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Vitamin D3 supplementation during weight loss: a double-blind randomized controlled trial

Abstract

Background: Vitamin D deficiency is associated with obesity; whether repletion supports weight loss and changes obesity-related biomarkers is unknown.

Objective: We compared 12 mo of vitamin D3 supplementation with placebo on weight, body composition, insulin, and C-reactive protein (CRP) in postmenopausal women in a weight-loss intervention.

Design: A total of 218 overweight/obese women (50–75 y of age) with serum 25-hydroxyvitamin D [25(OH)D] ≥10 ng/mL but <32 ng="" ml="" were="" randomly="" assigned="" to="" weight="" loss="" 2000="" iu="" oral="" vitamin="" d="" sub="" style="margin: 0px; padding: 0px; border: 0px; outline-style: none; font-weight: inherit; font-style: inherit; font-size: 0.85em; font-family: inherit; line-height: 0; text-align: inherit;" data-mce-style="margin: 0px; padding: 0px; border: 0px; outline-style: none; font-weight: inherit; font-style: inherit; font-size: 0.85em; font-family: inherit; line-height: 0; text-align: inherit;">3/d or weight loss + daily placebo. The weight-loss intervention included a reduced-calorie diet (10% weight loss goal) and 225 min/wk of moderate-to-vigorous aerobic activity. Mean 12-mo changes in weight, body composition, serum insulin, CRP, and 25(OH)D were compared between groups (intent-to-treat) by using generalized estimating equations.

Results: A total of 86% of participants completed the 12-mo measurements. The mean (95% CI) change in 25(OH)D was 13.6 (11.6, 15.4) ng/mL in the vitamin D3arm compared with −1.3 (−2.6, −0.3) ng/mL in the placebo arm (P < 0.0001). Changes in weight [−7.1 (−8.7, −5.7) compared with –7.4 (−8.1, −5.4) kg], body mass index (in kg/m2: both −2.8), waist circumference [−4.9 (−6.7, −2.9) compared with −4.5 (−5.6, −2.6) cm], percentage body fat [−4.1 (−4.9, −2.9) compared with −3.5 (−4.5, −2.5)], trunk fat [−4.1 (−4.7, −3.0) compared with −3.7 (−4.3, −2.9) kg], insulin [−2.5 (−3.4, −1.7) compared with −2.4 (−3.3, −1.4) μU/mL], and CRP [−0.9 (−1.2, −0.6) compared with −0.79 (−0.9, −0.4) mg/mL] were similar between groups (all P > 0.05). Compared with women who achieved 25(OH)D <32 ng="" ml="" women="" randomly="" assigned="" to="" vitamin="" d="" who="" became="" replete="" ie="" 25="" oh="" 32="" lost="" more="" weight="" 8="" 11="" 1="" 6="" 9="" compared="" with="" 5="" 7="" 2="" 0="" kg="" em="" style="margin: 0px; padding: 0px; border: 0px; outline-style: none; font-weight: inherit; font-size: inherit; font-family: inherit; line-height: inherit; text-align: inherit; vertical-align: baseline;" data-mce-style="margin: 0px; padding: 0px; border: 0px; outline-style: none; font-weight: inherit; font-size: inherit; font-family: inherit; line-height: inherit; text-align: inherit; vertical-align: baseline;">P = 0.05], waist circumference [−6.6 (−9.3, −4.3) compared with −2.5 (−4.6, −2.0) cm; P = 0.02], and percentage body fat [−4.7 (−6.1, −3.5) compared with −2.6 (−3.9, −2.2); P = 0.04]. Among women with complete pill counts (97% adherence), the mean decrease in CRP was 1.18 mg/mL (46%) in the vitamin D arm compared with 0.46 mg/mL (25%) in the placebo arm (P = 0.03).

Conclusions: Vitamin D3 supplementation during weight loss did not increase weight loss or associated factors compared with placebo; however, women who became replete experienced greater improvements. 

Full Text

Alex's Notes: Just a reminder that you should keep the study population/demographics in mind when interpreting the results because they greatly influence the physiological response that people have from, well, everything. That said, the study is interesting in that it again shows how different everyone is with regard to Vitamin D supplementation and that the effects are through blood levels, not supplemental dosage. The participants were on average 60 years old with 47% body-fat and a baseline serum 25(OH)D level of 21.4 ng/mL. While most the individuals in the experiemental group reached 26 ng/mL by the end of the 12 months, about half of the individuals averaged 41 ng/mL, and those that were above 32 ng/mL experienced greater fat-loss and improved insulin sensativity. If you recall from last week, it was shown that 26 ng/mL is the LOWEST that you can be assured normal glucose tolerance. Given that the participants diets were nearly 50% carbohydrates, it is no wonder that the group with better tolerance lost more weight.

Anyways, in my opinion the important take-away is that you need to ensure you have adaquate serum 25(OH)D for health. What is that level? Probably somewhere between 40 and 60 ng/mL, but more research is definitely needed. How much should you supplement with? Test, retest, and retest to find YOUR right dosage. Everyone is different, although Examine says that 2000 will at least get you out of deficiancy.

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