Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease
Manson JE, Cook NR, Lee IM, Christen W, Bassuk SS, Mora S, Gibson H, Gordon D, Copeland T, D'Agostino D, Friedenberg G, Ridge C, Bubes V, Giovannucci EL, Willett WC, Buring JE, VITAL Research Group
The New England journal of medicine · 1186 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Institute of Mental Health
- Government
- National Cancer Institute
- Government
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Government
- NCI NIH HHS
- Government
- NIMH NIH HHS
- Government
- NHLBI NIH HHS
- Government
- NIAMS NIH HHS
- Grants
- National Institute of Mental Health (R01MH091448); National Cancer Institute (R01 CA138962); National Heart, Lung, and Blood Institute (U01 HL145386); National Cancer Institute (U01CA138962); National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR059086); National Heart, Lung, and Blood Institute (R01 CA138962)
Based on 8 listed funder(s).
Publication
- Published
- 2018-11-10 · N Engl J Med · vol. 380 · issue 1 · pp. 33–44
- Publisher
- Massachusetts Medical Society
- Cited
- 1642 citations · more than 100% of similar papers · 109.9× the field average
- Impact
- Top 10% most cited in its field
- References
- 41 works
- Access
- Free to read
- Research areas
- Vitamin D Research Studies · Metabolism, Diabetes, and Cancer · Vitamin C and Antioxidants Research
- Keywords
- Medicine, Vitamin D and neurology, Disease, Cancer prevention, Cancer, Randomized controlled trial, Cardiovascular health, Vitamin, Internal medicine, Clinical trial
- MeSH
- humans, neoplasms, cardiovascular diseases, vitamins, vitamin d, treatment failure, incidence, follow-up studies, double-blind method, dietary supplements, aged, middle aged, female, male
16 authors
From US
- JoAnn E. MansonBrigham and Women's Hospital; Harvard University
- Nancy R. CookBrigham and Women's Hospital; Harvard University
- I‐Min LeeBrigham and Women's Hospital; Harvard University
- William ChristenBrigham and Women's Hospital; Harvard University
- Shari S. BassukBrigham and Women's Hospital; Harvard University
- Samia MoraBrigham and Women's Hospital; Harvard University
Abstract
Background
It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited.
Methods
We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.
Results
A total of 25,871 participants, including 5106 black participants, underwent randomization. Supplementation with vitamin D was not associated with a lower risk of either of the primary end points. During a median follow-up of 5.3 years, cancer was diagnosed in 1617 participants (793 in the vitamin D group and 824 in the placebo group; hazard ratio, 0.96; 95% confidence interval [CI], 0.88 to 1.06; P=0.47). A major cardiovascular event occurred in 805 participants (396 in the vitamin D group and 409 in the placebo group; hazard ratio, 0.97; 95% CI, 0.85 to 1.12; P=0.69). In the analyses of secondary end points, the hazard ratios were as follows: for death from cancer (341 deaths), 0.83 (95% CI, 0.67 to 1.02); for breast cancer, 1.02 (95% CI, 0.79 to 1.31); for prostate cancer, 0.88 (95% CI, 0.72 to 1.07); for colorectal cancer, 1.09 (95% CI, 0.73 to 1.62); for the expanded composite end point of major cardiovascular events plus coronary revascularization, 0.96 (95% CI, 0.86 to 1.08); for myocardial infarction, 0.96 (95% CI, 0.78 to 1.19); for stroke, 0.95 (95% CI, 0.76 to 1.20); and for death from cardiovascular causes, 1.11 (95% CI, 0.88 to 1.40). In the analysis of death from any cause (978 deaths), the hazard ratio was 0.99 (95% CI, 0.87 to 1.12). No excess risks of hypercalcemia or other adverse events were identified.
Conclusions
Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .).
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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