Effect of Vitamin D Supplementation on Weight Loss, Glycemic Indices, and Lipid Profile in Obese and Overweight Women: A Clinical Trial Study

Relationship between Vitamin D3 Deficiency, Metabolic Syndrome and VDR, GC, and CYP2R1 Gene Polymorphisms

The presence of vitamin D3 deficiency associated with the presence of metabolic syndrome (MS) has important public health effects. This study aims to investigate the relationship between vitamin D3 deficiency, MS and vitamin D3 receptor (VDR), GC Vitamin D binding protein (GC), and cytochrome P450 family 2 subfamily R member 1 (CYP2R1) gene polymorphisms, and genes whose encoded proteins are responsible for vitamin D3 metabolism and transport. A total of 58 participants were included in this study (age 39 ± 12 years) and were selected over a 12-month period. They were divided into four groups, depending on the presence of polymorphisms in VDR, GC, and CYP2R1 genes and their weight status. At baseline, in months 3, 6, and 12, biochemical parameters including 25(OH)D3, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and homeostatic model assessment (HOMA index), the insulin resistance indicator were measured. Our results show that all subjects in the polymorphism group supplemented with vitamin D3 reached an optimal level of vitamin D3 associated with high concentrations of 25(OH)D3. Weight loss was most significant in patients in the POW group (overweight patients).

Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review

Nowadays, the interest in the extraskeletal effects of vitamin D is growing. In the literature, its several possible actions have been confirmed. Vitamin D seems to have a regulatory role in many different fields-inflammation, immunity, and the endocrine system-and many studies would demonstrate a possible correlation between vitamin D and cardiovascular disease. In this paper, we deepened the relationship between vitamin D and dyslipidemia by reviewing the available literature. The results are not entirely clear-cut: on the one hand, numerous observational studies suggest a link between higher serum vitamin D levels and a beneficial lipid profile, while on the other hand, interventional studies do not demonstrate a significant effect. Understanding the possible relationship between vitamin D and dyslipidemia may represent a turning point: another link between vitamin D and the cardiovascular system.

Are There Any Correlations between Vitamin D, Calcium, and Magnesium Intake and Coronary and Obesity Indices?

OBJECTIVE

The association between nutrient intake and obesity and coronary problems has received great attention. So, this study aimed to examine the association between vitamin D, calcium, and magnesium intake and obesity and coronary indices.

METHODS

A total of 491 male and female university employees (18-64 years) were randomly included in a cross-sectional study. Blood samples were drawn, and the lipid profile was analyzed. Different anthropometrics were measured. Obesity and coronary indices were calculated based on standard formulas. A 24-h recall was used to measure the average dietary intake of vitamin D, calcium, and magnesium.

RESULTS

For the total sample, vitamin D had a significantly weak correlation with the abdominal volume index (AVI) and weight-adjusted waist index (WWI). However, calcium intake had a significant moderate correlation with the AVI and a weak correlation with the conicity index (CI), body roundness index (BRI), body adiposity index (BAI), WWI, lipid accumulation product (LAP), and atherogenic index of plasma (AIP). In males, there was a significant weak correlation between calcium and magnesium intake and the CI, BAI, AVI, WWI, and BRI. Additionally, magnesium intake had a weak correlation with the LAP. In female participants, calcium and magnesium intake had a weak correlation with CI, BAI, AIP, and WWI. Additionally, calcium intake showed a moderate correlation with the AVI and BRI and a weak correlation with the LAP.

CONCLUSION

Magnesium intake had the greatest impact on coronary indices. Calcium intake had the greatest impact on obesity indices. Vitamin D intake had minimal effects on obesity and coronary indices.

Effects of vitamin D supplementation on metabolic parameters, serum irisin and obesity values in women with subclinical hypothyroidism: a double-blind randomized controlled trial

Purpose

Subclinical hypothyroidism is an early, mild form of hypothyroidism that may progress to overt hypothyroidism if untreated. The current study aimed to assess the effects of vitamin D supplementation on hormonal (thyroid stimulating hormone [TSH], triiodothyronine, thyroxine, and free thyroxine) parameters, lipid profiles, serum irisin, and obesity indices in women with subclinical hypothyroidism.

Methods

The present randomized, double-blind, placebo-controlled clinical trial was carried out on 44 women with subclinical hypothyroidism. The participants were allocated to two groups (22 patients in each group) that received vitamin D (50,000 IU/week) or placebo for 12 weeks. Fasting blood samples, anthropometric and body composition measurements, physical activity levels, and dietary intakes were collected at baseline and at the end of the study.

Results

Vitamin D supplementation significantly decreased TSH, total cholesterol, and fat mass percentage, and significantly increased serum vitamin D and irisin levels and fat-free mass percentage compared to the control group (all, p<0.05). Changes in thyroid hormones, other lipid profiles, and anthropometric indices were not significantly different between the groups.

Conclusion

Our study indicates that vitamin D administration improves serum TSH, total cholesterol, irisin, and body composition in women with subclinical hypothyroidism. More well-designed clinical trials are required to confirm these findings and clarify the effects of vitamin D supplementation on both genders of patients.Clinical trial registration: https://www.irct.ir/trial/57482, Identifier IRCT20100408003664N25.

Association between serum vitamin D levels and lipid profiles: a cross-sectional analysis

Vitamin D is an essential nutrient that plays a crucial role in calcium homeostasis and bone health. Recent research suggests that vitamin D may also have an impact on lipid metabolism, specifically the level of circulating lipids in the blood. We aim to investigate it role among healthy participate. We conducted a cross-sectional study of 15,600 patients who were referred to the laboratories of university hospitals. We measured the serum levels of Vitamin D as well as triglycerides, total cholesterol, LDL, and HDL using ELISA. We found that the mean serum level of Vitamin D was 40.31 ± 20.79 ng/mL. Of the participants, 16.7% had a serum level of Vitamin D less than 20 ng/mL, 57.7% had a level between 21 and 40 ng/mL, and 13.5% had a level between 41 and 60 ng/mL. Additionally, 12.2% had a level greater than 60 ng/mL. We performed a one-way analysis of variance and found that as the serum level of Vitamin D increased, the mean LDL level decreased significantly. Our study provides evidence of a significant relationship between serum levels of Vitamin D and LDL levels in patients. The findings suggest that vitamin D status may play a role in regulating lipid metabolism and may have implications for the prevention and treatment of cardiovascular disease. Further research is needed to elucidate the underlying mechanisms of this relationship and to determine optimal levels of vitamin D intake for maintaining lipid profiles.

Impact of a Food Rebalancing Program Associated with Plant-Derived Food Supplements on the Biometric, Behavioral, and Biological Parameters of Obese Subjects

Between 2021 and 2023, the Scientific Council of Dietplus®, a group specialized in overweight and obesity management, conducted a clinical study on 170 volunteer subjects with a BMI > 29 Kg/m2 consecutively recruited. The Dietplus® program comprises nutritional education, intensive, personalized coaching, and consuming food supplements rich in plant derivatives. The aim of this study was to assess the effect of the Dietplus® program on biometric, behavioral, and biological parameters. A control group of 30 obese patients was followed for a similar 12-week period. Mean weight loss reached 9 ± 2.1 kg in the Dietplus® test group versus a 1 ± 0.1 kg weight gain in the control group. Excess weight loss reached 33 ± 13%, and fat mass loss was 7.6% (p < 0.001); waist circumference was reduced by 30%. Quality of Life, Nutriscore, and Prochaska di Clemente scale significantly improved (p < 0.001). Biological parameters showed substantial improvements in the carbohydrate profile and insulin resistance (HOMA index) and in the lipid profile with lower plasma triglyceride (p < 0.01) and VLDL (p < 0.01) concentrations. Inflammatory parameters (orosomucoid, ultrasensitive C-reactive protein, and PINI indices) were also substantially reduced. These results indicate a substantial benefit in subjects who followed the Dietplus® program. (Dietplus® 116 Rue Robert Bunsen, 57460 Behren-lès-Forbach, France is active in France Belgium and Spain. Plant Derived Food Supplements are produced in France). Indeed, improvements were observed in all biometric, behavioral, and metabolic parameters.

Vitamins and Minerals for Blood Pressure Reduction in the General, Normotensive Population: A Systematic Review and Meta-Analysis of Six Supplements

Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.

1α,25(OH)2D3 ameliorates insulin resistance by alleviating γδ T cell inflammation via enhancing fructose-1,6-bisphosphatase 1 expression

Background: Chronic inflammation caused by immune cells is the central link between obesity and insulin resistance. Targeting the inflammatory process is a highly promising method for reversing systemic insulin resistance. Methods: Blood samples were prospectively collected from 68 patients with type 2 diabetes. C57BL/6J mice were fed either a high-fat diet (HFD) or normal chow (NC). We performed phenotypical and functional analyses of immune cells using flow cytometry. Vitamin D receptor (VDR) knockout γδ T cells were constructed using Cas9-gRNA targeted approaches to identify 1α,25(OH)2D3/VDR signaling pathway-mediated transcriptional regulation of fructose-1,6-bisphosphatase (FBP1) in γδ T cells. Results: Serum vitamin D deficiency aggravates inflammation in circulating γδ T cells in type 2 diabetes patients. We defined a critical role for 1α,25(OH)2D3 in regulating glycolysis metabolism, protecting against inflammation, and alleviating insulin resistance. Mechanistically, 1α,25(OH)2D3-VDR promoted FBP1 expression to suppress glycolysis in γδ T cells, thereby inhibiting Akt/p38 MAPK phosphorylation and reducing inflammatory cytokine production. Notably, therapeutic administration of 1α,25(OH)2D3 restrained inflammation in γδ T cells and ameliorated systemic insulin resistance in obese mice. Conclusions: Collectively, these findings show that 1α,25(OH)2D3 plays an important role in maintaining γδ T cell homeostasis by orchestrating metabolic programs, and is a highly promising target for preventing obesity, inflammation, and insulin resistance.

Neuroprotective and Cardiometabolic Role of Vitamin E: Alleviating Neuroinflammation and Metabolic Disturbance Induced by AlCl3 in Rat Models

Cardiovascular diseases (CVDs) and neurodegenerative disorders, such as diabetes mellitus and Alzheimer's disease, share a common pathophysiological link involving insulin resistance (IR), inflammation, and hypertension. Aluminium chloride (AlCl3), a known neurotoxicant, has been associated with neurodegeneration, cognitive impairment, and various organ dysfunctions due to the production of reactive oxygen species (ROS) and oxidative stress. In this study, we aimed to investigate the potential protective effects of metformin and vitamin E against AlCl3-induced neuroinflammation and cardiometabolic disturbances in rat models. Rats were divided into five groups: a normal control group, an AlCl3-treated diseased group without any treatment, and three groups exposed to AlCl3 and subsequently administered with metformin (100 mg/kg/day) alone, vitamin E (150 mg/kg/day) orally alone, or a combination of metformin (100 mg/kg/day) and vitamin E (150 mg/kg/day) for 45 days. We analyzed serum biomarkers and histopathological changes in brain, heart, and pancreatic tissues using H&E and Masson's trichrome staining and immunohistochemistry (IHC). Electrocardiogram (ECG) patterns were observed for all groups. The AlCl3-treated group showed elevated levels of inflammatory biomarkers, MDA, and disturbances in glycemic and lipid profiles, along with reduced insulin levels. However, treatment with the combination of metformin and vitamin E resulted in significantly reduced glucose, cholesterol, LDL, and TG levels, accompanied by increased insulin and HDL levels compared to the individual treatment groups. Histopathological analyses revealed that combination therapy preserved neuronal structures, muscle cell nuclei, and normal morphology in the brain, heart, and pancreatic tissues. IHC demonstrated reduced amyloid plaques and neurofibrillary tangles in the combination-treated group compared to the AlCl3-treated group. Moreover, the combination group showed a normal ECG pattern, contrasting the altered pattern observed in the AlCl3-treated group. Overall, our findings suggest that metformin and vitamin E, in combination, possess neuroprotective and cardiometabolic effects, alleviating AlCl3-induced neuroinflammation and metabolic disturbances.

Physiological Basis for Using Vitamin D to Improve Health

Vitamin D is essential for life-its sufficiency improves metabolism, hormonal release, immune functions, and maintaining health. Vitamin D deficiency increases the vulnerability and severity of type 2 diabetes, metabolic syndrome, cancer, obesity, and infections. The active enzyme that generates vitamin D [calcitriol: 1,25(OH)₂D], CYP27B1 (1α-hydoxylase), and its receptors (VDRs) are distributed ubiquitously in cells. Once calcitriol binds with VDRs, the complexes are translocated to the nucleus and interact with responsive elements, up- or down-regulating the expression of over 1200 genes and modulating metabolic and physiological functions. Administration of vitamin D₃ or correct metabolites at proper doses and frequency for longer periods would achieve the intended benefits. While various tissues have different thresholds for 25(OH)D concentrations, levels above 50 ng/mL are necessary to mitigate conditions such as infections/sepsis, cancer, and reduce premature deaths. Cholecalciferol (D₃) (not its metabolites) should be used to correct vitamin D deficiency and raise serum 25(OH)D to the target concentration. In contrast, calcifediol [25(OH)D] raises serum 25(OH)D concentrations rapidly and is the agent of choice in emergencies such as infections, for those who are in ICUs, and for insufficient hepatic 25-hydroxylase (CYP2R1) activity. In contrast, calcitriol is necessary to maintain serum-ionized calcium concentration in persons with advanced renal failure and hypoparathyroidism. Calcitriol is, however, ineffective in most other conditions, including infections, and as vitamin D replacement therapy. Considering the high costs and higher incidence of adverse effects due to narrow therapeutic margins (ED50), 1α-vitamin D analogs, such as 1α-(OH)D and 1,25(OH)₂D, should not be used for other conditions. Calcifediol analogs cost 20 times more than D₃-thus, they are not indicated as a routine vitamin D supplement for hypovitaminosis D, osteoporosis, or renal failure. Healthcare workers should resist accepting inappropriate promotions, such as calcifediol for chronic renal failure and calcitriol for osteoporosis or infections-there is no physiological rationale for doing so. Maintaining the population's vitamin D sufficiency (above 40 ng/mL) with vitamin D₃ supplements and/or daily sun exposure is the most cost-effective way to reduce chronic diseases and sepsis, overcome viral epidemics and pandemics, and reduce healthcare costs. Furthermore, vitamin D sufficiency improves overall health (hence reducing absenteeism), reduces the severity of chronic diseases such as metabolic and cardiovascular diseases and cancer, decreases all-cause mortality, and minimizes infection-related complications such as sepsis and COVID-19-related hospitalizations and deaths. Properly using vitamin D is the most cost-effective way to reduce chronic illnesses and healthcare costs: thus, it should be a part of routine clinical care.

Relationship between Lifestyle and Residence Area with 25(OH)D Levels in Older Adults

The aim of this study was to investigate whether the habitat of older adults living in the urban and rural areas is a contributing factor to altered serum 25(OH)D levels. An analytical, cross-sectional research with a quantitative approach was conducted in the upper backwoods of Paraíba with older adults registered at the Reference Center for Social Assistance (CRAS), addressing residents of both rural area (n = 41) and urban area (n = 43) who were randomly chosen to participate in the study. Data collection took place between January and February 2020. Higher rates of handgrip strength were observed in rural older adults (29.22 ± 8.92 Kgf) with serum 25(OH)D levels in the range of 30 to 40 ng/mL when compared to older adults with concentrations below 30 ng/mL (21.82 ± 5.00 Kgf) and above 40 ng/mL (23.47 ± 6.88 Kgf). Older people living in the urban area, with 25(OH)D levels above 40 ng/mL, presented a lower muscle power index when compared to individuals with vitamin levels from 21 to 29 ng/mL (17.40 ± 6.34 s; 15.33 ± 2.00 s). The urbanization associated with 25(OH)D levels can cause changes in skeletal and respiratory muscle strength, because the habitat associated with 25(OH)D levels affects the parameters of muscle strength of the upper limbs for older adults living in a rural area and the muscle strength of the lower limbs for those living in an urban area.

Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters

OBJECTIVES

Vitamin D plays an essential role in neonatal skeletal development and maternal weight gain during pregnancy. We aim to study the association between vitamin D status, maternal weight, and materno-neonatal bone metabolism parameters.

METHODS

From January to June 2017, we conducted this cross-sectional study among 103 pregnant women (21-42 years old) and their singletons. The levels of serum 25-(OH)D, PTH, P1NP, OC, and CTX were measured for mothers and neonates (cord blood). Serum vitamin D and OC were measured using chemiluminescence and two-site immunoradiometric assay, respectively. Meanwhile, P1NP, CTX, and PTH were measured by ELISA.

RESULTS

The average serum vitamin D levels from mothers were 15.1 ng/mL during pregnancy and 16.2 ng/mL in the umbilical cord. At baseline, vitamin D deficient mothers were more likely to have higher PTH (36.4 vs. 18 pg/mL; p=0.029) and lower P1NP levels (90 vs. 92.5 ng/mL; p=0.026). Also, vitamin D deficient status was associated with lower fetal weight (3,293 vs. 3,358 g; p=0.019). Maternal weight was significantly correlated with P1NP (65.86 vs. 109.35; p=0.001) and OC (14.52 vs. 18.24; p=0.038), as well as cord vitamin D level (13.31 vs. 18.46; p=0.039) among normal vs. overweight women. No significant differences were found for the correlation between maternal weight and fetal parameters except for fetal weight which significantly increased with the increase in maternal weight (overweight vs. obese women=3,280 vs. 3,560; p=0.06).

CONCLUSIONS

Maternal vitamin D status is associated with maternal and neonatal bone metabolism parameters as well as maternal and neonatal weight.

TetraSOD®, a Unique Marine Microalgae Ingredient, Promotes an Antioxidant and Anti-Inflammatory Status in a Metabolic Syndrome-Induced Model in Rats

Increased oxidative stress has been linked to the pathogenic process of obesity and can trigger inflammation, which is often linked with the risk factors that make up metabolic syndrome (MetS), including obesity, insulin resistance, dyslipidaemia and hypertension. TetraSOD^®, a natural marine vegan ingredient derived from the microalgae Tetraselmis chuii that is high in the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) has recently demonstrated in vitro increased activity of these key antioxidant enzymes. In the present study, the potential bioactive effects of three dietary dosages of TetraSOD^® in enhancing antioxidant and anti-inflammatory mechanisms to combat the metabolic disturbances that compose MetS were assessed in rats given a cafeteria (CAF) diet. Chronic supplementation with 0.17, 1.7, and 17 mg kg⁻¹ day⁻¹ of TetraSOD^® for 8 weeks ameliorated the abnormalities associated with MetS, including oxidative stress and inflammation, promoting endogenous antioxidant defence mechanisms in the liver (GPx and GSH), modulating oxidative stress and inflammatory markers in plasma (NOx, oxLDL and IL-10), and regulating genes involved in antioxidant, anti-inflammatory and immunomodulatory pathways in the liver, mesenteric white adipose tissue (MWAT), thymus, and spleen. Overall, TetraSOD^® appears to be a potential therapeutic option for the management of MetS.

The interactive effect of vitamin D3 supplementation and vitamin D receptor polymorphisms on weight and body composition in overweight women with hypovitaminosis D: a randomized, double-blind, placebo-controlled clinical trial

Different responses to vitamin D supplementation may be due to genes involved in vitamin D metabolism, including the vitamin D receptor (VDR) gene. The present study aimed to determine the interactive effect of vitamin D supplementation and VDR polymorphisms, including FokI (rs2228570) and BsmI (1544410) on weight and body composition in overweight women with hypovitaminosis D. This study comprised two phases: a double-blind, randomized and a before-after clinical trial. In the first phase, 50 healthy overweight women aged 20-45 years with hypovitaminosis D were randomly categorized into intervention and control groups and were given 50 000 IU/w vitamin D3 or placebo for 12 weeks. In the second phase, 75 women received 50 000 IU/w of vitamin D3 for 12 weeks. All variables were measured at baseline and after 12 weeks. Circulating 25(OH)D was measured using an ELISA kit. Anthropometric indices were calculated according to standard protocol (WHO-TRH-854). Body composition was determined using the body impedance analysis method. The VDR polymorphisms were detected using the PCR sequence. Supplementation resulted in a significant increase in the level of 25(OH)D in the intervention group but did not affect the anthropometric profile of the subjects. When considering FokI genotypes, carriers of the FF genotype had higher fat mass reduction than carriers of Ff + ff genotypes.

Interrelationship between Vitamin D and Calcium in Obesity and Its Comorbid Conditions

Obesity has been linked to vitamin D (VD) deficiency and low calcium (CAL) status. In the last decade, dietary supplementation of vitamin D and calcium (VD–CAL) have been extensively studied in animal experiments and human studies. However, the physiological mechanisms remain unknown as to whether the VD–CAL axis improves homeostasis and reduces biomarkers in regulating obesity and other metabolic diseases directly or indirectly. This review sought to investigate their connections. This topic was examined in scientific databases such as Web of Science, Scopus, and PubMed from 2011 to 2021, and 87 articles were generated for interpretation. Mechanistically, VD–CAL regulates from the organs to the blood, influencing insulin, lipids, hormone, cell, and inflammatory functions in obesity and its comorbidities, such as non-alcoholic fatty liver disease, cardiovascular disease, and type-2 diabetes mellitus. Nevertheless, previous research has not consistently shown that simultaneous VD–CAL supplementation affects weight loss or reduces fat content. This discrepancy may be influenced by population age and diversity, ethnicity, and geographical location, and also by degree of obesity and applied doses. Therefore, a larger prospective cohort and randomised trials are needed to determine the exact role of VD–CAL and their interrelationship.

Vitamin D Supplementation and Genetic Polymorphisms Impact on Weight Loss Diet Outcomes in Caucasians: A Randomized Double-Blind Placebo-Controlled Clinical Study

Vitamin D deficiency or insufficiency is common in obese people, with some studies suggesting that low vitamin D level might be an independent predictor of obesity. Thus, the purpose of the present randomized, double-blind, placebo-controlled study was to investigate the effect of oral spray vitamin D₃ 3000 IU supplementation along with personalized weight-loss diet on obesity markers in overweight and obese Caucasians with vitamin d deficiency or insufficiency. The impact of vitamin D receptor (VDR) and adrenergic receptors (ADRs) genetic variants on vitamin D levels and weight loss diet outcomes was also investigated. After signing informed consent, a total of 125 eligible volunteers were randomly assigned into vitamin D (vitamin D₃ 3000 IU/d oral spray supplementation, n = 76) or placebo (xylitol, water, mint, n = 49) group following a weight loss program (600 calories less than the total energy expenditure of each volunteer) for 3 months. Fat mass, BMI, REE and 25(OH)D serum level were monitored on baseline and each month. DNA samples were extracted from buccal swabs and genotyped for the rs2228570 (VDR), rs1544410 (VDR), rs731236 (VDR), rs1800544 (ADRA2A), rs1801252 (ADRB1), rs1042713 (ADRB2), and rs4994 (ADRB3) polymorphisms. Statistical analysis was performed using SPSS package (v.23). Between group comparisons revealed significant improvement in serum 25(OH)D level and greater reduction in weight, BMI and fat percentage in the vitamin D group compared to placebo group (p < 0.05). In the vitamin D group, carriers of the rs2228570 T allele tended to have greater vitamin D level improvement compared with the homozygous C allele (p = 0.067). Furthermore, heterozygous (CT) for the rs731236 tended to have lesser weight loss (p = 0.068) and for the rs1042713, a lower decline in fat percentage was observed for homozygous AA carriers compared to the heterozygous (p = 0.051). In the control group, differences in weight loss (p = 0.055) and BMI (p = 0.045) were observed between rs1544410 AA and GG homozygous. In conclusion, vitamin D oral spray supplementation seems to improve vitamin D status and decrease obesity markers during a weight-loss intervention in overweight/obese Caucasians with vitamin D deficiency or insufficiency. Also, the results of the present study indicate that VDR and ADRs genetic polymorphisms seem to influence vitamin D supplementation response and obesity markers.

The Action of Vitamin D in Adipose Tissue: Is There the Link between Vitamin D Deficiency and Adipose Tissue-Related Metabolic Disorders?

Adipose tissue plays an important role in systemic metabolism via the secretion of adipocytokines and storing and releasing energy. In obesity, adipose tissue becomes dysfunctional and characterized by hypertrophied adipocytes, increased inflammation, hypoxia, and decreased angiogenesis. Although adipose tissue is one of the major stores of vitamin D, its deficiency is detective in obese subjects. In the presented review, we show how vitamin D regulates numerous processes in adipose tissue and how their dysregulation leads to metabolic disorders. The molecular response to vitamin D in adipose tissue affects not only energy metabolism and adipokine and anti-inflammatory cytokine production via the regulation of gene expression but also genes participating in antioxidant defense, adipocytes differentiation, and apoptosis. Thus, its deficiency disturbs adipocytokines secretion, metabolism, lipid storage, adipogenesis, thermogenesis, the regulation of inflammation, and oxidative stress balance. Restoring the proper functionality of adipose tissue in overweight or obese subjects is of particular importance in order to reduce the risk of developing obesity-related complications, such as cardiovascular diseases and diabetes. Taking into account the results of experimental studies, it seemed that vitamin D may be a remedy for adipose tissue dysfunction, but the results of the clinical trials are not consistent, as some of them show improvement and others no effect of this vitamin on metabolic and insulin resistance parameters. Therefore, further studies are required to evaluate the beneficial effects of vitamin D, especially in overweight and obese subjects, due to the presence of a volumetric dilution of this vitamin among them.

Mechanisms Linking Vitamin D Deficiency to Impaired Metabolism: An Overview

Vitamin D deficiency is a common health problem worldwide. Despite its known skeletal effects, studies have begun to explore its extra-skeletal effects, that is, in preventing metabolic diseases such as obesity, hyperlipidemia, and diabetes mellitus. The mechanisms by which vitamin D deficiency led to these unfavorable metabolic consequences have been explored. Current evidence indicates that the deficiency of vitamin D could impair the pancreatic β-cell functions, thus compromising its insulin secretion. Besides, vitamin D deficiency could also exacerbate inflammation, oxidative stress, and apoptosis in the pancreas and many organs, which leads to insulin resistance. Together, these will contribute to impairment in glucose homeostasis. This review summarizes the reported metabolic effects of vitamin D, in order to identify its potential use to prevent and overcome metabolic diseases.

The Effect of All Extremity High Intensity Interval Training on Athero-Protective Factors and Endothelial Function in Overweight and Obese Women

Context:

Obesity is associated with endothelial dysfunction and cardiovascular diseases. Adiponectin and fibroblast growth factor 21 (FGF21) as hormones are highly contributive in cardiovascular system, while they are disrupted through obesity. Weight-bearing high intensity interval training (HIIT) as an effective procedure in preventing obesity-related complications in adults with obesity may be limited due to the subjects' muscular weakness and complications interfering walking.

Aims:

The purpose of this study was to assess the effectiveness of non-weight bearing all extremity HIIT (all ex. HIIT) on FGF21, adiponectin, nitric oxide (NO), and flow mediated dilation (FMD) in overweight and obese women.

Methods:

Thirty healthy overweight and obese sedentary university female students within 20.53 ± 1.50 age range and BMI ≥27 kg.m^-2 were assigned in two experimental and control groups. All ex. HIIT consisted of 4 × 4 min at 85–90% max HR with an interspersed with 3 × 3 min recovery per round at 70% max HR by upper and lower ergometers in a simultaneous manner on 10 weeks of four sessions of 40 min each. FGF21, adiponectin, NO, FMD, weight, waist and maximal oxygen uptake (VO_2max) were measured in pre and post-tests. Paired sample t-test and analysis of covariance are applied for statistical analysis.

Results:

Results indicated a significant increase in adiponectin (P ≤ 0.01) and FMD (P ≤ 0.001), while there existed no changes in FGF21 at (P ≥ 0.10) and NO (P ≥ 0.84). The weight and waist decreased at (P ≤ 0.001), and the VO_2max increased at (P ≤ 0.001).

Conclusions:

All ex. HIIT may be a safe alternative for overweigh and obese women who have complications with weight-bearing exercises, and may increase adiponectin, and improve the FMD, aerobic fitness, and body composition.

Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance

The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.

Elevated Plasma Concentrations of Vitamin D-Binding Protein Are Associated with Lower High-Density Lipoprotein and Higher Fat Mass Index in Overweight and Obese Women

(1) Background: Observational studies have established that vitamin D-binding protein (DBP) and 25-hydroxyvitamin D₃ (25(OH)D) concentrations are the major factors affecting the bioavailability of 25(OH)D. It has also been shown that poor 25(OH)D bioavailability elevates the risk of obesity and its related cardio-metabolic disorders. However, the relationship between 25(OH)D and DBP concentrations with cardio-metabolic risk factors in overweight and obese cohorts has not been established. Consequently, we evaluated the association between DBP and 25(OH)D concentrations with lipid profile, blood pressure (BP), and body composition in overweight and obese women. (2) Methods: In this cross-sectional study of 236 overweight and obese women, DBP and 25(OH)D concentrations were measured using an enzyme-linked immunosorbent assay. Body composition was assessed via bioelectrical impedance analysis. Lipid profile and BP were assessed by an auto-analyzer and digital BP monitor, respectively. The associations were examined by multivariate logistic regression. (3) Results: The indicated showed an inverse relationship between DBP and high-density lipoprotein (HDL) (p = 0.010) concentrations (where individuals with higher DBP had lower HDL) which, after adjusting for possible cofounders, remained significant (p = 0.006). Moreover, DBP concentration was positively associated with fat mass index (FMI) after adjustment (p = 0.022). No significant relationships were observed among 25(OH)D and target variables. (4) Conclusions: In conclusion, lower concentrations of HDL and higher values of FMI are associated with higher concentrations of DBP in overweight and obese women. These findings present novel awareness regarding the association of DBP with some metabolic and body composition variables in overweight and obese women. However, a two-way causal relationship between DBP and target variables should be considered.

Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating—including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.

Independent and Combined Effects of Calcium and Vitamin D Supplementation on Blood Lipids in Overweight or Obese Premenopausal Women: A Triple-Blind Randomized Controlled Clinical Trial

Background:

Dyslipidemia is often associated with obesity and contributes to the increased risk of atherosclerosis, heart disease, and stroke. This study was designed to evaluate the independent or combined effect of calcium and vitamin D (Ca + Vit D) supplementation on blood lipid profile in overweight or obese premenopausal women.

Methods:

This study is a triple-blind, randomized, parallel, placebo-controlled trial. About 100 overweight or obese (body mass index (BMI) of 25–40 kg/m²) premenopausal (aged 30–50 years) women, recruited from Shiraz University of Medical Sciences (SUMS) clinics, were allocated into 4 groups: (1) calcium (Ca) supplementation (2 tablets per day; each containing 500 mg calcium carbonate), (2) vitamin D (Vit D) supplementation (2 tablets per day; each containing 200 IU vitamin D3), (3) Ca + Vit D supplementation (2 tablets per day; each containing 500 mg calcium carbonate plus 200 IU vitamin D3), (4) placebo supplementation (2 tablets per day, containing micro-cellulose). All participants received a 500 kcal energy-restricted diet. Blood lipids, serum vitamin D, and anthropometric indices were measured at baseline and after 8 weeks. Physical activity and 3-day dietary records were taken at baseline and every 4 weeks during the intervention.

Results:

At 8 weeks, triglyceride levels were significantly decreased in the Ca group (P = 0.002). Low-density lipoprotein (LDL) levels were decreased in the Ca + Vit D group (P = 0.04) and high-density lipoprotein (HDL) levels decreased in both the Ca and Ca + Vit D groups (P = 0.006, P = 0.004, respectively). The results of one-way ANOVA indicated that changes in the serum lipid profile levels were not significantly different among the four groups (P = 0.90, P = 0.86, P = 0.61, P = 0.27, and P = 0.19, respectively for TG, TC, LDL, HDL, and LDL/HDL). The results were not significant even after adjusting for potential covariates.

Conclusions:

Although the results were not significantly different among the four treated groups at 8 weeks, within-group changes like the reduction in triglyceride and LDL levels, respectively in the Ca group and Ca + Vit D group, and HDL levels in both the Ca and Ca + Vit D groups were significant. These changes may have potentially significant public health implications.

Flavocoxid Ameliorates Aortic Calcification Induced by Hypervitaminosis D3 and Nicotine in Rats Via Targeting TNF-α, IL-1β, iNOS, and Osteogenic Runx2

PURPOSE

This research was designed to investigate the effects and mechanisms of flavocoxid (FCX) on vascular calcification (VC) in rats.

METHODS

Vitamin D₃ and nicotine were administered to Wistar rats, which then received FCX (VC-FCX group) or its vehicle (VC group) for 4 weeks. Control and FCX groups served as controls. Systolic (SBP) and diastolic (DBP) blood pressures, heart rate (HR), and left ventricular weight (LVW)/BW were measured. Serum concentrations of calcium, phosphate, creatinine, uric acid, and alkaline phosphatase were determined. Moreover, aortic calcium content and aortic expression of runt-related transcription factor (Runx2), osteopontin (OPN), Il-1β, α-smooth muscle actin (α-SMA), matrix metalloproteinase-9 (MMP-9), inducible nitric oxide synthase (iNOS), and tumor necrosis factor-α (TNF-α) were assessed. Oxidative status in aortic homogenates was investigated.

RESULTS

Compared to untreated VC rats, FCX treatment prevented body weight loss, reduced aortic calcium deposition, restored normal values of SBP, DBP, and HR, and attenuated LV hypertrophy. FCX also improved renal function and ameliorated serum levels of phosphorus, calcium, and ALP in rats with VC. FCX abolished aortic lipid peroxidation in VC rats. Moreover, VC-FCX rats showed marked reductions in aortic levels of Il-1β and osteogenic marker (Runx2) and attenuated aortic expression of TNF-α, iNOS, and MMP-9 proteins compared to untreated VC rats. The expression of the smooth muscle lineage marker α-SMA was greatly enhanced in aortas from VC rats upon FCX treatment.

CONCLUSION

These findings demonstrate FCX ability to attenuate VDN-induced aortic calcinosis in rats, suggesting its potential for preventing arteiocalcinosis in diabetic patients and those with chronic kidney disease.

Intramuscular adipocyte and fatty acid differences between high-fat and control rabbit groups subject to a restricted diet

Fatty acids of intramuscular fat (IMF) in rabbits can influence meat quality, but it is unclear which fatty acids benefit to human health. A rabbit model of weight gain and weight loss was constructed using two rabbit groups and two growth stages. Stage 1 included control group1 fed a commercial diet(CG1) and experimental group1 fed a high fat diet (EG1). Stage 2 include control group2(CG2) and experimental group2 (EG2) both fed a restricted commercial diet. We detected differences in blood biochemical indicators as well as changes in intramuscular adipose cells and intramuscular fatty acid content in control and experiment groups at two stages. High fat induction can make rabbits become obese, have higher concentrations of glucose (GLU), total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C) and free fatty acid (FFA), and lower concentrations of insulin (INS). In addition, a high-fat diet promotes hypertrophy of precursor adipocytes in femoral muscles. Conversely, a restricted diet causes weight loss, decreases the concentration of TG, FFA, and INS in CG2 and EG2, and increases the deposition of unsaturated fatty acids in the femoral muscle. The content of monounsaturated trans oleic acid (C18:1n-9T) in EG2 was significantly higher than in CG2, whereas oleic acid (C18:1n-9C) was significantly lower in EG2 than in CG2. The polyunsaturated fatty acids Linolenate (C18:3 n-3) and cis-5,8,11,14,17-Eicosapentaenoate (C20:5 n-3) increased in CG2 and EG2. The content of Linoleate (C18:2 n-6) and γ-Linolenic acid (C18:3 n-6) significantly increased in CG2. The content of cis-11,14-Eicosatrienoic acid (C20:2) decreased significantly in CG2, but increased significantly in EG2.Thus, a high-fat diet can increase the formation of unhealthy fatty acids. Conversely, weight loss due to a restricted diet leads to an increase in unsaturated fatty acids in the femoral muscle, indicating that it reduces obesity symptoms and it may improve meat quality in rabbit.

Age-Related Skeletal Muscle Dysfunction Is Aggravated by Obesity: An Investigation of Contractile Function, Implications and Treatment

Obesity is a global epidemic and coupled with the unprecedented growth of the world's older adult population, a growing number of individuals are both old and obese. Whilst both ageing and obesity are associated with an increased prevalence of chronic health conditions and a substantial economic burden, evidence suggests that the coincident effects exacerbate negative health outcomes. A significant contributor to such detrimental effects may be the reduction in the contractile performance of skeletal muscle, given that poor muscle function is related to chronic disease, poor quality of life and all-cause mortality. Whilst the effects of ageing and obesity independently on skeletal muscle function have been investigated, the combined effects are yet to be thoroughly explored. Given the importance of skeletal muscle to whole-body health and physical function, the present study sought to provide a review of the literature to: (1) summarise the effect of obesity on the age-induced reduction in skeletal muscle contractile function; (2) understand whether obesity effects on skeletal muscle are similar in young and old muscle; (3) consider the consequences of these changes to whole-body functional performance; (4) outline important future work along with the potential for targeted intervention strategies to mitigate potential detrimental effects.

The effects of eggshell calcium (Biomin H® ) and its combinations with alfacalcidol (1α-hydroxyvitamin D3) and menaquinone-7 (vitamin K2) on ovariectomy-induced bone loss in a rat model of osteoporosis

The purpose of this study was to investigate the impact of eggshell calcium (Biomin H® dietary supplement) and its combinations with alfacalcidol (1α-hydroxyvitamin D3 ) and menaquinone-7 (vitamin K2 ) on ovariectomy-induced bone loss in rats. Adult female rats (n = 48) were divided into 6 groups of 8 individuals each: sham-operated rats (SHAM); ovariectomized (OVX) rats untreated; OVX rats treated with Biomin H® (BIO); OVX rats simultaneously receiving Biomin H® , vitamin D3 (BIO + D3 ); OVX rats simultaneously treated with Biomin H® , vitamin K2 (BIO + K2 ) and OVX rats treated with Biomin H® , vitamin D3 , vitamin K2 (BIO + D3  + K2 ) during 8 weeks. Biochemical parameters, bone mineral density (BMD), bone mineral content (BMC) and femoral bone microstructure were determined. Plasma calcium and phosphate were increased in BIO + D3 and BIO + D3  + K2 groups as compared to OVX. Alkaline phosphatase was elevated in OVX, BIO versus SHAM, BIO + D3  + K2 groups. When compared to OVX group, decreased urine deoxypyridinoline was observed in all treated groups and femoral BMD, BMC were higher in BIO, BIO + D3 , BIO + D3  + K2 groups. The BIO + K2 rats had similar densitometrical values than OVX individuals. Microcomputed tomography revealed increased trabecular relative bone volume (due to an increase in trabecular number) in BIO + D3 , BIO + D3  + K2 as compared to OVX. The higher relative bone volume in BIO + D3 , BIO + D3  + K2 groups was also accompanied by an increase in bone surface. In the cortical bone, an enhanced periosteal bone apposition was identified in BIO, BIO + D3 , BIO + K2 , BIO + D3  + K2 groups. The rats from BIO + D3  + K2 group had a higher area of primary osteon's vascular canals. In BIO + D3 , BIO + K2 , BIO + D3  + K2 groups, an increased area of secondary osteons was determined in comparison with OVX. Our results indicate the beneficial effect of triple application of Biomin H® , vitamin D3 , vitamin K2 , as well as simultaneous administration of Biomin H® , vitamin D3 on the inhibition of ovariectomy-induced bone loss in a rat model of osteoporosis.

Micronutrient status and associated factors of adiposity in primary school children with normal and high body fat in Colombo municipal area, Sri Lanka

BACKGROUND

The prevalence of obesity and associated risk of chronic diseases are increasing among the paediatric population. The effectiveness of preventive measures and interventions are likely to improve when all factors which associate with obesity in a specific target group are considered. Currently such comprehensive data is unavailable for Sri Lankan children aged 8-9 years.

METHODS

This paper pertains to the data collected from August-2015 to November-2016 for a case-control study which included cases (high body fat) (N = 160; males-81) and controls (normal body fat) (N = 164; males-80) recruited from primary schools in the Colombo Municipal area. Anthropometry and body composition (Bioelectrical impedance analysis-BIA) were measured. Diet, physical activity and socio-demographic data were collected using validated interviewer administered questionnaires. Serum concentrations of vitamins A, D [25(OH)D], E, folate (serum and red blood cell-RBC), zinc (Zn), selenium (Se), copper (Cu), iron (Fe), magnesium (Mg), calcium (Ca), chromium (Cr), manganese (Mn), cobalt (Co), ferritin, leptin and high sensitivity C-reactive protein (hs-CRP) were assessed using fasting blood samples.

RESULTS

Cases were from higher socio-economic strata and spent significantly less time on physical activities, more time on sedentary behaviours and consumed higher energy compared to the controls. Cases from both genders had significantly lower levels of vitamin D [25 (OH)D], Fe and Mg (all p < 0.05) and higher levels of Cu and Ca (all p < 0.01) compared to controls. Higher levels of ferritin and Cr were seen among male (p < 0.001) and female (p > 0.05) cases compared to the controls. However, total serum folate levels were lower in male (p < 0.01) and female (p > 0.05) cases while the RBC folate levels were higher among male (p < 0.01) and female (p > 0.05) cases compared with controls. Vitamins A, E, Se, Mn and Co (p > 0.05) were not significantly different between groups. The inflammatory markers, both hs-CRP and leptin levels were higher among cases (p < 0.001) compared to the controls.

CONCLUSIONS

This study highlights higher socio-economic status, lower physical activity, more sedentary behaviours, higher energy intake and inconsistent distribution of micronutrients among the children with high body fat when compared with the control group. Increased levels of inflammatory markers indicate the presence of the risk of chronic inflammation in children with high body fat.

Mechanistic Effects of Vitamin D Supplementation on Metabolic Syndrome Components in Patients with or without Vitamin D Deficiency

The prevalences of metabolic syndrome (MetS) and vitamin D deficiency are increasing dramatically worldwide. MetS is a major challenge because it can increase the risk of most non-communicable diseases. The beneficial effect of vitamin D on MetS components remains controversial, so the present review focused on the clinical effects of vitamin D supplementation on MetS components. Vitamin D can inhibit the protein expression of nuclear factor beta; improve arterial stiffness; decrease renin-angiotensin-aldosterone system activity, parathyroid hormone levels, inflammatory cytokines, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, and lanosterol 14 α-demethylase enzyme activity; increase the activity of lipoprotein lipase; alter gene expression in C2C12 cells; and improve phospholipid metabolism and mitochondrial oxidation. We tried to elucidate and analyze almost all evidence from randomized controlled trial studies of the efficacy of vitamin D supplementation in patients with MetS. The findings of the present study reported beneficial effects of vitamin D supplementation on mentioned factors. Vitamin D supplementation is recommended in people with vitamin D deficiency even if it has no considerable effect on most MetS factors. However, existing data from interventional studies are insufficient to reach a definitive conclusion about the effect of vitamin D supplementation on MetS components in patients without vitamin D deficiency. Thus, new clinical studies are needed to test the hypothesis that vitamin D supplementation could alleviate MetS components in patients with sufficient intake of vitamin D.

Serum vitamin D status and metabolic syndrome: a systematic review and dose-response meta-analysis

BACKGROUD/OBJECTIVES

Evidence has suggested an association between serum vitamin D and metabolic syndrome (MetS), but prospective studies are very limited. The objective was to assess the dose-response association between serum vitamin D concentration and MetS risk using a systematic review and meta-analysis of updated observational studies.

MATERIALS/METHODS

Using MEDLINE, PubMed, and Embase, a systematic literature search was conducted through February 2020 and the references of relevant articles were reviewed. A random-effects model was used to estimate the summary odds ratio/relative risk and 95% confidence interval (CI). Heterogeneity among studies was evaluated with I² statistic. In total, 23 observational studies (19 cross-sectional studies, and four cohort studies) were included in the meta-analysis.

RESULTS

The pooled estimates (95% CI) for MetS per 25-nmol/L increment in serum vitamin D concentration were 0.80 (95% CI, 0.76–0.84; I² = 53.5) in cross-sectional studies, and 0.85 (95% CI, 0.72–0.98; I² = 85.8) in cohort studies. Similar results were observed, irrespectively of age of study population, study location, MetS criteria, and adjustment factors. There was no publication bias for the dose-response meta-analysis of serum vitamin D concentrations and MetS.

CONCLUSIONS

Dose-response meta-analysis demonstrated that a 25-nmol/L increment in the serum vitamin D concentration was associated with 20% and 15% lower risks of MetS in cross-sectional studies and cohort studies, respectively.

Vitamin D Insufficiency Reduces Grip Strength, Grip Endurance and Increases Frailty in Aged C57Bl/6J Mice

Low 25-OH serum vitamin D (VitD) is pervasive in older adults and linked to functional decline and progression of frailty. We have previously shown that chronic VitD insufficiency in "middle-aged" mice results in impaired anaerobic exercise capacity, decreased lean mass, and increased adiposity. Here, we examine if VitD insufficiency results in similar deficits and greater frailty progression in old-aged (24 to 28 months of age) mice. Similar to what we report in younger mice, older mice exhibit a rapid and sustained response in serum 25-OH VitD levels to differential supplementation, including insufficient (125 IU/kg chow), sufficient (1000 IU/kg chow), and hypersufficient (8000 IU/kg chow) groups. During the 4-month time course, mice were assessed for body composition (DEXA), physical performance, and frailty using a Fried physical phenotype-based assessment tool. The 125 IU mice exhibited worse grip strength (p = 0.002) and inverted grip hang time (p = 0.003) at endpoint and the 8000 IU mice transiently displayed greater rotarod performance after 3 months (p = 0.012), yet other aspects including treadmill performance and gait speed were unaffected. However, 125 and 1000 IU mice exhibited greater frailty compared to baseline (p = 0.001 and p = 0.038, respectively), whereas 8000 IU mice did not (p = 0.341). These data indicate targeting higher serum 25-OH vitamin D levels may attenuate frailty progression during aging.

Febuxostat attenuates vascular calcification induced by vitamin D3 plus nicotine in rats

This study was undertaken to investigate the possible ameliorative influences of febuxostat (FEB) on vitamin D3 plus nicotine (VDN)-induced vascular calcification (VC) in Wistar rats. VDN rats received a single dose of vitamin D3 (300.000 IU/kg, I.M) and two oral doses of nicotine (25 mg/kg) on day 1. They were then administrated FEB, in two doses (10 and 15 mg/kg/day, orally), or the drug vehicle, for 4 weeks. Age-matched normal rats served as control. At the end of the experiment, body weight, kidney function parameters, serum ionic composition, cardiovascular measures, aortic calcium deposition and aortic levels of oxidative stress markers, interleukin 1β (IL-1β), runt-related transcription factor 2 (Runx2) and osteopontin (OPN) were determined. Aortic immunoexpressions of tumor necrosis factor-α (TNF-α), inducible nitric oxide synthase (iNOS), matrix metalloproteinase-9 (MMP-9) and α-smooth muscle actin (α-SMA) were evaluated. FEB significantly restored body weight loss, ameliorated kidney function and diminished serum disturbances of calcium and phosphorus in VDN rats. Moreover, FEB reduced VDN-induced elevations in aortic calcium deposition, SBP and DBP. FEB (15 mg/kg) markedly decreased left ventricular hypertrophy and bradycardia in VDN group. Mechanistically, FEB dose-dependently improved oxidative damage, decreased levels of IL-1β and Runx2, lessened expression of TNF-α, iNOS and MMP-9 and enhanced expression of OPN and α-SMA in VDN aortas relative to controls. These findings indicate that FEB, mainly at the higher administered dose (15 mg/kg), successfully attenuated VDN-induced VC. FEB may be useful in reducing VC in patients at high risk, including those with chronic kidney disease and diabetes mellitus.

Serum 25-hydroxyvitamin D level in relation to weight change and the risk of weight gain in adults of normal weight at baseline: the Norwegian HUNT cohort study

OBJECTIVE

We sought to investigate the relationship of serum 25-hydroxyvitamin D (25(OH)D) level with weight change and the risk of weight gain in an adult population who had normal weight at baseline and were followed up for 11 years.

DESIGN

A population-based prospective cohort study.

SETTING

Nord-Trøndelag, Norway.

PARTICIPANTS

The study included 1501 adults who participated in the second and third surveys of the Nord-Trøndelag Health Study (HUNT2 (1995-1997) and HUNT3 (2006-2008)) and had a normal body mass index ≥18.5 and <25.0 kg/m² at baseline.

PRIMARY AND SECONDARY OUTCOME MEASURES

Relative weight change (%) was calculated as ((HUNT3 weight-HUNT2 weight)/HUNT2 weight×100). Relative annual weight change (%) was calculated as (relative weight change/follow-up years×100). Clinical weight gain was defined as relative weight change ≥5% over the 11 years, while annual weight gain was defined as relative annual weight change >1.25%.

METHODS

Multiple regression models were used to estimate adjusted coefficients for the relative annual weight change and risk ratios (RRs) for the risk of clinical weight gain and of annual weight gain.

RESULTS

Each 25 nmol/L increase in season-standardised serum 25(OH)D level at baseline was associated with a reduction of 0.05% (95% CI -0.11 to 0.01) for relative annual weight change, a 10% (RR 0.90, 95% CI 0.82 to 0.97) reduced risk of clinical weight gain, and a 19% (RR 0.81, 95% CI 0.65 to 1.00) reduced risk of annual weight gain. A statistically significant trend was evident for the risk of clinical weight gain when 25(OH)D levels were treated as a categorical variable (p=0.006).

CONCLUSIONS

The findings suggested an inverse association of serum 25(OH)D level with the risk of clinical weight gain in adults who had normal weight at baseline over 11 years' follow-up.

Tuning Adipogenic Differentiation in ADSCs by Metformin and Vitamin D: Involvement of miRNAs

Fat tissue represents an important source of adipose-derived stem cells (ADSCs), which can differentiate towards several phenotypes under certain stimuli. Definite molecules as vitamin D are able to influence stem cell fate, acting on the expression of specific genes. In addition, miRNAs are important modulating factors in obesity and numerous diseases. We previously identified specific conditioned media able to commit stem cells towards defined cellular phenotypes. In the present paper, we aimed at evaluating the role of metformin on ADSCs differentiation. In particular, ADSCs were cultured in a specific adipogenic conditioned medium (MD), in the presence of metformin, alone or in combination with vitamin D. Our results showed that the combination of the two compounds is able to counteract the appearance of an adipogenic phenotype, indicating a feedforward regulation on vitamin D metabolism by metformin, acting on CYP27B1 and CYP3A4. We then evaluated the role of specific epigenetic modulating genes and miRNAs in controlling stem cell adipogenesis. The combination of the two molecules was able to influence stem cell fate, by modulating the adipogenic phenotype, suggesting their possible application in clinical practice in counteracting uncontrolled lipogenesis and obesity-related diseases.

Vitamin D Supplementation in Laboratory-Bred Mice: An In Vivo Assay on Gut Microbiome and Body Weight

Saudi Arabia is in a tropical geographical region with a population that has access to adequate diet. There is, however, a high level of vitamin D deficiency in the Kingdom, comorbid with other disease. There is the postulation of a correlation between a healthy gut microbiota and balanced levels of serum vitamin D. This investigation looks into the effect of vitamin D supplementation on the gut flora of laboratory-bred mice as well as any possible association on body weight. BALB/C mice weighing between 34 and 35.8 g were divided into 4 groups and placed on daily doses of vitamin D of 3.75 µg (low dose), 7.5 µg (normal dose), and 15 µg (high dose). The fourth group was the control group that did not receive any supplementation with vitamin D. Body weights were monitored on weekly basis, while faecal samples from the rectum were obtained for microbial culturing and the monitoring of bacterial colony count using the Vitek 2 Compact automated system (BioMerieux, Marcy-l’Etoile, France) according to manufacturer’s guidelines. The data presented as mean ± SD, while significant differences were determined with 2-way analysis of variance in comparing differences within and between treatment groups. The different doses of vitamin D showed varying effects on the body weight and gut microbial colonies of the mice. There was a highly significant difference between the control, 15 µg (high), and 7.5 µg (normal) dose groups. This is suggestive that supplementation with vitamin D could a role in the gut microbial flora in the gut which could reflect in changes in body weight.

Effects of Vitamin D Supplementation on General and Central Obesity: Results from 20 Randomized Controlled Trials Involving Apparently Healthy Populations

Background: The obesity pandemic has been paralleled by a high prevalence of vitamin D deficiency (VDD). There is growing epidemiological evidence linking low vitamin D status with obesity events. In addition, observational studies also show that obesity may increase the risk of VDD. However, there is insufficient knowledge to understand whether there is a causality between the two. Moreover, the impact of vitamin D supplementation on obesity indices has shown inconsistent outcomes. Objective: This meta-analysis aimed to assess whether vitamin D supplementation modified general and central obesity indices in apparently healthy populations. Methods: A systematic retrieval of relevant randomized controlled trials (RCTs) was undertaken using Pubmed, Embase, Web of Knowledge and Chinese National Knowledge Infrastructure databases. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were used to assess the changes in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and 25-hydroxyvitamin D (25[OH]D) from baseline. Results: Twenty RCTs involving 3,153 participants reporting either BMI, WC, WHR or 25(OH)D met the inclusion criteria. When compared with placebo, vitamin D supplementation had no significant decreases in BMI (WMD = –0.09 kg/m2, 95% CI –0.19 to 0.01, p = 0.08), WC (WMD = –0.71 cm, 95% CI –1.58 to 0.16, p = 0.112) or WHR (WMD = 0.00, 95% CI –0.01 to 0.01, p = 0.749). However, in the subgroups of females, Asia region studies and intervention duration ≥6 months, a beneficial and significant reduction in BMI and WC was noted (all p < 0.026). On the other hand, pooled results showed that there was a significant increase in serum 25(OH)D levels (WMD = 13.20 ng/mL, 95% CI 9.83–16.58, p < 0.001) after vitamin D intervention. No publication bias was found in our study. Conclusions: Overall, supplementation with vitamin D produced no significant effect on the BMI, WC or WHR of healthy adults.

Calcitriol Prevents Neuroinflammation and Reduces Blood-Brain Barrier Disruption and Local Macrophage/Microglia Activation

Multiple sclerosis (MS) is a progressive disease of the central nervous system (CNS) that involves damage to the myelin sheath surrounding axons. MS therapy is based on immunomodulatory drugs that reduce disease recurrence and severity. Vitamin D is a hormone whose immunomodulatory ability has been widely demonstrated, including in experimental autoimmune encephalomyelitis (EAE), which is an animal model of CNS inflammation. In this study, we evaluated the potential of very early intervention with the active form of vitamin D (1,25-dihydroxyvitamin D3) to control neuroinflammation during EAE development. EAE was induced in C57BL/6J mice and 1,25-dihydroxyvitamin D3 administration began 1 day after disease induction. This procedure decreased prevalence, clinical score, inflammation, and demyelination. It also reduced MHCII expression in macrophages and microglia as well as the level of oxidative stress and messenger RNA (mRNA) expression for NLRP3, caspase-1, interleukin (IL)-1β, CX₃CR1, CCL17, RORc and Tbx21 at the CNS. Otherwise, mRNA expression for ZO-1 increased at the lumbar spinal cord. These effects were accompanied by the stabilization of blood-spinal cord barrier permeability. The results of this study indicate that early intervention with 1,25-dihydroxyvitamin D3 can control the neuroinflammatory process that is the hallmark of EAE and MS immunopathogenesis and should thus be explored as an adjunct therapy for MS patients.

Obesity and overweight decreases the effect of vitamin D supplementation in adults: systematic review and meta-analysis of randomized controlled trials

Overweight and obesity are associated with vitamin D deficiency (VitD), which are both important health problems. Reduced serum vitamin D levels has been registered in all phases of life and is commonly associated with the genesis of overweight and obesity. Thus, the objective of this review with meta-analysis was to investigate and evidence the efficacy of vitamin D supplementation in vitamin D. Interventional studies were searched for in 5 databases, without restriction of publication date or language. The absolute mean difference was used as a summary measure of the selected studies. A total of 2370 studies were identified, of which 18 descriptive articles were eligible - based on criteria and variables of selection and exclusion. Then the data were synthesized and submitted to meta-analysis. The results evidence that after supplementation individuals with obesity presented increased serum vitamin D 39.83 nmol/L (95% CI: 34.06-45.61) in relation to the control/placebo group. However, the obese state decreased serum vitamin D concentration by -38.17 nmol/L (95% CI: -59.90/-16.44) compared to the normal weight group. In addition, increasing the dose of VitD supplementation does not appear to contribute significantly to increased serum VitD levels. The study observed that obesity in adults reduced the effect of vitamin D supplementation. Therefore, research should be developed on the optimal dose of vitamin D supplementation for people with obesity.Systematic Review Registration: PROSPERO number CRD42018091.

Widespread vitamin D deficiency and its sex-specific association with adiposity in Chinese children and adolescents

OBJECTIVES

Vitamin D is involved in various physiologic and pathologic processes in the human body. The aim of this study was to determine the prevalence of vitamin D deficiency and the association of adiposity indicators with 25-hydroxyvitamin D (25[OH]D) in Chinese children and adolescents.

METHODS

This was a population-based, nationwide, multicenter cross-sectional study involving 10 696 participants (51.2% boys) 6 to 18 y of age. Total body fat mass was assessed by dual-energy x-ray absorptiometry, and measures of body mass index (BMI), fat mass index (FMI), fat mass percentage (FMP), and plasma 25(OH)D concentrations were obtained.

RESULTS

The adjusted mean of 25(OH)D was 39.3 nmol/L for all participants, 40.7 nmol/L for boys, and 37.9 nmol/L for girls. Of the children, 30% had vitamin D deficiency (25[OH]D <30 nmol/L) and 80% had vitamin D insufficiency (25[OH]D <50 nmol/L). The prevalence rates of vitamin D deficiency and insufficiency were higher in girls (31%, 83.4%, respectively) than in boys (22.8%, 78.7%, respectively). An L-shape relationship between age and 25(OH)D was observed in all children, with a threshold age of 14 y. Also, there was an inverted U-shaped association of BMI with 25(OH)D, and multivariable linear models shown FMI and FMP were inversely associated with 25(OH)D concentrations, particularly in boys (β = -0.86 and -0.83, respectively, all P < 0.05).

CONCLUSIONS

Vitamin D deficiency was widespread and its sex-specific association with an excess of body fat in Chinese children and adolescents. The findings indicate that targeted screening and treatment guidelines may be useful.

Long-term vitamin D and high-dose n-3 fatty acids' supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD

This study was performed to evaluate the effects of vitamin D and n-3 fatty acids' co-supplementation on markers of cardiometabolic risk in diabetic patients with CHD. This randomised, double-blinded, placebo-controlled trial was conducted among sixty-one vitamin D-deficient diabetic patients with CHD. At baseline, the range of serum 25-hydroxyvitamin D levels in study participants was 6·3-19·9 ng/ml. Subjects were randomly assigned into two groups either taking 50 000 IU vitamin D supplements every 2 weeks plus 2× 1000 mg/d n-3 fatty acids from flaxseed oil (n 30) or placebo (n 31) for 6 months. Vitamin D and n-3 fatty acids' co-supplementation significantly reduced mean (P = 0·01) and maximum levels of left carotid intima-media thickness (CIMT) (P = 0·004), and mean (P = 0·02) and maximum levels of right CIMT (P = 0·003) compared with the placebo. In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β -0·40 mmol/l; 95 % CI -0·77, -0·03; P = 0·03), insulin (β -1·66 μIU/ml; 95 % CI -2·43, -0·89; P < 0·001), insulin resistance (β -0·49; 95 % CI -0·72, -0·25; P < 0·001) and LDL-cholesterol (β -0·21 mmol/l; 95 % CI -0·41, -0·01; P = 0·04), and a significant increase in insulin sensitivity (β +0·008; 95 % CI 0·004, 0·01; P = 0·001) and HDL-cholesterol (β +0·09 mmol/l; 95 % CI 0·01, 0·17; P = 0·02) compared with the placebo. Additionally, high-sensitivity C-reactive protein (β -1·56 mg/l; 95 % CI -2·65, -0·48; P = 0·005) was reduced in the supplemented group compared with the placebo group. Overall, vitamin D and n-3 fatty acids' co-supplementation had beneficial effects on markers of cardiometabolic risk.

Is Vitamin D Supplementation Useful for Weight Loss Programs? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background and Objectives: The controversy about the impact of vitamin D supplementation on weight loss treatment was observed in several randomized controlled trials (RCTs). This meta-analysis investigates the effects of vitamin D supplementation (cholecalciferol or ergocalciferol) on weight loss through holistic measurements of Body Mass Index (BMI), weight and waist circumference. Materials and Methods: Google Scholar, WOS, PubMed and Scopus were explored to collect relevant studies. The selected articles focused on vitamin D supplementation in overweight and obese individuals with different conditions. Eleven RCTs were included into this meta-analysis with a total of 947 subjects, with a mean of the follow-up from 1 to 12 months and different vitamin D interventions (from 25,000 to 600,000 IU/monthly of cholecalciferol). Results: The meta-analyzed mean differences for random effects showed that cholecalciferol supplementation deceases the BMI by -0.32 kg/m² (CI95% -0.52, -0.12 kg/m², p = 0.002) and the waist circumference by -1.42 cm (CI95% -2.41, -0.42 cm, p = 0.005), but does not statistically affect weight loss -0.43 kg (CI95% -1.05, +0.19 kg, p = 0.17). Conclusions: This meta-analysis lays the foundation for defining the potential clinical efficacy of vitamin D supplementation as a potential therapeutic option for weight loss programs, but further studies are needed to confirm the validity of these findings and delineate potential underlying mechanisms.

Avaliação da frequência de deficiência de vitamina D em pacientes com obesidade

Introdução: A obesidade é um problema de saúde pública mundial. Além das diversas alterações metabólicas encontradas em indivíduos obesos, há evidências de alterações no sistema endócrino, como observado no metabolismo da vitamina D.Objetivos:Avaliar a frequência de deficiência de vitamina D em uma amostra de pacientes adultos com obesidade.Materiais e métodos: Foi realizado um estudo transversal retrospectivo analisando 183 prontuários dos pacientes atendidos pela primeira vez buscando tratamento para obesidade. Após os fatores de exclusão, restaram 113 prontuários válidos.Resultados: O IMC variou de 30.1 a 77.1, com uma mediana de 44.5 kg/m2. Trinta pacientes (26,55 %) tinham a Vitamina D abaixo de 20 ng/ml, sendo considerados com diagnóstico de Deficiência de Vitamina D. Nenhum correlação foi encontrada entre os níveis de Vitamina D e os parâmetros antropométricos. Houve associação significativa estatística dos níveis de Vitamina D com colesterol total (r=-0.26; p=0.0053), LDL-colesterol (r=-0.25; p=0.0071), além de uma tendência à significância com os níveis de TGP (r=0.16; p=0.088).Conclusão: Houve uma elevada frequência de deficiência de vitamina D em pacientes obesos. Não houve correlação entre os níveis de vitamina D e os marcadores antropométricos, porém foi encontrada uma correlação inversa de vitamina D com níveis de colesterol total e LDL-colesterol, mostrando a relação com a dislipidemia. Também, houve uma tendência à significância com os níveis de TGP, o que provavelmente remete à esteatose hepática, comum em obesos.

Vitamin D supplementation and muscle strength in pre-sarcopenic elderly Lebanese people: a randomized controlled trial

Previous studies have shown that improving vitamin D status among the elderly may lead to an improvement in muscle mass and muscle strength. In our study, vitamin D supplementation showed significant improvements in vitamin D concentrations as well as appendicular muscle mass in pre-sarcopenic older Lebanese people. However, we found no significant effect on muscle strength.

INTRODUCTION

Improving vitamin D status might improve muscle function and muscle mass that lead to sarcopenia in older subjects. The aim of this randomized, controlled, double-blind study was to examine the effect of vitamin D supplementation on handgrip strength and appendicular skeletal muscle mass in pre-sarcopenic older Lebanese subjects. We also examined whether this effect differs in normal vs. obese subjects.

METHODS

Participants (n = 128; 62 men and 66 women) deficient in vitamin D (25(OH)D = 12.92 ± 4.3 ng/ml) were recruited from Saint Charles Hospital, Beirut, Lebanon. The participants were given a supplement of 10,000 IU of cholecalciferol (vitamin D group; n = 64) to be taken three times a week or a placebo tablet (placebo group; n = 64) for 6 months. One hundred fifteen subjects completed the study: 59 had normal weight, while 56 were obese. Strength and functional assessment and biochemical analysis were performed at the start and after 6 months.

RESULTS

Compared to placebo, the vitamin D supplemented group showed significant improvements in appendicular skeletal muscle mass (ASMM) (P < 0.001) but not in handgrip strength (P = 0.2901). ANCOVA for ASMM adjusting for obesity and including the interaction between obesity and vitamin D showed a significant interaction. The increase in ASMM with vitamin D in normal-weight subjects was higher than that of obese subjects (B = 35.09 vs. B = 2.19).

CONCLUSION

Treatment with vitamin D showed beneficial effects on appendicular muscle mass in pre-sarcopenic older Lebanese men and women. However, it had no effect on muscle strength relative to placebo. This trial was registered at isrctn.org as ISRCTN16665940.