New analyses from the massive potential research referred to as VITAL solid further doubt on the worth of routine vitamin D and omega-3 fatty acid dietary supplements for typically wholesome people.

Every day administration of two,000 IU of vitamin D, in lots of instances on prime of dietary supplements that research members have been taking over their very own, had no impact on fracture threat over some 5 years, stated Meryl LeBoff, MD, of Brigham and Girls’s Hospital in Boston, on the American Society for Bone and Mineral Analysis (ASBMR) annual assembly held on-line and in San Diego.

With nearly equal numbers of members receiving vitamin D versus placebo, numbers of incident fractures of every kind have been almost equal as nicely, at 769 versus 782, for a hazard ratio of 0.98 (95% CI 0.89-1.08), LeBoff stated. Numbers have been additionally very comparable between teams for non-vertebral fractures and hip fractures.

And two different substudies from VITAL, each introduced as “e-posters” at ASBMR by Sharon Chou, MD, additionally of Brigham and Girls’s, discovered no profit from omega-3 dietary supplements in members’ bodily talents or in biomarkers of bone well being.

It is simply the instance of a rigorous randomized trial contradicting anecdotal and observational experiences that dietary supplements have necessary preventive results.

VITAL, you could recall, randomized some 25,000 typically wholesome folks, of whom about 20% have been Black, in a 4×4 design to double placebo, 2,000 IU/day vitamin D3, 1,000 mg/day omega-3 capsules, or each dietary supplements. Median follow-up was simply over 5 years. Most cancers and cardiovascular occasions have been the prespecified major outcomes (for which there was no profit), however the design included further substudies to look at different purported results of those dietary supplements.

The brand new evaluation of fracture charges in VITAL is of explicit curiosity as a result of, for all the advantages claimed for vitamin D, bone well being has the strongest proof. The present authorities advice of 400 IU per day is predicated on research indicating that vitamin D is important to take care of bone integrity.

However whether or not supplementation at 2,000 IU per day along with the conventional sources — dietary consumption and daylight publicity — offers further safety was much less clear.

VITAL enrolled a comparatively unselected group of males (ages 50 and up) and ladies (ages 55 and up) to obtain the each day vitamin D and/or omega-3 dietary supplements within the placebo-controlled, double-blind, double-dummy research. Members’ comparatively younger age (imply 67) was a focal point for no less than one member of LeBoff’s viewers, who questioned whether or not the outcomes are related for older people, for whom fracture threat is best.

“We will not generalize to 80-year-olds,” LeBoff acknowledged.

And vitamin D advocates might nicely criticize different points of the trial, such because the dosing (7,000 IU/day or extra are sometimes beneficial) and goal vitamin D blood ranges.

However the outcomes have been additionally bolstered by the rigorous adjudication of fractures. LeBoff identified that the dietary supplements have been very efficient in elevating blood ranges of the lively vitamin D metabolite, 25-(OH)D, with most members receiving the lively product reaching ranges of no less than 40 ng/mL. (Ranges of 30 ng/mL are conventionally thought-about enough for bone well being.)

Additionally, fracture charges have been comparable amongst participant teams outlined by baseline ranges (<20, 20-29, or ≥30 ng/mL).

Within the poster displays, Chou and colleagues defined that bone advantages have additionally been claimed for omega-3 fatty acids, with animal research pointing to “elevated calcium absorption, decreased urinary calcium excretion, and decreased irritation and bone resorption.”

They sought to look at the query in a VITAL subgroup, consisting of members within the New England space who have been introduced in for imaging checks and bodily exams. No signal of the purported advantages have been seen. Measures of bone mineral density general and at key areas, bone energy, cortical thickness, and polar stress energy index have been all comparable in members receiving the lively dietary supplements versus placebo.

The identical was true for bodily talents, as measured by checks of grip energy, strolling pace, chair stands, steadiness, and different goal efficiency assessments.

  • John Gever was Managing Editor from 2014 to 2021; he’s now a daily contributor.

Disclosures

VITAL was funded by the NIH.