during intervention. Results A total of 913 infants were included. Minor allele homozygosity of all studied GC SNPs, their combined haplotypes, and rs4588/rs7041 diplotype 2/2 were associated with lower 25OHD concentrations at all time points in one or both intervention groups [analysis of covariance (ANCOVA) P < 0.043], with the exception of rs7041, which did not affect 25OHD at birth. In the high-dose supplementation group receiving 30 μg/d vitamin D3, but not in those receiving 10 µg/d, genotype of rs2282679, rs4588, and rs7041; diplotype; and Haplo3SNP significantly affected intervention response (repeated measurement ANCOVA Pinteraction < 0.019). Minor allele homozygotes had lower 25OHD concentrations and smaller increases in 25OHD throughout the intervention. Conclusions In infants, vitamin D binding protein genotype affects 25OHD concentration and efficiency of high-dose vitamin D3 supplementation.

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