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Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren

Urashima et al., Am. J. Clin. Nutr. 2010, 91:5, 1255-60, doi:10.3945/ajcn.2009.29094
Mar 2010  
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Vitamin D for COVID-19
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RCT for vitamin D supplementation and seasonal influenza A in schoolchildren, showing 10.8% incidence in children in the vitamin D3 group compared with 18.6% in the placebo group, relative risk RR 0.58 [0.34-0.99], p = 0.04.
The reduction was more prominent in children who had not been taking other vitamin D supplements. RR 0.36 [0.17-0.79], p 0.006, and who started nursery school after age 3y, RR 0.36 [0.17-0.78], p = 0.005.
Reduced incidence of influenza B was not seen, RR 1.39 [0.90-2.15], p = 0.13.
Urashima et al., 10 Mar 2010, peer-reviewed, 6 authors.
This PaperVitamin DAll
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren
Mitsuyoshi Urashima, Takaaki Segawa, Minoru Okazaki, Mana Kurihara, Yasuyuki Wada, Hiroyuki Ida
The American Journal of Clinical Nutrition, doi:10.3945/ajcn.2009.29094
Background: To our knowledge, no rigorously designed clinical trials have evaluated the relation between vitamin D and physiciandiagnosed seasonal influenza. Objective: We investigated the effect of vitamin D supplements on the incidence of seasonal influenza A in schoolchildren. Design: From December 2008 through March 2009, we conducted a randomized, double-blind, placebo-controlled trial comparing vitamin D 3 supplements (1200 IU/d) with placebo in schoolchildren. The primary outcome was the incidence of influenza A, diagnosed with influenza antigen testing with a nasopharyngeal swab specimen. Results: Influenza A occurred in 18 of 167 (10.8%) children in the vitamin D 3 group compared with 31 of 167 (18.6%) children in the placebo group [relative risk (RR), 0.58; 95% CI: 0.34, 0.99; P = 0.04]. The reduction in influenza A was more prominent in children who had not been taking other vitamin D supplements (RR: 0.36; 95% CI: 0.17, 0.79; P = 0.006) and who started nursery school after age 3 y (RR: 0.36; 95% CI: 0.17, 0.78; P = 0.005). In children with a previous diagnosis of asthma, asthma attacks as a secondary outcome occurred in 2 children receiving vitamin D 3 compared with 12 children receiving placebo (RR: 0.17; 95% CI: 0.04, 0.73; P = 0.006). Conclusion: This study suggests that vitamin D 3 supplementation during the winter may reduce the incidence of influenza A, especially in specific subgroups of schoolchildren. This trial was registered at as UMIN000001373.
and signs of influenza by reducing cytokine secretion. In this study, vitamin D reduced the incidence of influenza A, but not of influenza B. The cytokine secretion pattern can differ between influenza A and influenza B (18) . If vitamin D modulates cytokine secretion, preventive effects of vitamin D may be different between influenza A and influenza B. Because taking vitamin D 3 supplements for 1 y with a dose ranging from 200 to 2000 IU in schoolchildren has been shown to be safe (19) , we set the dose of vitamin D 3 at 1200 IU in this trial. No serious adverse events occurred. It reportedly takes '3 mo to reach a steady state of vitamin D concentrations by supplementation (20) . Thus, December might be theoretically
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