GETTY X2 and Clinical Nutrition , Kuopio , Finland .
Vitamin D has a universal action in humans as witnessed by the large number of vitamin D receptors in tissues throughout the body . 1 Moreover , observational data have suggested that low levels of the vitamin are associated with an increased risk of cardiovascular diseases ( CVD ) including hypertension , heart failure and ischaemic heart disease , 2 as well as some cancers . 3 Nevertheless , the evidence derived from observational studies is less robust than from randomised controlled trials although a 2007 meta-analysis of randomised trials with vitamin D , indicated a lower mortality risk from any cause . 4 In addition , in a 4-year randomised trial of calcium and vitamin D supplementation in post-menopausal women , the authors found that vitamin D status was a significant , independent predictor of cancer risk . 5
For the present study , 6 the Finnish team sought to investigate the impact of two high vitamin D3 supplementation doses on the incidence of CVD and cancer , among generally heathy individuals aged 60 years and older . They recruited participants without a history of either cancer of CVD . These individuals were then randomised to receive identical pills containing either 1600IU / day or 3200IU / day of vitamin D3 or placebo for a period of at least 5 years . Serum 25 ( OH ) D3 levels were measured at baseline and after 6 and 12 months . The primary endpoints of the trial were incidence major CVD events , defined as a composite of myocardial infarction , stroke , and CVD mortality and any invasive cancer . The secondary endpoint was an expansion of the primary endpoint to include coronary revascularisation or a percutaneous coronary intervention , incident colorectal , breast , prostate and total cancer mortality .
Findings A total of 2495 individuals with a mean age of 68.2 years ( 43 % women ) were included in the analysis and randomised to placebo ( 830 ), 1600IU / day ( 832 ) or 3200IU / day ( 833 ).
A sub-cohort of 503 individuals were subjected to more detailed analysis with a mean baseline 25 ( OH ) D of 74.8nmol / l . After 6 months , the mean increase in 25 ( OH ) D was 23.4nmol / l ( 1600IU / day group ) and 43.6nmol / l ( 3200IU / day group ).
During a mean follow-up of 4.3 years , 41 , 42 and 36 major CVD events in the placebo , 1600 IU and 3200IU groups respectively . Compared with placebo , the hazard ratio for the 1600IU group was 0.97 ( 95 % CI 0.63 – 1.49 ) and 0.84 ( 0.54 – 1.31 ) for the 3200IU group .
Invasive cancer occurred in 41 , 48 and 40 of those in the placebo , 1600IU and 3200IU groups , respectively and again , these differences were not statistically significant . There were also no significant differences in the secondary outcomes or in total mortality .
The authors concluded that neither dose of vitamin D had any perceivable impact on major CVD events or invasive cancer in older adults which might have been due to participants having sufficient baseline levels of vitamin D . They suggested that future trials should focus on those who are specifically vitamin D deficient .
References 1 Carlberg C . Genome-wide ( over ) view on the actions of vitamin D . Front Physiolo 2014 ; 5:167 2 Judd SE , Tangpricha V . Vitamin D deficiency and risk for cardiovascular disease . Am J Med Soc 2009 ; 338 ( 1 ): 40 – 4 . 3 Garland CF et al . Vitamin D for cancer prevention : global perspective Ann Epidemiol 2009 ; 19 ( 7 ): 468 – 83 . 4 Autier P , Gandini S . Vitamin D supplementation and total mortality : a meta-analysis of randomised controlled trials . Arch Intern Med 2007 ; 167 ( 16 ): 1730 – 7 . 5 Lappe JM et al . Vitamin D and calcium supplementation reduces cancer risk : results of a randomised trial . Am J Clin Nutr 2007 ; 85 ( 6 ): 1586 – 91 . 6 Virtanen JK et al . Vitamin D supplementation and prevention of cardiovascular disease and cancer in the Finnish Vitamin D Trial – a randomised controlled trial . Am J Clin Nutr 2022 ; https :// doi . org / 10.1093 / ajcn / nqab419
Krill oil derived omega-3 free fatty acid mixture significantly reduces triglyceride levels
A krill oil formulation containing a mixture of free omega-3 fatty acids and phospholipid acid esters , has been shown to produce a significant reduction in triglycerides in two randomised , placebo-controlled trials . This was the finding by a team from the Tufts Friedman School of Nutrition Science and Policy , Boston , US .
Hypertriglyceridaemia ( TG ) represents a common lipid abnormality seen in those with visceral obesity , metabolic syndrome and type 2 diabetes . 1 The omega 3 fatty acids , eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) are known to reduce plasma triglyceride levels . 2 Nevertheless , uncertainty remains over whether omega-3 oils can reduce major cardiovascular events , with one study 3 observing no effect whereas another 4 concluded that in those with TG , omega-3 significantly reduced ischaemic events .
Given this uncertainty , the US team turned to an investigational drug that contained a mixture of free omega-3 fatty acids and these acids as phospholipid esters derived from krill oil . 5 The team undertook two identical , placebo trials , TRILOGY 1 ( NCT03398005 ) and TRILOGY 2 ( NCT03361501 ), with a view to determining if the krill oil mixture could lower elevated triglyceride levels after 12 weeks of treatment .
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