Real‐world evidence for the effectiveness of vitamin D supplementation in reduction of total and cause‐specific mortality. (17th October 2022)

• Record Type: Journal Article
• Authors: Sha, Sha; Nguyen, Thi Mai Ngoc; Kuznia, Sabine; Niedermaier, Tobias; Zhu, Anna; Brenner, Hermann; Schöttker, Ben
• Is Part Of: Journal of internal medicine. Volume 293:Number 3(2023)
• Page Start: 384
• Page End: 397
• Publication Date: 2022-10-17
• Subjects: cancer -- cohort study -- dietary supplement -- mortality -- vitamin D; Internal medicine -- Periodicals; Medicine -- Periodicals; 616
• DOI: 10.1111/joim.13578
• Languages: English
• ISSNs: 0954-6820

Abstract

Abstract: Background: Meta‐analyses of randomized controlled trials (RCTs) have demonstrated the efficacy of vitamin D supplementation for reduced cancer mortality, all‐cause mortality, and respiratory tract infections. However, whether and to what extent this translates into effectiveness in real‐world practice is unknown. Methods: We assessed the association of vitamin D supplement use (as an over‐the‐counter drug or as part of a multivitamin product), vitamin D deficiency (25‐hydroxyvitamin D, 25[OH]D <30 nmol/L), and insufficiency (25[OH]D 30 to <50 nmol/L) with all‐cause and cause‐specific mortality in 445, 601 participants, aged 40–73 years, from the UK Biobank cohort. Results: A total of 4.3% and a further 20.4% of the study participants reported regularly taking vitamin D or multivitamin supplements, respectively. Still, the majority had either vitamin D deficiency (21.0%) or insufficiency (34.3%). We detected 49 independent determinants of vitamin D deficiency and vitamin D supplement use and used them to adjust Cox regression models for all mortality outcomes. A total of 29, 107 (6.5%) participants died during a median follow‐up time of 11.8 years. Both vitamin D deficiency and insufficiency were strongly associated with all mortality outcomes. Self‐reported vitamin D supplement use (83% over‐the‐counter/17% prescription drugs) and multivitamin intake were significantly associated with 10% and 5% lower all‐cause mortality, respectively. Furthermore, regular vitamin D supplement users had 11%, 11%, and 29% lower cancer, cardiovascular disease, and respiratory disease mortality than nonusers, respectively (not significant for cardiovascular disease mortality). Conclusion: This large study suggests that in the real world, the efficacy of vitamin D supplements in reducing mortality may be at least as good as observed in RCTs. Abstract :