Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years: The VDAART Randomized Clinical Trial.
Augusto A. Litonjua,Augusto A. Litonjua,Vincent J. Carey,Vincent J. Carey,Nancy Laranjo,Benjamin J. Harshfield,Thomas F. McElrath,Thomas F. McElrath,George T. O'Connor,Megan Sandel,Ronald E. Iverson,Aviva Lee-Paritz,Robert C. Strunk,Robert C. Strunk,Leonard B. Bacharier,Leonard B. Bacharier,George A. Macones,Robert S. Zeiger,Michael Schatz,Bruce W. Hollis,Eve Hornsby,Catherine M. Hawrylowicz,Ann Chen Wu,Scott T. Weiss,Scott T. Weiss +24 more
TLDR
In pregnant women at risk of having a child with asthma, supplementation with 4400 IU/d of vitamin D compared with 400IU/d significantly increased vitamin D levels in the women, but this did not meet statistical significance; however, the study may have been underpowered.Abstract:
Importance Asthma and wheezing begin early in life, and prenatal vitamin D deficiency has been variably associated with these disorders in offspring. Objective To determine whether prenatal vitamin D (cholecalciferol) supplementation can prevent asthma or recurrent wheeze in early childhood. Design, Setting, and Participants The Vitamin D Antenatal Asthma Reduction Trial was a randomized, double-blind, placebo-controlled trial conducted in 3 centers across the United States. Enrollment began in October 2009 and completed follow-up in January 2015. Eight hundred eighty-one pregnant women between the ages of 18 and 39 years at high risk of having children with asthma were randomized at 10 to 18 weeks’ gestation. Five participants were deemed ineligible shortly after randomization and were discontinued. Interventions Four hundred forty women were randomized to receive daily 4000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D, and 436 women were randomized to receive a placebo plus a prenatal vitamin containing 400 IU vitamin D. Main Outcomes and Measures Coprimary outcomes of (1) parental report of physician-diagnosed asthma or recurrent wheezing through 3 years of age and (2) third trimester maternal 25-hydroxyvitamin D levels. Results Eight hundred ten infants were born in the study, and 806 were included in the analyses for the 3-year outcomes. Two hundred eighteen children developed asthma or recurrent wheeze: 98 of 405 (24.3%; 95% CI, 18.7%-28.5%) in the 4400-IU group vs 120 of 401 (30.4%, 95% CI, 25.7%-73.1%) in the 400-IU group (hazard ratio, 0.8; 95% CI, 0.6-1.0; P = .051). Of the women in the 4400-IU group whose blood levels were checked, 289 (74.9%) had 25-hydroxyvitamin D levels of 30 ng/mL or higher by the third trimester of pregnancy compared with 133 of 391 (34.0%) in the 400-IU group (difference, 40.9%; 95% CI, 34.2%-47.5%, P Conclusions and Relevance In pregnant women at risk of having a child with asthma, supplementation with 4400 IU/d of vitamin D compared with 400 IU/d significantly increased vitamin D levels in the women. The incidence of asthma and recurrent wheezing in their children at age 3 years was lower by 6.1%, but this did not meet statistical significance; however, the study may have been underpowered. Longer follow-up of the children is ongoing to determine whether the difference is clinically important. Trial Registration clinicaltrials.gov Identifier:NCT00920621read more
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Journal ArticleDOI
Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions.
Roger Bouillon,Claudio Marcocci,Geert Carmeliet,Daniel D. Bikle,John H. White,Bess Dawson-Hughes,Paul Lips,Craig F Munns,Craig F Munns,Marise Lazaretti-Castro,Andrea Giustina,John P. Bilezikian +11 more
TL;DR: There is a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health, and what is plausible regarding the health effects of vitamin D.
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Vitamin D supplementation for women during pregnancy
TL;DR: In this paper, the effect of supplementing with vitamin D alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes.
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Obesity and asthma
TL;DR: This work examines the epidemiology and characteristics of obese asthma in children and adults, as well as the changes in lung function seen in each age group, and discusses the better recognized factors and mechanisms involved in disease pathogenesis.
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Comparative analysis of nutritional guidelines for vitamin D.
TL;DR: Government and scientific societies are regularly updating their recommendations for intake of vitamin D, especially for groups that should (infants) or prefer to (especially elderly individuals) avoid direct sunlight, an overview of such guidelines is presented.
Journal ArticleDOI
Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials
Philippe Autier,Patrick Mullie,Alina Macacu,Miruna Dragomir,M. Boniol,Kim Coppens,Cécile Pizot,Mathieu Boniol +7 more
TL;DR: There remains little evidence to suggest that vitamin D supplementation has an effect on most conditions, including chronic inflammation, despite use of increased doses of vitamin D, strengthening the hypothesis that low vitamin D status is a consequence of ill health, rather than its cause.
References
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Asthma and wheezing in the first six years of life. The Group Health Medical Associates.
Fernando D. Martinez,Anne L. Wright,Lynn M. Taussig,Catharine J. Holberg,Marilyn Halonen,Wayne J. Morgan +5 more
TL;DR: Children who started wheezing in early life and continued to wheeze at the age of six were more likely than the children who never wheezed to have mothers with a history of asthma, but do not have increased risks of asthma or allergies later in life.
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The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know
A. Catharine Ross,JoAnn E. Manson,Steven A. Abrams,John F. Aloia,John F. Aloia,Patsy M. Brannon,Steven K. Clinton,Ramon Durazo-Arvizu,J. Christopher Gallagher,Richard L. Gallo,Glenville Jones,Christopher S. Kovacs,Susan Taylor Mayne,Clifford J. Rosen,Sue A. Shapses +14 more
TL;DR: The Committee concluded that the prevalence of vitamin D inadequacy in North America has been overestimated and urgent research and clinical priorities were identified, including reassessment of laboratory ranges for 25-hydroxyvitamin D, to avoid problems of both undertreatment and overtreatment.
Journal ArticleDOI
Estimates of optimal vitamin D status
Bess Dawson-Hughes,Robert P. Heaney,Michael F. Holick,Paul Lips,Pierre J. Meunier,Reinhold Vieth,Reinhold Vieth +6 more
TL;DR: Based on the available evidence, it is believed that if older men and women maintain serum levels of 25(OH)D that are higher than the consensus median threshold of 75 nmol/l, they will be at lower risk of fracture.
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