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Cited by 76Vitamin D Research StudiesRespiratory viral infections researchPediatric health and respiratory diseases

Vitamin D3and gargling for the prevention of upper respiratory tract infections: a randomized controlled trial

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Goodall, Emma C, Granados, Andrea C, Luinstra, Kathy, Pullenayegum, Eleanor, Coleman, Brenda L, Loeb, Mark, Smieja, Marek·2014·BMC Infectious Diseases
DOI 10.1186/1471-2334-14-273PMC PMC4041358
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Abstract

BACKGROUND: We undertook a 2X2 factorial, randomized controlled trial (RCT) to assess whether vitamin D3 supplementation (10,000 international units per week) versus placebo and gargling versus no gargling could prevent viral, clinical upper respiratory tract infection (URTI) in university students. METHODS: We randomized 600 students into 4 treatment arms: 1) vitamin D3 and gargling, 2) placebo and gargling, 3) vitamin D3 and no gargling, and 4) placebo and no gargling. Students completed weekly electronic surveys and submitted self-collected mid-turbinate nasal flocked swabs during September and October in 2010 or 2011. Symptomatic students also completed an electronic symptom diary. The primary and secondary outcomes were the occurrence of symptomatic clinical URTI and laboratory confirmed URTI respectively. RESULTS: Of 600 participants, 471 (78.5%) completed all surveys while 43 (7.2%) completed none; 150 (25.0%) reported clinical URTI. Seventy participants (23.3%) randomized to vitamin D3 reported clinical URTI compared to 80 (26.7%) randomized to placebo (RR:0.79, CI95:0.61-1.03, p = 0.09). Eighty-five participants (28.3%) randomized to gargling reported clinical URTI compared to 65 participants (21.7%) randomized to the no gargling arm (RR:1.3, CI95:0.92-1.57, p = 0.19). Laboratory testing identified 70 infections (46.7 per 100 URTIs). Vitamin D3 treatment was associated with a significantly lower risk for laboratory confirmed URTI (RR: 0.54, CI95:0.34-0.84, p = 0.007) and with a significantly lower mean viral load measured as log10 viral copies/mL (mean difference: -0.89, CI95: -1.7, -0.06, p = 0.04). Fewer students assigned to gargling experienced laboratory confirmed URTI, however this was not statistically significant (RR:0.82, CI95:0.53-1.26, p = 0.36). CONCLUSIONS: These results suggest that vitamin D3 is a promising intervention for the prevention of URTI. Vitamin D3 significantly reduced the risk of laboratory confirmed URTI and may reduce the risk of clinical infections. CLINICAL TRIALS REGISTRATION: NCT01158560.

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Crossref · 10.1186/1471-2334-14-273

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  • In a meta-analysis of gargling versus control based on two trials, the pooled estimate suggested little or no difference for clinical upper respiratory tract infection (RR 0.91, 95% CI 0.63 to 1.31; 830 participants).

    “In a meta‐analysis of gargling versus control based on two trials the pooled estimate of effect suggested little or no difference for the outcome of clinical URTI due to gargling (RR 0.91, 95% CI 0.63 to 1.31; 830 participants; Analysis 6.1)”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Goodall 2014

    The Results > Outcomes passage reports no statistically significant difference in clinical URTI for gargling versus control, supporting the claim's broad conclusion. This paper reports a single randomized trial, however, not a two-trial meta-analysis; it does not report the pooled RR of 0.91, 95% CI of 0.63–1.31, or 830 participants. (LLM, conf=0.87)

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  • Pooling the results of two trials that compared gargling with tap water versus control did not show a favourable effect in reducing upper respiratory tract infections (RR 0.91, 95% CI 0.63 to 1.31).

    “pooling the results of the two trials that compared gargling with tap water versus control did not show a favourable effect in reducing URTIs (RR 0.91, 95% CI 0.63 to 1.31) (Goodall 2014; Satomura 2005).”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Goodall 2014

    The Methods (Interventions) specify tap-water gargling, and the Results (Outcomes) report no significant reduction in clinical URTIs in this trial. Goodall 2014 does not report a pooled analysis of two trials or the cited RR of 0.91 (95% CI 0.63–1.31); its own clinical-URTI estimates differ. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Goodall 2014 found no difference in laboratory-confirmed upper respiratory tract infections between gargling (tap water) and no-gargling groups (RR 0.82, 95% CI 0.53 to 1.26; P=0.36).

    “Goodall 2014 found no difference in laboratory‐confirmed URTIs between the gargling (tap water) and no‐gargling groups (RR for gargling versus no gargling 0.82, 95% CI 0.53 to 1.26; P = 0.36).”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Goodall 2014

  • Goodall 2014 reported symptom severity was greater in the gargling group for clinical and laboratory-confirmed upper respiratory tract infection, but not statistically significant (225.3 vs 191.8, and 210.5 vs 191.8).

    “Goodall 2014 reported that symptom severity was greater in the gargling group for clinical and laboratory‐confirmed URTI, but this was not statistically significant (225.3 versus 191.8, and 210.5 versus 191.8, respectively).”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Goodall 2014

  • Three trials addressed the use of gargling in preventing respiratory infections.

    “Three trials addressed the use of gargling in preventing respiratory infections (Goodall 2014; Ide 2014; Satomura 2005).”

    From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Goodall 2014

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  1. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2334/14/273/prepub

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Authors
Goodall, E. C., Granados, A. C., Luinstra, K., Pullenayegum, E., Coleman, B. L., Loeb, M., & Smieja, M.
Affiliations
  • McMaster University (CA)
  • St. Joseph’s Healthcare Hamilton (CA)
  • Hospital for Sick Children (CA)
  • Mount Sinai Hospital (CA)
  • Population Health Research Institute (CA)
Corresponding author
Smieja, Marek
ORCID
Venue
BMC Infectious Diseases
Publisher
Springer Science and Business Media LLC
Published
2014-05-19
Volume
14
Issue
1
Pages
273-273
ISSN
1471-2334 (ISSN-L)
DOI
10.1186/1471-2334-14-273
PMC
PMC4041358
OpenAlex
W1963831504
Cited by
75
References
37
Citations by year
2026: 1 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 12 · 2020: 17 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 7 · 2015: 4 · 2014: 1
FWCI
3.46
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Infectious Diseases (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion)
Funders
Canadian Institutes of Health Research (86940_1)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
Keywords
vitamin D3 supplementation, gargling, upper respiratory tract infection, infection control, university students, viral load, nasal swabs, symptom diary, vitamin D deficiency, rhinovirus, influenza A virus, influenza B, respiratory syncytial virus, RSV-B
MeSH terms
Adolescent, Cholecalciferol, Female, Humans, Male, Respiratory Tract Infections, Risk, Students, Vitamins, Health Behavior, Dietary Supplements, Biomedical Research, Young Adult, Healthy Volunteers

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