Vitamin D supplementation and prevention of cardiovascular disease and cancer in the Finnish Vitamin D Trial: a randomized controlled trial. Issue 5 (4th January 2022)

• Record Type: Journal Article
• Authors: Virtanen, Jyrki K; Nurmi, Tarja; Aro, Antti; Bertone-Johnson, Elizabeth R; Hyppönen, Elina; Kröger, Heikki; Lamberg-Allardt, Christel; Manson, JoAnn E; Mursu, Jaakko; Mäntyselkä, Pekka; Suominen, Sakari; Uusitupa, Matti; Voutilainen, Ari; Tuomainen, Tomi-Pekka; Hantunen, Sari
• Is Part Of: American journal of clinical nutrition. Volume 115:Issue 5(2022)
• Page Start: 1300
• Page End: 1310
• Publication Date: 2022-01-04
• Subjects: vitamin D -- supplementation study -- randomized controlled trial -- elderly -- cardiovascular disease -- cancer; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqab419
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Vitamin D insufficiency is associated with risks of cardiovascular diseases (CVD) and cancer in observational studies, but evidence for benefits with vitamin D supplementation is limited. Objectives: To investigate the effects of vitamin D3 supplementation on CVD and cancer incidences. Methods: The study was a 5-year, randomized, placebo-controlled trial among 2495 male participants ≥60 years and post-menopausal female participants ≥65 years from a general Finnish population who were free of prior CVD or cancer. The study had 3 arms: placebo, 1600 IU/day, or 3200 IU/day vitamin D3 . Follow-up was by annual study questionnaires and national registry data. A representative subcohort of 551 participants had more detailed in-person investigations. The primary endpoints were incident major CVD and invasive cancer. Secondary endpoints included the individual components of the primary CVD endpoint (myocardial infarction, stroke, and CVD mortality), site-specific cancers, and cancer death. Results: During the follow-up, there were 41 (4.9%), 42 (5.0%), and 36 (4.3%) major CVD events in the placebo, 1600 IU/d (compared with placebo: HR: 0.97; 95% CI: 0.63–1.49; P = 0.89), and 3200 IU/d (HR: 0.84; 95% CI: 0.54–1.31; P = 0.44) arms, respectively. Invasive cancer was diagnosed in 41 (4.9%), 48 (5.8%), and 40 (4.8%) participants in the placebo, 1600 IU/d (HR: 1.14; 95% CI: 0.75–1.72; P = 0.55), and 3200 IU/d (HR: 0.95; 95% CI: 0.61–1.47; P = 0.81) arms, respectively. There were no significant differences in the secondary endpoints or total mortality. In the subcohort, the mean baseline serum 25-hydroxyvitamin D concentration was 75 nmol/L (SD, 18 nmol/L). After 12 months, the concentrations were 73 nmol/L (SD, 18 nmol/L), 100 nmol/L (SD, 21 nmol/L), and 120 nmol/L (SD, 22 nmol/L) in the placebo, 1600 IU/d, and 3200 IU/d arms, respectively. Conclusions: Vitamin D3 supplementation did not lower the incidences of major CVD events or invasive cancer among older adults, possibly due to sufficient vitamin D status in most participants at baseline. Graphical Abstract: