Effect of High-Dose vs Standard-Dose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children
JAMA. 2017;318(3):245-254. doi:10.1001/jama.2017.8708
Table 2 found Influenza 2X less likely for 2,000 IU vs 400 IU
Type | 400 IU | 2,000 IU | Risk |
Influenza A | 20 | 7 | |
Influenza B | 11 | 9 | |
Influenza A or B | 31 | 16 | Risk 0.50 p=.02 (fairly certain) |
Outrageous titles reporting on this study
High-Dose Vitamin D May Not Curb Kids' Colds
High-dose vitamin D fails against young children's upper respiratory infections
High-dose vitamin D may not reduce cold risk in young children: study
Vitamin D-on't
High-dose Vitamin D Doesn't Appear to Reduce the Winter Sniffles for Children
Parents take note! High dosage of Vitamin D will not protect your child from common cold
Vitamin D will NOT protect your child from a cold: Myth-busting study says 'more isn't always better' to help toddlers stay healthy
Lack of Vitamin D found to not be linked to “cold season”
Turns Out, Vitamin D Won't Prevent Your Child's Cold
- Both groups achieved sufficient vitamin D levels by the end of the trial (4-9 months)
- There doubtless would have been a big difference if compared to children without any supplementation
- Normal RTI rate is 3/year. Both low dose and high dose children in this study had only 1 RTI/year
That is, both 400 IU and 2,000 IU reduced RTI by 3 X
Suspect that the children in this study had one or more of the following
- Children were outdoors more in the middle of the day in the summer
- Parents supplemented children with Vitamin D
- Children were getting several glasses a day of full-fat milk
Skim milk results in far less vitamin D getting into the body
See also VitaminDWiki
- Overview Colds and flu and Vitamin D
- Respiratory infections reduced by 63 percent with 4000 IU vitamin D daily - RCT Dec 2012
Note: This study did not notice a difference until about 4 months, which was the length of study on this page - Vitamin D and Respiratory Tract Infections – meta-analysis with charts June 2013
- Respiratory tract infection eliminated in 36 percent of people by 4000 IU of Vitamin D – RCT Sept 2015
- Acute respiratory tract infections prevented by vitamin D (even when ignoring the dose size – Meta-analysis Feb 2017
- Half the risk of Influenza -A in infants taking 1200 IU of vitamin D for 4 months – RCT Jan 2018
- Vitamin D and Respiratory Tract Infections – meta-analysis with charts June 2013
- Reduced viral respiratory tract infections by half by having more than 38 ng of vitamin D – June 2010
- Respiratory infection in infant was 7 X more likely if low cord Vitamin D – March 2017
- Search "Respiratory Tract Infection" 413 items as of July 2017
Mary Aglipay, MSc1; Catherine S. Birken, MD2,3,4,5; Patricia C. Parkin, MD2,3,4,5; et al Mark B. Loeb, MD, MSc6,7; Kevin Thorpe, MMath8,9; Yang Chen, MA, MSc8; Andreas Laupacis, MD8,10,11; Muhammad Mamdani, MPH, PharmD8; Colin Macarthur, PhD2,3,4,5; Jeffrey S. Hoch, PhD4,8,12; Tony Mazzulli, MD13,14; Jonathon L. Maguire, MD, MSc1,2,3,4,8; for the TARGet Kids! Collaboration
Key Points
- Question Does high-dose vitamin D supplementation (2000 IU/d) help to prevent wintertime viral upper respiratory tract infections compared with standard-dose vitamin D supplementation (400 IU/d) among preschool children?
- Findings In this multisite randomized clinical trial that included 703 children, the number of wintertime laboratory-confirmed viral upper respiratory tract infections was higher in the high-dose group than the standard-dose group, not a statistically significant difference.
- Meaning Vitamin D dosing higher than 400 IU/d may not be indicated for preventing wintertime viral upper respiratory tract infections in children.
Abstract
Importance Epidemiological studies support a link between low 25-hydroxyvitamin D levels and a higher risk of viral upper respiratory tract infections. However, whether winter supplementation of vitamin D reduces the risk among children is unknown.
Objective To determine whether high-dose vs standard-dose vitamin D supplementation reduces the incidence of wintertime upper respiratory tract infections in young children.
Design, Setting, and Participants A randomized clinical trial was conducted during the winter months between September 13, 2011, and June 30, 2015, among children aged 1 through 5 years enrolled in TARGet Kids!, a multisite primary care practice–based research network in Toronto, Ontario, Canada.
Interventions Three hundred forty-nine participants were randomized to receive 2000 IU/d of vitamin D oral supplementation (high-dose group) vs 354 participants who were randomized to receive 400 IU/d (standard-dose group) for a minimum of 4 months between September and May.
Main Outcome Measures The primary outcome was the number of laboratory-confirmed viral upper respiratory tract infections based on parent-collected nasal swabs over the winter months. Secondary outcomes included the number of influenza infections, noninfluenza infections, parent-reported upper respiratory tract illnesses, time to first upper respiratory tract infection, and serum 25-hydroxyvitamin D levels at study termination.
Results Among 703 participants who were randomized (mean age, 2.7 years, 57.7% boys), 699 (99.4%) completed the trial. The mean number of laboratory-confirmed upper respiratory tract infections per child was 1.05 (95% CI, 0.91-1.19) for the high-dose group and 1.03 (95% CI, 0.90-1.16) for the standard-dose group, for a between-group difference of 0.02 (95% CI, −0.17 to 0.21) per child. There was no statistically significant difference in number of laboratory-confirmed infections between groups (incidence rate ratio [RR], 0.97; 95% CI, 0.80-1.16). There was also no significant difference in the median time to the first laboratory-confirmed infection: 3.95 months (95% CI, 3.02-5.95 months) for the high-dose group vs 3.29 months (95% CI, 2.66-4.14 months) for the standard-dose group, or number of parent-reported upper respiratory tract illnesses between groups (625 for high-dose vs 600 for standard-dose groups, incidence RR, 1.01; 95% CI, 0.88-1.16). At study termination, serum 25-hydroxyvitamin D levels were
- 48.7 /mL (95% CI, 46.9-50.5 ng/mL) in the high-dose group and
- 36.8 ng/mL (95% CI, 35.4-38.2 ng/mL) in the standard-dose group.
Conclusions and Relevance Among healthy children aged 1 to 5 years, daily administration of 2000 IU compared with 400 IU of vitamin D supplementation did not reduce overall wintertime upper respiratory tract infections. These findings do not support the routine use of high-dose vitamin D supplementation in children for the prevention of viral upper respiratory tract infections.
clinicaltrials: NCT01419262
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