Vitamin D is of proven benefit in
preventing respiratory tract infections.
The NNT (Number Needed to Treat
https://en.wikipedia.org/wiki/Number_needed_to_treat )
showed that NNT to prevent one
episode of 'flu for very deficient
patients was 4 compared to 40
for the flu vaccine! Vitamin D is
ten times more effective
than vaccination.
Vitamin D supplementation to prevent
acute respiratory tract infections:
systematic review and meta-analysis
of individual participant data
Adrian R Martineau, professor of
respiratory infection and immunity
Centre for Primary Care and Public Health,
Blizard Institute, Barts and
The London School of Medicine and Dentistry,
Queen Mary University of London,
London E1 2AB, UK
Asthma UK Centre for Applied Research,
Blizard Institute, Queen Mary University of
London, London, UK
Other Authors:
David A Jolliffe, postdoctoral research fellow
Richard L Hooper, reader in medical statistics
Lauren Greenberg, medical statistician
John F Aloia, professor of medicine
Peter Bergman, associate professor
Gal Dubnov-Raz, consultant paediatrician
Susanna Esposito, professor of paediatrics
Davaasambuu Ganmaa, assistant professor
Adit A Ginde, professor of emergency medicine
Emma C Goodall, assistant professor
Cameron C Grant, associate professor
Christopher J Griffiths, professor of primary care
Wim Janssens, professor of pneumonology
Ilkka Laaksi, chief administrative medical officer
Semira Manaseki-Holland, senior clinical lecturer
David Mauger, professor of public health sciences and statistics
David R Murdoch, professor of pathology
Rachel Neale, associate professor
Judy R Rees, assistant professor
Steve Simpson Jr, postdoctoral research fellow
Iwona Stelmach, professor of paediatric allergy
Geeta Trilok Kumar, associate professor
Mitsuyoshi Urashima, professor of molecular epidemiology
Carlos A Camargo Jr, professor of emergency medicine, medicine, and epidemiology
Acknowledgement:
This article and extract
remain the property of
its authors
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Abstract
Objectives
To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.
Design
Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.
Data sources
Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015.
Eligibility criteria for study selection
Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome.
Results
25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96.6%) participants. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity <0.001). In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses (adjusted odds ratio 0.81, 0.72 to 0.91) but not in those receiving one or more bolus doses (adjusted odds ratio 0.97, 0.86 to 1.10; P for interaction=0.05). Among those receiving daily or weekly vitamin D, protective effects were stronger in those with baseline 25-hydroxyvitamin D levels <25 nmol/L (adjusted odds ratio 0.30, 0.17 to 0.53) than in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (adjusted odds ratio 0.75, 0.60 to 0.95; P for interaction=0.006). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted odds ratio 0.98, 0.80 to 1.20, P=0.83). The body of evidence contributing to these analyses was assessed as being of high quality.
Conclusions
Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.
Systematic review registration
PROSPERO CRD42014013953.
