Vitamin D and calcium: a systematic review of health outcomes
Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, Lichtenstein A, Patel K, Raman G, Tatsioni A, Terasawa T, Trikalinos TA
Evidence report/technology assessment · 112 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2009-08-01 · Evid Rep Technol Assess (Full Rep) · número 183 · págs. 1–420
- Editorial
- National Institutes of Health
- Citado
- 318 citas · más que el 93% de estudios similares · 2.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 0 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Vitamin D Research Studies · Nutrition and Health Studies · Bone health and osteoporosis research
- Palabras clave
- vitamin D, calcium, Dietary Reference Intakes, serum 25-hydroxyvitamin D, calcium intake, bone health, bone mineral density, cardiovascular disease, oncological outcomes, colorectal cancer, prostate cancer, breast cancer, preeclampsia, hypertension, blood pressure, body weight, child growth, postmenopausal women, immune function, pancreatic cancer, dietary supplementation
- MeSH
- humans, calcium, dietary, vitamin d, treatment outcome, nutritional requirements, pregnancy, adult, female, male, randomized controlled trials as topic
12 autores
- Mei Chun Chung
- Ethan M. Balk
- Michael Brendel
- Stanley Ip
- Joseph Lau
- Jounghee Lee
- Alice Hinda Lichtenstein
- Kamal Patel
- Gowri Raman
- Athina Tatsioni🇺🇸United States Department of Health and Human Services
- Teruhiko Terasawa
- Thomas A Trikalinos
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Since the 1997 Dietary Reference Intake (DRI) values for vitamin D and calcium were established new data have become available on their relationship, both individually and combined, to a wide range of health outcomes. The Institute of Medicine/Food and Nutrition Board has constituted a DRI committee to undertake a review of the evidence and potential revision of the current DRI values for these nutrients. To support this review, several US and Canadian federal government agencies commissioned a systematic review of the scientific literature for use during the deliberations by the committee. The intent of providing a systematic review to the committee is to support transparency of the literature review process and provide a foundation for subsequent reviews of the nutrients.
Purpose
To systematically summarize the evidence on the relationship between vitamin D, calcium, and a combination of both nutrients on a wide range of health outcomes as identified by the IOM, AHRQ and technical expert panel convened to support the project.
Data sources
MEDLINE; Cochrane Central; Cochrane Database of Systematic Reviews; and the Health Technology Assessments; search limited to English-language articles in humans.
Study selection
Primary interventional or observational studies that reported outcomes of interest in human subjects in relation to vitamin D and/or calcium, as well as systematic reviews that met the inclusion and exclusion criteria. Cross sectional and retrospective case-control studies were excluded.
Data extraction
A standardized protocol with predefined criteria was used to extract details on study design, interventions, outcomes, and study quality.
Data synthesis
We summarized 165 primary articles and 11 systematic reviews that incorporated over 200 additional primary articles. Available evidence focused mainly on bone health, cardiovascular diseases or cancer outcomes. For many outcomes, it was difficult to draw firm conclusions on the basis of the available literature concerning the association of either serum 25(OH)D concentration or calcium intake, or the combination of both nutrients. Findings were inconsistent across studies for colorectal and prostate cancer, and pregnancy-related outcomes including preeclampsia. There were few studies for pancreatic cancer and immune function. Among trials of hypertensive adults, calcium supplementation lowered systolic, but not diastolic, blood pressure by 2-4 mm Hg. For body weight, the trials were consistent in finding no significant effect of increased calcium intake on weight. For growth rates, a meta-analysis did not find a significant effect on weight or height gain attributable to calcium supplement in children. For bone health, one systematic review found that vitamin D plus calcium supplementation resulted in small increases in BMD of the spine and other areas in postmenopausal women. For breast cancer, calcium intakes in premenopausal women were associated with a decreased risk. For prostate cancer, some studies reported that high calcium intakes were associated with an increased risk.
Limitations
Studies on vitamin D and calcium were not specifically targeted at life stages (except for pregnant and postmenopausal women) specified for the determination of DRI. There is large variation on the methodological quality of studies examined. Use of existing systematic reviews limits analyses that could be performed on this source of information.
Conclusions
The majority of the findings concerning vitamin D, calcium, or a combination of both nutrients on the different health outcomes were inconsistent. Synthesizing a dose-response relation between intake of either vitamin D, calcium, or both nutrients and health outcomes in this heterogeneous body of literature proved challenging.
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