Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Open accessAbstract
BACKGROUND: Low levels of 25-OH vitamin D are associated with respiratory tract infection (RTI). However, results from randomized controlled trials are inconclusive. Therefore, we performed a systematic review and meta-analysis to assess the preventive effect of vitamin D supplementation on RTI. METHODS: Randomized, controlled trials of vitamin D for prevention of RTI were used for the analysis. The risks of within-trial and publication bias were assessed. Odds ratios of RTI were pooled using a random-effects model. Heterogeneity was assessed using Cochran's Q and I(2). Meta-regressions and subgroup analyses were used to assess the influence of various factors on trial outcome. The pre-defined review protocol was registered at the PROSPERO international prospective register of systematic reviews, registration number CRD42013003530. FINDINGS: Of 1137 citations retrieved, 11 placebo-controlled studies of 5660 patients were included in the meta-analysis. Overall, vitamin D showed a protective effect against RTI (OR, 0.64; 95% CI, 0.49 to 0.84). There was significant heterogeneity among studies (Cohran's Q p<0.0001, I(2) = 72%). The protective effect was larger in studies using once-daily dosing compared to bolus doses (OR = 0.51 vs OR = 0.86, p = 0.01). There was some evidence that results may have been influenced by publication bias. INTERPRETATION: Results indicate that vitamin D has a protective effect against RTI, and dosing once-daily seems most effective. Due to heterogeneity of included studies and possible publication bias in the field, these results should be interpreted with caution.
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Supplementation with vitamin D can protect against respiratory tract infections and reduce the risk of acute respiratory illness and influenza, especially with once-daily dosing.
“Supplementation with vitamin D can protect against respiratory tract infections and reduce the risk of acute respiratory illness and influenza, especially with once-daily dosing [112,113,114,115].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [114]
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- Authors
- Bergman, P., Lindh, Å. U., Björkhem-Bergman, L., & Lindh, J. D.
- Affiliations
- Karolinska Institutet (SE)
- Saint Göran Hospital (SE)
- Corresponding author
- Lindh, Jonatan D.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-06-19
- Volume
- 8
- Issue
- 6
- Pages
- e65835
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3686844
- OpenAlex
- W2088966225
- Cited by
- 429
- References
- 45
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 21 · 2023: 30 · 2022: 48 · 2021: 63 · 2020: 82 · 2019: 18 · 2018: 25 · 2017: 27 · 2016: 31 · 2015: 32 · 2014: 23 · 2013: 7
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Karolinska Institutet
- Stockholms Läns Landsting
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- vitamin D supplementation, respiratory infections, infection control, 25-hydroxyvitamin D, once-daily dosing, bolus dosing, publication bias, trial heterogeneity
- MeSH terms
- Female, Humans, Male, Prospective Studies, Respiratory Tract Infections, Vitamin D, Odds Ratio, Randomized Controlled Trials as Topic, Treatment Outcome, Dietary Supplements
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