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Nikooyeh B, Zahedirad M, Kalayi A, Shariatzadeh N, Hollis BW, Neyestani TR. Improvement of vitamin D status through consumption of either fortified food products or supplement pills increased hemoglobin concentration in adult subjects: Analysis of pooled data from two randomized clinical trials. Nutr Health 2023; 29:567-574. [PMID: 35238225 DOI: 10.1177/02601060221085351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: It is documented that vitamin D may have a role in erythropoiesis as its deficiency is accompanied by an increased risk of anemia. Aim: This study aimed to examine whether improvement of vitamin D status through daily consumption of either fortified foods or supplements could impinge on certain hematologic parameters in adults. Methods: We pooled data from our two separate clinical trials and made five experimental groups. As part of their usual diet, one group consumed 500 mL/day of yogurt drink fortified with 1000 IU of vitamin D (D-yogurt, n = 27) whereas one group consumed 500 mL/day of the plain yogurt drink (P-yogurt, n = 27). In addition three other groups consumed either 50 g/day bread fortified with 1000 IU of vitamin D (D-bread) or supplement containing 1000 IU vitamin D (D-supplement, n = 27) or placebo (placebo, n = 27). Biochemical measurements were performed before and after the intervention. Results: In all three vitamin D-supplemented groups, serum 25(OH)D concentration increased after the intervention period, which was interestingly accompanied by a significant increment of hemoglobin (D-yogurt, p < 0.001, D-bread, p = 0.003, D-supplement, p < 0.001). Analyses indicated that among participants in vitamin D-intervention groups, being in D-yogurt group was more favourable predictor of improvement in hemoglobin concentrations compared with the placebo (p < 0.001), D-bread (p = 0.045) and P-yogurt (p = 0.001). Conclusion: Improvement of vitamin D status via regular intake of either vitamin D-fortified food products or supplements can result in a significant increment of hemoglobin in adult subjects. This finding has very important clinical as well as public health implications.
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Affiliation(s)
- Bahareh Nikooyeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Shariatzadeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bruce W Hollis
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, 29425, United States
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The Interdependency and Co-Regulation of the Vitamin D and Cholesterol Metabolism. Cells 2021; 10:cells10082007. [PMID: 34440777 PMCID: PMC8392689 DOI: 10.3390/cells10082007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/30/2022] Open
Abstract
Vitamin D and cholesterol metabolism overlap significantly in the pathways that contribute to their biosynthesis. However, our understanding of their independent and co-regulation is limited. Cardiovascular disease is the leading cause of death globally and atherosclerosis, the pathology associated with elevated cholesterol, is the leading cause of cardiovascular disease. It is therefore important to understand vitamin D metabolism as a contributory factor. From the literature, we compile evidence of how these systems interact, relating the understanding of the molecular mechanisms involved to the results from observational studies. We also present the first systems biology pathway map of the joint cholesterol and vitamin D metabolisms made available using the Systems Biology Graphical Notation (SBGN) Markup Language (SBGNML). It is shown that the relationship between vitamin D supplementation, total cholesterol, and LDL-C status, and between latitude, vitamin D, and cholesterol status are consistent with our knowledge of molecular mechanisms. We also highlight the results that cannot be explained with our current knowledge of molecular mechanisms: (i) vitamin D supplementation mitigates the side-effects of statin therapy; (ii) statin therapy does not impact upon vitamin D status; and critically (iii) vitamin D supplementation does not improve cardiovascular outcomes, despite improving cardiovascular risk factors. For (iii), we present a hypothesis, based on observations in the literature, that describes how vitamin D regulates the balance between cellular and plasma cholesterol. Answering these questions will create significant opportunities for advancement in our understanding of cardiovascular health.
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Power determination in vitamin D randomised control trials and characterising factors affecting it through a novel simulation-based tool. Sci Rep 2021; 11:10804. [PMID: 34031451 PMCID: PMC8144427 DOI: 10.1038/s41598-021-90019-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/12/2021] [Indexed: 11/21/2022] Open
Abstract
Thousands of observational studies have linked vitamin D deficiency with numerous diseases, but randomised controlled trials (RCTs) often fail to show benefit of supplementation. Population characteristics and trial design have long been suspected to undermine power but were not systematically investigated. We propose a flexible generative model to characterise benefit of vitamin D supplementation at the individual level, and use this to quantify power in RCTs. The model can account for seasonality and population heterogeneity. In a simulated 1-year trial with 1000 participants per arm and assuming a 25-hydroxyvitamin D (25OHD) increase of 20 nmol/L due to the intervention, with baseline 25OHD in the population of 15, 35, 50, 60 and 75 nmol/L, the power to detect intervention effect was 77%, 99%, 95%, 68% and 19%, respectively. The number of participants required per arm to achieve 80% power according to baseline 25OHD of 15–60 nmol/L was 1200, 400, 600 and 1400, respectively. As expected, larger increases in 25OHD due to supplementation improved power in certain scenarios. For a population baseline of 50 nmol/L, with 1500 participants in each arm, there was 100% power to detect a 20 nmol/L 25OHD increase while it was 76% for a 10 nmol/L increase. Population characteristics and trial design, including temporal considerations, have a dramatic impact on power and required sample size in vitamin D RCTs.
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Nikooyeh B, Zargaraan A, Kalayi A, Shariatzadeh N, Zahedirad M, Jamali A, Khazraie M, Hollis B, Neyestani TR. Vitamin D-fortified cooking oil is an effective way to improve vitamin D status: an institutional efficacy trial. Eur J Nutr 2019; 59:2547-2555. [PMID: 31606753 DOI: 10.1007/s00394-019-02103-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 09/26/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE High prevalence of vitamin D deficiency (VDD) justifies a cost-effective and sustainable strategy to combat VDD in the community. This study was undertaken for the first time to evaluate the efficacy of daily consumption of vitamin D fortified sunflower oil with a meal. METHODS This single-blind trial was conducted in two separate institutions: one as intervention (D-fortified sunflower oil) group (DO, n1 = 39) and the other as control (unfortified sunflower oil) group (SO, n2 = 33). Participants consumed their lunches cooked either with D-fortified or unfortified cooking sunflower oil (500 IU/30 g) for 12 weeks. Dietary, anthropometric and biochemical assessments were done for all participants before and after the intervention. RESULTS A total of 65 subjects from both sexes aged 32.5 ± 4 years completed the intervention period. Serum 25(OH)D showed a significant increase in DO and a decrease in SO group (8.8 ± 9.3 vs. - 7.4 ± 6.4 ng/mL, p < 0.001). The rise in serum 25(OH)D in DO group was accompanied by a significant decrease in iPTH (DO: - 10.2 ± 29.4 vs. SO: + 9.2 ± 29.5 pg/mL; p = 0.009). A significant reduction in weight (p = 0.004), BMI (p = 0.029), waist girth (p < 0.001), serum total cholesterol (p = 0.0290) and LDL-C (p = 0.010) was observed in DO, as compared with SO group. CONCLUSIONS Cooking oil can be considered as an efficacious vehicle for mass fortification program to combat VDD. The improvement of vitamin D status may bring about betterment of certain cardiometabolic risk factors. REGISTRATION NUMBER Clinicaltrials.gov: NCT03826654.
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Affiliation(s)
- Bahareh Nikooyeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Science, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Shariatzadeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Jamali
- Laboratory of Quality Control, Kourosh Food Industry, Tehran, Iran
| | | | - Bruce Hollis
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Nikooyeh B, Neyestani T. Efficacy of Food Fortification with Vitamin D in Iranian Adults: A Systematic Review and Meta-Analysis. NUTRITION AND FOOD SCIENCES RESEARCH 2018. [DOI: 10.29252/nfsr.5.4.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Genetic and non-genetic effects of increased sun and vitamin D exposure: role in the observed healthy changes in cardiometabolic risk factors in Iranian children. Public Health Nutr 2018; 21:3125-3128. [PMID: 29871711 DOI: 10.1017/s1368980018001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Aquino SLS, da Cunha ATO, Pereira HT, Freitas EPS, Fayh APT, Lima JG, Lima SCVC, Sena-Evangelista KCM, Pedrosa LFC. Predictors of 25-hydroxyvitamin D status among individuals with metabolic syndrome: a cross-sectional study. Diabetol Metab Syndr 2018; 10:45. [PMID: 29928318 PMCID: PMC5987652 DOI: 10.1186/s13098-018-0346-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/25/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The risk of metabolic syndrome can be influenced by inadequate vitamin D levels, and exposure to sunlight is the main external source of vitamin D. The present study assessed the influence of environmental, biological, and nutritional factors in relation to seasonal 25-hydroxyvitamin D (25OHD) concentration in individuals with metabolic syndrome. METHODS This cross-sectional study enrolled 180 individuals with metabolic syndrome aged between 18 and 80 years. The 25OHD concentration was considered the dependent variable; independent variables included age, sex, skin color, use of sunscreen, skin type, sun exposure score, ultraviolet radiation index, geographic location, season, body mass index, waist:hip ratio, waist circumference, parathyroid hormone level, total serum calcium level, and calcium and vitamin D intake. RESULTS The average vitamin D in individuals evaluated in summer 32 ± 10 ng/mL was greater than in the winter 26 ± 8 ng/mL (p < 0.017). HDL-cholesterol was the only component of the MetS that differed significantly between the seasons (p < 0.001), showing higher concentrations in autumn 45 ± 8 mg/dL than in summer 35 ± 8 mg/dL. In the multiple regression model, gender, WHR, sun exposure score, and winter vs. summer explained 10% of the variation in 25OHD concentration (p = 0.004). CONCLUSIONS Sex, waist:hip ratio, sun exposure, and summer season were predictors of 25OHD status among individuals with metabolic syndrome. HDL-cholesterol was the only component of metabolic syndrome that differed significantly between the seasons.
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Affiliation(s)
- Séphora Louyse Silva Aquino
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
| | - Aline Tuane Oliveira da Cunha
- Postgraduate Program in Health Sciences, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59012-570 Brazil
| | - Hermilla Torres Pereira
- Postgraduate Program in Health Sciences, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59012-570 Brazil
| | - Erika Paula Silva Freitas
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
| | - Josivan Gomes Lima
- Department of Clinical Medicine, Endocrine Unit, Federal University of Rio Grande do Norte, Natal, RN 59010-180 Brazil
| | - Severina Carla Vieira Cunha Lima
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
| | - Karine Cavalcanti Maurício Sena-Evangelista
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
| | - Lucia Fátima Campos Pedrosa
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN 59078-970 Brazil
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