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Vitamin D2v. vitamin D3 supplementation in raising 25OHD status: preliminary findings of a meta-analysis

Published online by Cambridge University Press:  15 August 2011

S. A. Lanham-New ,
H. Lambert ,
L. Tripkovic ,
C. P. Smith ,
G. Bucca ,
K. Hart ,
S. Penson ,
G. Chope ,
E. Hyppönen  and
J. L. Berry
...Show all authors
S. A. Lanham-New
Affiliation:
Nutritional Sciences Division, University of Surrey, Guildford GU2 7HX
H. Lambert
Affiliation:
Nutritional Sciences Division, University of Surrey, Guildford GU2 7HX
L. Tripkovic
Affiliation:
Nutritional Sciences Division, University of Surrey, Guildford GU2 7HX
C. P. Smith
Affiliation:
Microbial Sciences Division, University of Surrey, Guildford GU2 7HX
G. Bucca
Affiliation:
Microbial Sciences Division, University of Surrey, Guildford GU2 7HX
K. Hart
Affiliation:
Nutritional Sciences Division, University of Surrey, Guildford GU2 7HX
S. Penson
Affiliation:
Campden BRI, Chipping Campden, Gloucestershire GL55 6LD
G. Chope
Affiliation:
Campden BRI, Chipping Campden, Gloucestershire GL55 6LD
E. Hyppönen
Affiliation:
Institute of Child Health, University College London, London WC1 2WP
J. L. Berry
Affiliation:
Vitamin D Research Group, Department of Medicine, University of Manchester, Manchester M13 9PL
R. Vieth
Affiliation:
Departments of Nutritional Sciences and Laboratory Medicine and Pathobiology, University of Toronto, Canada
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Abstract

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Proceedings of the Nutrition Society , Volume 70 , Issue OCE3: Joint Irish Section and American Society for Nutrition Meeting, 15–17 June 2011, 70th anniversary: ‘Vitamins in early development and healthy ageing: impact on infectious and chronic disease’ , 2011 , E94
Copyright
Copyright © The Authors 2011

There is growing evidence for the positive effects of vitamin D in reducing risk from disease and all cause mortality. This has increased our awareness of the need for evidence-based strategies to redress the high prevalence of low vitamin D status in the UK. We have just completed a 48-month FSA-funded study (known as the D-FINES study) in which we show that South Asian women were vitamin D deficient for the entire year and Caucasian women were below 50 nmol/l during the winter months (1). In a parallel study in Aberdeen, post-menopausal Caucasian Scottish women had a 10 nmol/l lower 25OHD status in comparison with post-menopausal Caucasian women living in Southern England (2). While food fortification is a sustainable solution for the prevention of vitamin D deficiency, the Food Industry needs to determine the most effective means of carriage, optimal concentration and chemical form of vitamin D if it is to maximise the effectiveness of fortification. The aim of this study was to undertake a meta-analysis of vitamin D2v. vitamin D3 RCTs in raising 25-hydroxyvitamin D status.

The literature search for the meta-analysis used the ISI Web of Knowledge using terms: ‘vitamin D2 and D3’ or ‘ergocalciferol and cholecalciferol’; ‘supplementation’ and ‘25 hydroxyvitamin D’. The Inclusion criteria was: (1) healthy adults, male or female; (2) study compared D2 and D3 in various vehicles; (3) outcome measure serum 25(OH)D; (4) intervention trials (one exception) nine studies included: eight intervention trials and one observational total subjects: n 919; age: 18–97 years; supplement dose: 1000–4000 IU/d for 14 d 3 months; or 50 000–300 000 IU bolus; oral and im. As shown below, six out of the eight RCT found the change in 25HOD status was greater in the vitamin D3 form in comparison with the vitamin D2 form.

The published studies were: Armas (2004) J Clin End Metab 89, 5387–5391: D2<D3; Biancuzzo (2010) Am J Clin Nutr 91, 1621–1626: No diff; Glendenning (2009) Bone 45, 870–875: D2<D3; Holick (2008) J Clin End Metab 93, 677–681: No diff; Leventis (2009) Scand J Rheumatol 38, 149–153: D2<D3; Romagnoli (2008) J Clin End Metab 93, 3015–3020: D2<D3; Tjellessen (1986) Bone Miner 1, 407–413: D2<D3; Trang (1998) Am J Clin Nutr 68, 854–8: D2<D3. All studies (except two) found 25OHD change higher with vitamin D3.

Fig. 1. Forest plot: change in 25(OH)D status between D2 v. D3.

These results are further confirmed in the Forest Plots as shown in Fig. 1. Further analysis of the meta-analysis data is currently underway but these data suggest that vitamin D3 is a superior form of vitamin D for raising 25HOD status.

References

1.Macdonald, HM, Mavroeidi, A, Fraser, WD et al. (2011) Effect of sunlight and diet on seasonal differences in the vitamin D status of cohorts of healthy post-menopausal women living in the North and South of the UK: a major cause for concern. Osteoporosis Int (In the Press).CrossRefGoogle Scholar
2.Darling, AL, Hart, K, Macdonald, HM et al. (2011) Interaction between diet and sunlight exposure on vitamin D status in pre-menopausal Asian and Caucasian women living in Southern England: multilevel modelling analysis of the D-FINES study. Proc Nutr Soc 2010 69, OCE1, E125. To be submitted to J Clin Endocrin Metab.Google Scholar
Figure 0

Fig. 1. Forest plot: change in 25(OH)D status between D2 v. D3.