Recent meta-analyses reinforce the finding that 10 - 20 μg per day of vitamin D can reduce all-cause mortality and cancer mortality in middle-aged and older people .
Although vitamin D doses were greater than those assessed in the past , we found no new evidence that supplementation could have an effect on most non-skeletal conditions , including cardiovascular disease , adiposity , glucose metabolism , mood disorders , muscular function , tuberculosis , and colorectal adenomas , or on maternal and perinatal conditions .
The compilation of results from 83 trials showed that vitamin D supplementation had no significant effect on biomarkers of systemic inflammation .
The main new finding highlighted by this systematic review is that vitamin D supplementation might help to prevent common upper respiratory tract infections and asthma exacerbations .
There remains little evidence to suggest that vitamin D supplementation has an effect on most conditions , including chronic inflammation , despite use of increased doses of vitamin D , strengthening the hypothesis that low vitamin D status is a consequence of ill health , rather than its cause .
We further hypothesise that vitamin D supplementation could exert immunomodulatory effects that strengthen resistance to acute infections , which would reduce the risk of death in debilitated individuals .
Sample size slippages in randomised trials: exclusions and the lost and wayward
Proper r and omisation means little if investigators can not include all r and omised participants in the primary analysis . Participants might ignore follow-up , leave town , or take aspartame when instructed to take aspirin . Exclusions before r and omisation do not bias the treatment comparison , but they can hurt generalisability . Eligibility criteria for a trial should be clear , specific , and applied before r and omisation . Readers should assess whether any of the criteria make the trial sample atypical or unrepresentative of the people in which they are interested . In principle , assessment of exclusions after r and omisation is simple : none are allowed . For the primary analysis , all participants enrolled should be included and analysed as part of the original group assigned ( an intent-to-treat analysis ) . In reality , however , losses frequently occur . Investigators should , therefore , commit adequate re sources to develop and implement procedures to maximise retention of participants . Moreover , research ers should provide clear , explicit information on the progress of all r and omised participants through the trial by use of , for instance , a trial profile . Investigators can also do secondary analyses on , for instance , per- protocol or as-treated participants . Such analyses should be described as secondary and non-r and omised comparisons . Mish and ling of exclusions causes serious method ological difficulties . Unfortunately , some explanations for mish and ling exclusions intuitively appeal to readers , disguising the seriousness of the issues . Creative mismanagement of exclusions can undermine trial validity
Recent meta-analyses reinforce the finding that 10 - 20 μg per day of vitamin D can reduce all-cause mortality and cancer mortality in middle-aged and older people .
Although vitamin D doses were greater than those assessed in the past , we found no new evidence that supplementation could have an effect on most non-skeletal conditions , including cardiovascular disease , adiposity , glucose metabolism , mood disorders , muscular function , tuberculosis , and colorectal adenomas , or on maternal and perinatal conditions .
The compilation of results from 83 trials showed that vitamin D supplementation had no significant effect on biomarkers of systemic inflammation .
The main new finding highlighted by this systematic review is that vitamin D supplementation might help to prevent common upper respiratory tract infections and asthma exacerbations .
There remains little evidence to suggest that vitamin D supplementation has an effect on most conditions , including chronic inflammation , despite use of increased doses of vitamin D , strengthening the hypothesis that low vitamin D status is a consequence of ill health , rather than its cause .
We further hypothesise that vitamin D supplementation could exert immunomodulatory effects that strengthen resistance to acute infections , which would reduce the risk of death in debilitated individuals .