Diverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT
Effect of monthly vitamin D on diverticular disease hospitalization: post-hoc analysis of a randomized controlled trial
Clinical Nutrition https://doi.org/10.1016/j.clnu.2020.08.030
Zhenqiang Wu ab JoannaBroadbJohnSluyteraDebbieWaayera Carlos A.Camargo Jr.c Robert Scragg a
Big increase in diverticular disease in the group not getting the monthly vitamin D
Background & aims
Some studies have linked low vitamin D status and high risk of diverticular disease, but the causal relationship between vitamin D and diverticular disease remains unclear; clinical trial data are warranted. The objective was to assess the efficacy of vitamin D3 supplementation on diverticular disease hospitalization.
Methods
Post-hoc analysis of a community-based randomized double-blind placebo-controlled trial (RCT) with 5108 participants randomized to receive monthly 100,000 IU vitamin D (n=2558) or identical placebo (n=2550). The outcome was time to first diverticular disease hospitalization from randomization to the end of intervention (July 2015), including a prespecified subgroup analysis in participants with baseline deseasonalized 25-hydroxyvitamin D (25(OH)D) levels <50 nmol/L.
Results
Over a median of 3.3 years follow-up, 74 participants had diverticular disease hospitalization. There was no difference in the risk of diverticular disease hospitalization between vitamin D supplementation (35/2558=1.4%) and placebo (39/2550=1.5%) groups (adjusted hazard ratio [HR]=0.90; p=0.65), although in participants with deseasonalized 25(OH)D <50 nmol/L (n=1272), the risk was significantly lower in the vitamin D group than placebo (HR=0.08, p=0.02).
Discussion
Monthly 100,000 IU vitamin D3 does not reduce the risk of diverticular disease hospitalization in the general population. Further RCTs are required to investigate the effect of vitamin D supplementation on the diverticular disease in participants with low 25(OH)D levels.
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See also web
Higher Serum Levels of Vitamin D Are Associated With a Reduced Risk of Diverticulitis - Dec 2013
Paradigm shift: the Copernican revolution in diverticular disease - Nov 2019
Note: two of the risk factors (Smoking, obesity) are strongly associated with low vitamin D
RCT with 100,000 IU monthly
Across all 2550 patients - not statistically significant
For those 1272 who have Vitamin D levels 20ng - 12X improvement
Results would probably have been even better if used a gut-friendly form of Vitamin D
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