Vitamin D supports your health - but what if you're already in the hospital?
We’ve all heard about the benefits of vitamin D – ranging from bone health, to immune health, to muscle health. Recent data has even shown that vitamin D status is inversely related to mortality and there’s even data to demonstrate that for hospitalized patients, vitamin D deficiency is associated with a higher odds of developing a hospital-borne infection. So what do we know about the impact of vitamin D deficiency on mortality in hospitalized patients?
Amrein and colleagues conducted a randomized, double-blind, placebo-controlled clinical trial in which critically ill hospitalized patients with vitamin D deficiency (serum 25[OH]D ≤20 ng/mL) were given either a very high dose of vitamin D3 (540,000 IU with monthly maintenance doses of 90,000 IU for 5 months) or placebo. The primary outcome was the length of hospital stay and secondary outcomes included mortality (in-hospital and at 6 months).
In the end, there was no difference in hospital stay length or overall mortality between patients receiving vitamin D or placebo. However, in those with severe vitamin D deficiency (<12 ng/mL), significant reductions in mortality (in-hospital, 28 days, and 6 months) were observed in the vitamin D group, however the authors warned that these findings were hypothesis generating only but warranted further study, which seems rather fair considering this was a secondary analysis.
So what do we take away from this? For those of us who are, sadly, hospitalized and critically-ill, we can say that mild vitamin D deficiency has not proven to be the deciding factor in our ability to make it out of the hospital more quickly (for those patients with severe vitamin D deficiency, looks like right now we have a definite maybe). However, for the average person(who hopefully is not critically ill in a hospital bed), this study doesn’t change the fact that vitamin D is an essential nutrient and that adults and children need 600 IU/day according to the Institute of Medicine. And it doesn’t change the fact that over 90% of Americans do not meet the estimated average requirement for vitamin D from food. In the end, you should take away that meeting your vitamin D requirement remains important, and you can do so with an active lifestyle that includes getting sun exposure, a healthy diet, and a vitamin D containing dietary supplement to fill any nutrient gaps.
Amrein et al., Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. JAMA 2014 (epub ahead of print).
Fulgoni VL III, et al. Foods, fortificants, and supplements: where do Americans get their nutrients? J Nutr 2011; 141(10): 1847-1854.