AMA Announces Vitamin D Supplements Associated With Lower Mortality Rate

In a press release, the American Medical Association (AMA) announced that individuals who take vitamin D supplements have a lower risk of death from any cause over an average follow-up time of six-years, according to a meta-analysis of 18 previously published studies in the September 10, 2007 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Past studies have suggested that deficiencies in vitamin D might be associated with a higher risk of death from cancer, heart disease and diabetes—illnesses that account for 60 percent to 70 percent of deaths in high-income nations, according to background information in the article. “If the associations made between vitamin D and these conditions were consistent, then interventions effectively strengthening vitamin D status should result in reduced total mortality,” the authors write.

Philippe Autier, M.D., of the International Agency for Research on Cancer, Lyon, France, and Sara Gandini, Ph.D., of the European Institute of Oncology, Milano, Italy, searched for randomized controlled trials of vitamin D supplements published before November 2006. They analyzed 18 separate trials that included 57,311 participants and evaluated doses of vitamin D ranging from 300 to 2,000 international units, with an average dose of 528 international units. Most commercially available supplements contain between 400 and 600 international units.

Over an average follow-up period of 5.7 years, 4,777 of the participants died. Individuals who took vitamin D had a 7 percent lower risk of death than those who did not. In the nine trials that collected blood samples, those who took supplements had an average 1.4- to 5.2-fold higher blood level of vitamin D than those who did not.

“Mechanisms by which vitamin D supplementation would decrease all-cause mortality are not clear,” the authors write. Vitamin D could inhibit some mechanisms by which cancer cells proliferate, or it may boost the function of blood vessels or the immune system, they note.

Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Vitamin D-3 is produced in the skin on exposure to UVB radiation (290 to 320 nm), and is 10 times more bioactive. Vitamin D-2 is derived from plants and only enters the body via the diet.

“In conclusion, the intake of ordinary doses of vitamin D supplements seems to be associated with decreases in total mortality rates,” the authors write.

Source

Press Release, September 10, 2007. American Medical Association (AMA)

Arch Intern Med. 2007;167(16):1730-1737.

Editorial: Vitamin D and Total Mortality

The meta-analysis “adds a new chapter in the accumulating evidence for a beneficial role of vitamin D on health,” writes Edward Giovannucci, M.D., Sc.D., of the Harvard School of Public Health, Boston, in an accompanying editorial.

“Research on vitamin D should be continued to clearly elucidate the specific benefits and optimal intakes and levels of vitamin D,” Dr. Giovannucci writes. “Nonetheless, based on the total body of evidence of health conditions associated with vitamin D deficiency, abetted with the results from this meta-analysis, a more proactive attitude to identify, prevent and treat vitamin D deficiency should be part of standard medical care. From a broader public health perspective, the roles of moderate sun exposure, food fortification with vitamin D and higher-dose vitamin D supplements for adults need to be debated.”

Source: Arch Intern Med. 2007;167(16):1709-1710.

Key concepts: Vitamin D, mortality, AMA