The Efficacy of Vitamin D Supplementation During a Prolonged Submarine Patrol
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Submariners spend prolonged periods submerged without sunlight exposure and may benefit from vitamin D supplementation to maintain vitamin D status. The primary objective of this study was to determine the efficacy of daily vitamin D supplementation on maintenance of 25-hydroxyvitamin D (25(OH)D) during a 3-month submarine patrol. Submariners were randomly divided into three groups: placebo (n = 16), 1,000 IU/day (n = 20), or 2,000 IU/day (n = 17). Anthropometrics, self-reported dietary calcium and vitamin D intake, serum markers of vitamin D and bone metabolism, and peripheral quantitative computed tomography (pQCT) parameters of the tibia were determined before and after the patrol. Prior to departure, 49 % of the subjects were vitamin D insufficient (<50 nmol/L). Following the patrol, 25(OH)D increased in all groups (p < 0.001): 3.3 ± 13.1 (placebo), 4.6 ± 11.3 (1,000 IU/day), and 13 ± 14 nmol/L (2,000 IU/day). The changes in 25(OH)D levels were dependent upon the baseline concentration of 25(OH)D and body mass (p < 0.001). Osteocalcin increased by 38 % (p < 0.01), and pQCT analyses revealed small, yet significant increases in indices of tibial structure and strength (p < 0.05) that were independent of supplementation. These data suggest that vitamin D status was low prior to the patrol, and the subsequent changes in vitamin D status were dependent on the baseline 25(OH)D levels and body mass. Furthermore, short-term skeletal health does not appear to be negatively affected by 3 months of submergence in spite of a suboptimal response to vitamin D supplementation.
KeywordsBone Bone turnover Submergence Supplementation
We would like to extend our gratitude to the USS Nevada Gold Crew for their participation in this study. In addition, we would like to thank Commander, Submarine Force, Group 9, Squadron 17, and the Naval Branch Health Clinic, Bangor, WA for their permission to conduct this investigation. Additionally, we thank Dr.’s Scott Smith (NASA) and Sue Shapses (Rutgers University) for improving the quality of the research design, and CDR Fred Yeo (NSMRL), LT Joshua Swift (Armed Forces Radiobiological Research Institute), and Dr. Andrew Young (USARIEM) for critically reviewing the manuscript. Finally, we thank Dr. Annely Richardson, Mr. Lee Margolis, Ms. Nancy Murphy, SGT David Gonzalez, SPC Reginald Clyburn, SGT Glen Rossman, HMCM Darrin Way, LCDR Shawn Soutiere, and Dr. Jennifer Rood for their technical assistance. This work was supported by the Office of Naval Research, Warfighter Performance Department (Code 34), Award Number N0001411WX20143.
“The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy, Department of the Army, or the Department of Defense. Any citations of commercial organizations and trade names in this report do not constitute an official Department of the Navy, Department of the Army, or Department of Defense endorsement of approval of the products or services of these organizations.”
Human and Animal Rights and Informed Consent
The study protocol (NSMRL2012.0001) was approved by the Naval Submarine Medical Research Laboratory (NSMRL) institutional review board in compliance with all applicable federal regulations governing the protection of human subjects.
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