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Autoimmune risk decreased 30 percent by small amount of vitamin D and or Omega-3 – ViTAL Nov 7 2021

Vitamin D and Marine n-3 Fatty Acid Supplementation and Prevention of Autoimmune Disease in the VITAL Randomized Controlled Trial

Presented @ ACR Convergence, November 7, 2021
Jill Hahn1, Nancy Cook2, Erik Alexander3, Sonia Friedman3, Vadim Bubes3, Joseph Walter3, Gregory Kotler3, I-Min Lee3, JoAnn Manson3 and Karen Costenbader4, 1Harvard T.H. Chan School of Public Health, Boston, MA, 2Brigham and Womens' Hospital, Boston, MA, 3Brigham and Women's Hospital/ Harvard Medical School, Boston, MA, 4Brigham and Women's Hospital, Belmont, MA

NOTE: It appears that the the combined benefits started about year 1.
By year 4 either vitamin D or Omega-3 got similar benefit as the combination

Reduction by just Vitamin D

Background/Purpose: In observational studies, vitamin D has been inconsistently associated with reduced risk of several autoimmune diseases, and a large randomized, controlled trial has been lacking. Dietary marine-derived long-chain omega-3 (n−3) fatty acids decrease systemic inflammation and ameliorate symptoms in some autoimmune diseases, but no trials have tested whether supplementation lowers risk of developing autoimmune disease. We tested both vitamin D3 and n-3 fatty acids for the prevention of autoimmune disease within a large nationwide randomized, controlled trial.

Methods: VITamin D and OmegA-3 TriaL (VITAL), a U.S. nationwide randomized, double-blind, placebo-controlled trial, enrolled men at least 50 years and women at least 55 years of age in a two-by-two factorial design. Randomization to

  • vitamin D3 (2000 IU/d) and/or
  • n-3 fatty acids (1000 mg/d)

or placebo occurred from November 2011 to March 2014, and treatment continued through December 2017. (VITAL parent trial for cancer and cardiovascular disease prevention was reported in NEJM, January 3, 2019). We tested effects of vitamin D3 and n-3 fatty acids upon autoimmune disease incidence. Incident doctor-diagnosed autoimmune diseases were reported by participants annually and confirmed by medical record review by expert physicians for classification criteria (if existing). The primary endpoint was total incident autoimmune diseases, including rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and all others. Pre-specified secondary endpoints included individual most common autoimmune diseases; and probable autoimmune disease (evidence of incident autoimmune disease but lacking enough medical record data to confirm). Results were displayed in cumulative incidence curves and Cox regression models calculated hazard ratios (HR) of incident autoimmune diseases.

Results: 25,871 participants were randomized: 71% self-reported non-Hispanic Whites, 20% Black, and 9% other racial/ethnic groups, 51% women, mean age 67.1 years. During median follow-up of 5.3 years, confirmed autoimmune disease was diagnosed in 117 participants in the vitamin D3 group and 150 in the placebo group (HR 0.78, 95% confidence interval 0.61-1.00, p=0.04). Excluding the first 2 years in pre-specified analyses of the primary endpoint, the HR for vitamin D3 was 0.61 (0.43 – 0.86; 137 cases). Confirmed autoimmune disease was diagnosed in 123 participants in the n-3 fatty acids group and 144 in the placebo group (HR 0.85 (0.67-1.09). Excluding the first 2 years, the HR for the primary endpoint was 0.90 (0.64-1.26). (Table 1) When analyzed by factorial design subgroups, HRs for all three active arms vs. placebo/placebo were reduced by 25-30% (Figures 1-2). The number needed to treat with both agents for 5 years to prevent one autoimmune disease was 167 (94-769).

Conclusion: Supplementation for 5 years with vitamin D3 and/or n-3 fatty acids reduced incident autoimmune disease by 25-30% in older adults vs. those who received neither supplement. The effect of vitamin D3 appeared stronger after 2 years of supplementation.
 Download the PDF from VitaminDWiki
Clinical trial listing

Study was published in BMJ 3 months later - Jan 2022

 PDF doi: https://doi.org/10.1136/bmj-2021-066452

New Scientist report on this study - Jan 2022

New Scientist Jan 26 2022

Life Extension Report on his study - April 2022

Clips from PDF

A common method to screen for potential autoimmunity is the antinuclear antibody blood test or “ANA” for short.
In a study published in June 2020, researchers found that the prevalence of positive antinuclear antibody (ANA) tests is increasing in the United States.1 Groups with the greatest increase in this biomarker of autoimmune disease include males, non-Hispanic whites, adults 50 years and older, and adolescents. This study was the first to evaluate ANA changes over time in a large representative sampling of the American population.5 The study evaluated over 14,000 people enrolled in the U.S. National Health and Nutrition Examination Survey (NHANES).
The following increases in ANA (antinuclear antibodies) prevalence were found:

Autoimmune antibodies increased 44% in 20 years
1988-1991 11.0%
1999-2004 11.5%
2011-2012 15.9%

The scientists conducting this analysis state that the observed ANA increases were not explained by current trends in weight, alcohol, or smoking exposure. The findings are concerning because they suggest troubling potential increases in future autoimmune disease cases.

In November 2020, a nonprofit group called the Autoimmune Registry (www. autoimmuneregistry.org) published a comprehensive list of over 150 autoimmune diseases along with links to published literature and information about possible treatment options.6
This group states that between 15-30 million people in the United States suffer from an autoimmune disorder.
The Autoimmune Registry emphasizes how autoimmune diseases can affect every part of the human body-including skin, blood vessels, nerves, and immune and digestive systems.

In November 2021, findings from a follow-up analysis from a major clinical trial were published.4
In this study, subjects were randomized to receive daily vitamin D and fish oil or placebo for five years.7
This nationwide, double-blind, placebo-controlled trial enrolled men at least 50 years of age and women at least 55.
Compared to the placebo group, those given vitamin D3 and omega-3 supplements had a 25%-30% reduced incidence of autoimmune disease.4
This recent study tested vitamin D3 and omega-3 supplements versus placebo for prevention of autoimmune diseases in 25,871 Americans for a median of over five years.
The daily supplemental dose was 2,000 IU of vitamin D3 and 1,000 mg of omega-3 fatty acids.
In this study showing a 25%-30% reduction in autoimmune disease risk, the effect of vitamin D3 appeared to strengthen after two years of supplementation.
When the first two years of supplementation were excluded, the vitamin D3 group had a nearly 40% reduced autoimmune risk at a median of 5.3 years.
This is an important finding that confirms, for autoimmune disease, what has previously been observed— including in results from this same study cohort—for cancer. The effects of vitamin D on reducing cancer incidence and mortality become evident, or more pronounced, after continuous supplementation for one or two years or more.14-16
One reason for this is that some people in these studies have preexisting cancers that are only formally diagnosed one to two years after the study starts. When longer term data are analyzed, improved protective effects can be demonstrated.
 Download the PDF from VitaminDWiki

We can expect more benefit if they had done or more of the following:

  1. Had increased vitamin D dose for everyone - say 4,000 IU instead of 2,000 IU
  2. Had increased vitamin D dose even more if overweight or obese
  3. Had used non-daily vitamin D dosing (appears to get far more vitamin D to cells)
  4. Had used gut-friendly vitamin D (Important for > 20% of the population)
  5. Had used more Omega-3 ( many studies use 2X as much )
  6. Had decreased Omega-6 in diet (Omega-6 cancels benefits of Omega-3)
  7. Had increased Magnesium - which is needed to get benefits of Vitamin D
  8. Had included any of the 10+ activators of the Vitamin D Receptor

Some ViTAL reports on VitaminDWiki

Vitamin D and Omega-3 category starts with

393 Omega-3 items in category Omega-3 helps with: Autism (8 studies), Depression (29 studies), Cardiovascular (34 studies), Cognition (49 studies), Pregnancy (40 studies), Infant (32 studies), Obesity (13 studies), Mortality (7 studies), Breast Cancer (5 studies), Smoking, Sleep, Stroke, Longevity, Trauma (12 studies), Inflammation (18 studies), Multiple Sclerosis (9 studies), VIRUS (12 studies), etc
CIlck here for details

Autoimmune category starts with

See also web: consensus that ~50 diseases are autoimmune, ~50 more are suspected:

VitaminDWiki Omega-3 pages with VITAMIN in title (121 as of Nov 2021)

This list is automatically updated

Created by admin. Last Modification: Saturday March 19, 2022 22:37:25 GMT-0000 by admin. (Version 26)

Attached files

ID Name Comment Uploaded Size Downloads
17259 LEF April 2022-9-12.pdf admin 19 Mar, 2022 239.68 Kb 212
16930 bmj-2021-066452.full.pdf admin 27 Jan, 2022 325.45 Kb 285
16554 ViTAL Autoimmune vitamin D.jpg admin 07 Nov, 2021 37.85 Kb 437
16553 Vital follow-up.jpg admin 07 Nov, 2021 52.71 Kb 672
16552 Vitamin D and Marine n-3 Fatty Acid Supplementation and Prevention of Autoimmune Disease in the VITAL Randomized Controlled Trial - ACR Meeting Abstracts.pdf admin 07 Nov, 2021 751.19 Kb 287