Optimal methods of vitamin D supplementation to prevent acute respiratory infections: a systematic review, dose–response and pairwise meta-analysis of randomized controlled trials

DOI record: { "DOI": "10.1186/s12937-024-00990-w", "ISSN": [ "1475-2891" ], "URL": "http://dx.doi.org/10.1186/s12937-024-00990-w", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Vitamin D supplementation may prevent acute respiratory infections (ARIs). This study aimed to identify the optimal methods of vitamin D supplementation.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry were searched from database inception through July 13, 2023. Randomized-controlled trials (RCTs) were included. Data were pooled using random-effects model. The primary outcome was the proportion of participants with one or more ARIs.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>The analysis included 43 RCTs with 49320 participants. Forty RCTs were considered to be at low risk for bias. The main pairwise meta-analysis indicated there were no significant preventive effects of vitamin D supplementation against ARIs (risk ratio [RR]: 0.99, 95% confidence interval [CI]: 0.97 to 1.01, <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 49.6%). The subgroup dose–response meta-analysis indicated that the optimal vitamin D supplementation doses ranged between 400–1200 IU/day for both summer-sparing and winter-dominant subgroups. The subgroup pairwise meta-analysis also revealed significant preventive effects of vitamin D supplementation in subgroups of daily dosing (RR: 0.92, 95% CI: 0.85 to 0.99, <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 55.7%, number needed to treat [NNT]: 36), trials duration &lt; 4 months (RR: 0.81, 95% CI: 0.67 to 0.97, <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 48.8%, NNT: 16), summer-sparing seasons (RR: 0.85, 95% CI: 0.74 to 0.98, <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 55.8%, NNT: 26), and winter-dominant seasons (RR: 0.79, 95% CI: 0.71 to 0.89, <jats:italic>I</jats:italic><jats:sup><jats:italic>2</jats:italic></jats:sup> = 9.7%, NNT: 10).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>Vitamin D supplementation may slightly prevent ARIs when taken daily at doses between 400 and 1200 IU/d during spring, autumn, or winter, which should be further examined in future clinical trials.</jats:p>\n </jats:sec>", "alternative-id": [ "990" ], "article-number": "92", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "7 December 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "29 July 2024" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "14 August 2024" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethical approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "Institutional review board approval was not required since we used previously published studies." }, { "group": { "label": "Consent or publication", "name": 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