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Multivitamins: One Size Does Not Fit All

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Vitamin D & CRP

iStock-1465591757A systematic review and meta-analysis recently published in the Journal of the Academy of Nutrition and Dietetics examined the effects of vitamin D supplementation in post-menopausal women on both blood pressure and C-reactive protein, a marker of systemic inflammation and cardiovascular disease risk. This analysis included 7 randomized and controlled trials, directly comparing the effects of vitamin D against controls, with 6 arms each for systolic blood pressure, diastolic blood pressure, and C-reactive protein (CRP).

Although no effect on blood pressure was shown in these trials, a significant reduction in CRP (mean difference (MD) of -0.65 mg/L) was observed with vitamin D supplementation, including an MD of -0.91 mg/L in studies with a duration of 3 months or more, and an MD of -2.10 mg/L with doses of 1000 IU per day or less. This significant reduction in CRP is notable, in part because it is an apparent benefit of supplementation; potentially a more clinically relevant finding than the association between lower serum levels of CRP and a higher serum 25-OH vitamin D previously observed in several studies.

This is in line with many previous observational studies, such as a cross-sectional study that found that low 25-OH levels were associated with a nearly 3-fold increase in risk for cardiovascular events, magnified to nearly 5-fold when found in combination with elevated CRP levels. It is also consistent with several previously published meta-analyses of vitamin D supplementation, including a meta-analysis of 8 randomized trials that found vitamin D supplementation reduced CRP and improved glycemic control among participants with cardiovascular disease, and a meta-analysis of 33 trials that found vitamin D supplementation reduced CRP and malondialdehyde, and also improved multiple markers of antioxidant status (e.g., glutathione) among patients with diabetes.

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