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A parallel group double-blind RCT of vitamin D3 assessing physical function: is the biochemical response to treatment affected by overweight and obesity?

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Abstract

Summary

Vitamin D may affect skeletal muscle function. In a double-blind, randomised, placebo-controlled trial, we found that vitamin D3 supplementation (400 or 1,000 I.U. vs. placebo daily for 1 year with bimonthly study visits) does not improve grip strength or reduce falls.

Introduction

This study aimed to test the supplementation effects of vitamin D3 on physical function and examine associations between overweight/obesity and the biochemical response to treatment.

Methods

In a parallel group double-blind RCT, healthy postmenopausal women from North East Scotland (latitude—57° N) aged 60–70 years (body mass index (BMI), 18–45 kg/m2) were assigned (computer randomisation) to daily vitamin D3 (400 I.U. (n = 102)/1,000 I.U. (n = 101)) or matching placebo (n = 102) (97, 96 and 100 participants analysed for outcomes, respectively) from identical coded containers for 1 year. Grip strength (primary outcome), falls, diet, physical activity and ultraviolet B radiation exposure were measured bimonthly, as were serum 25(OH)D, adjusted calcium (ACa) and phosphate. Fat/lean mass (dual energy X-ray absorptiometry), anthropometry, 1,25-dihydroxyvitamin D and parathyroid hormone were measured at baseline and 12 months. Participants and researchers were blinded throughout intervention and analysis.

Results

Treatment had no effect on grip strength (mean change (SD)/year = −0.5 (2.5), −0.9 (2.7) and −0.4 (3.3) kg force for 400/1,000 I.U. vitamin D3 and placebo groups, respectively (P = .10, ANOVA)) or falls (P = .65, chi-squared test). Biochemical responses were similar across BMI categories (<25.25–29.99, ≥30 kg/m2) with the exception of a small change at 12-months in serum ACa in overweight compared to non-overweight participants (P = .01, ANOVA; 1,000 I.U. group). In the placebo group, 25(OH)D peak concentration change (winter to summer) was negatively associated with weight (r = −.268), BMI (r = −.198), total (r = −.278) and trunk fat mass (r = −.251), with total and trunk fat mass predictive of winter to summer 25(OH)D change (P = .01/.004 respectively, linear regression).

Conclusion

We found no evidence of an improvement in physical function following vitamin D3 supplementation for 1 year.

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Acknowledgements

This work was funded partly by the UK Food Standards Agency, the Department of Health and the National Osteoporosis Society. Any views expressed are the authors own. We thank Mrs. Lismy Cheripelli (Registered General Nurse, University of Aberdeen, UK) who made significant contributions to the acquisition of data and the continued welfare of our study participants; Prof. Roger Francis (University of Newcastle, UK) for his role as Trial Steering Committee Chair; Prof. Juliet Compston (University of Cambridge, UK) and Prof. Bernard Keavney and Dr. Mark Pearce (both of University of Newcastle, UK) as members of the Data Monitoring Committee; Mrs. Gladys McPherson (University of Aberdeen, UK), for providing randomization service, generating study codes to ensure blinding throughout data analysis, and performing code breaks after analysis; Ms. Katie Wilde (University of Aberdeen, UK) for developing and maintaining our electronic study database; Mrs. Lana Gibson (University of Aberdeen, UK) and Mrs. Jennifer Scott (University of Aberdeen, UK) for performing DXA scans; Mr. William Mutch (University of Aberdeen, UK) for contribution to biochemical analyses, and Ms Katrina Galbreith for help with data entry. Finally, we would like to thank all of the women who took part in our study.

Conflicts of interest

None.

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Authors and Affiliations

  1. School of Medicine and Dentistry, University of Aberdeen, Foresterhill, Aberdeen, AB252ZD, UK

    A. D. Wood, K. R. Secombes, F. Thies, L. S. Aucott, A. J. Black, D. M. Reid & H. M. Macdonald

  2. Grampian Osteoporosis Service, Woolmanhill Hospital, Aberdeen, AB251LD, UK

    A. J. Black

  3. School of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, AB252ZD, UK

    A. Mavroeidi

  4. Department of Clinical Biochemistry, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB252ZD, UK

    W. G. Simpson

  5. Norwich Medical School, University of East Anglia, Norwich, NR47TJ, UK

    W. D. Fraser

  6. Musculoskeletal Research, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB252ZD, UK

    H. M. Macdonald

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  1. A. D. Wood
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Correspondence to H. M. Macdonald.

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Wood, A.D., Secombes, K.R., Thies, F. et al. A parallel group double-blind RCT of vitamin D3 assessing physical function: is the biochemical response to treatment affected by overweight and obesity?. Osteoporos Int 25, 305–315 (2014). https://doi.org/10.1007/s00198-013-2473-8

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  • DOI: https://doi.org/10.1007/s00198-013-2473-8

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