Severe obesity is related to low vitamin D around the world – Aug 2023

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A systematic review and meta-analysis of vitamin D status of patients with severe obesity in various regions worldwide

Obes Facts , DOI: 10.1159/000533828 August 28, 2023
Neda Haghighat1, Zahra Sohrabi2, Reza Bagheri3, Marzieh Akbarzadeh2, Zahra Esmaeilnezhad2, Damoon Ashtary- Larky1, Reza Barati-Boldaji2, Morteza Zare2, Masoud Amini1, Seyed Vahid Hosseini4, Alexei Wong5, Hamidreza Foroutan1 forotanh at sums.ac.ir
1 Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
3 Department of Exercise Physiology, University of Isfahan, Isfahan, Iran.
4 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
5 Department of Health and Human Performance, Marymount University, Arlington, VA, United States.

Many charts in the PDF do not have good lables
Introduction: Managing nutritional deficiencies is an essential component in the treatment of severe obesity. Vitamin D deficiency is often reported in investigations in severe obese cohorts. However, no prior study has summarized findings on this topic. Consequently, the aim of this systematic review and meta-analysis was to investigate the 25- hydroxyvitamin D [25(OH)D] status in individuals with severe obesity in different regions worldwide. We also evaluated levels of calcium, PTH, and magnesium as secondary outcome measures.

Methods: We searched Medline, PubMed, Scopus, the Cochrane Library, and EMBASE for relevant observational studies published in English from 2009 to October 2021. The heterogeneity index among the studies was determined using the Cochran (Q) and I2 tests. Based on the heterogeneity results, the random-effect model was applied to estimate the prevalence of vitamin D deficiency.

Results: We identified 109 eligible observational studies. Overall,

• 59.44% of patients had vitamin D deficiency [25(OH)D <20 ng/ml], whereas
• 26.95% had vitamin D insufficiency [25(OH)D 20-30 ng/ml].

Moreover, the mean 25(OH)D levels was 18.65 ng/ml in 96 studies. The pooled mean estimate of the serum calcium, PTH and magnesium was

• Calcium: 9.26 mg/dl (95% CI: 9.19-9.32, I2=99.7%, p<0.001)
• PTH: 59.24 pg/ml (95% CI: 54.98, 63.51), I2= 99.7%, p < 0.001), and
• magnesium: 0.91 mg/dl (0.84, 0.98, I2= 100.0%, p < 0.001), respectively.

The results of the sub-group analysis indicated that the mean estimates of 25(OH)D was highest in North America [21.71 ng/ml (19.69, 23.74), (I2=97.2%, p<0.001)] and lowest in Southeast Asia [14.93 ng/ml (14.54, 15.33), (I2=0.0%, p = 0.778)].

Conclusion: The results obtained showed a significant prevalence of vitamin D deficiency among severely obese individuals in various geographical regions, whereas the highest and lowest mean estimates were reported for North America and Southeast Asia, respectively.
 Download the PDF from VitaminDWiki

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VitaminDWiki – Overview Obesity and Vitamin D contains

• FACT: People who are obese have less vitamin D in their blood
• FACT: Obese need a higher dose of vitamin D to get to the same level of vit D
• FACT: When obese people lose weight the vitamin D level in their blood increases
• FACT: Adding Calcium, perhaps in the form of fortified milk, often reduces weight
• FACT: 168 trials for vitamin D intervention of obesity as of Dec 2021
• FACT: Less weight gain by senior women with > 30 ng of vitamin D
• FACT: Dieters lost additional 5 lbs if vitamin D supplementation got them above 32 ng - RCT
• FACT: Obese lost 3X more weight by adding $10 of Vitamin D
• FACT: Those with darker skins were more likely to be obese Sept 2014
• OBSERVATION: Low Vitamin D while pregnancy ==> more obese child and adult
• OBSERVATION: Many mammals had evolved to add fat and vitamin D in the autumn
  • and lose both in the Spring - unfortunately humans have forgotten to lose the fat in the Spring
• SPECULATION: Low vitamin D might be one of the causes of obesity – several studies
• SUGGESTION: Probably need more than 4,000 IU to lose weight if very low on vitamin D due to
    risk factors such as overweight, age, dark skin, live far from equator,shut-in, etc.
• Obesity category has 428 items See also: Weight loss and Vitamin D - many studies   Child Obesity and Vitamin D - many studies

Obese need more Vitamin D

• Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study

• Normal weight     Obese     (50 ng = 125 nanomole)

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VitaminDWiki – Obesity is associated with low Vitamin D (and treated by D as well) – Aug 2019 contains:

Fast weight loss by Obese Adults: Summary of the data as of Sept 2019
1) 50,000 IU Vitamin D weekly for at least 6 months
   If gut problems, should use a gut-friendly form of vitamin D
2) Add calorie restriction diet and light exercise after ~2 months*
   * Vitamin D levels must be above 30ng/ml to help with weight loss
   * Start losing weight 2 months sooner if take a 50,000 IU daily for a week
3) More weight loss if also add Magnesium or cofactors
   30% Improved Vitamin D response with Magnesium - a Vitamin D Cofactor
   Note: Magnesium reduces weight loss by itself as well
   20% improved vitamin D response if also add Omega-3 a Vitamin D Cofactor
  Note: Omega-3 reduces weight loss by itself as well
4) More weight loss if also improve activation of Vitamin D Receptor
   Vitamin D Receptor activator: 0-30% improved Vitamin D response
   Obesity 1.5 X more likely if poor Vitamin D Receptor – meta-analysis Nov 2019
Update Dec 2019 - Dr. Greger plant-based eating (not diet) for both weight loss and health.
  His book does not mention Vitamin D nor Adenovirus

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VitaminDWiki - 11 studies in both categories Obesity and Magnesium

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