Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3068, Australia.
School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia.
Eur J Nutr. 2023 Mar;62(2):951-964. doi: 10.1007/s00394-022-03038-z. Epub 2022 Nov 4.
PURPOSE: Vitamin D supplementation may have non-skeletal health benefits and enhance exercise responsiveness, particularly in those with low vitamin D levels. We determined whether, compared with placebo, vitamin D supplementation taken prior to and during a 12-week exercise program improves physical function, body composition or metabolic health, in overweight and obese older adults with vitamin D deficiency. METHODS: Fifty overweight or obese older adults (mean ± SD age: 60 ± 6 years; BMI 30.6 ± 5.7 kg/m) with vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] < 50 nmol/L) were recruited. Participants were randomly allocated to receive either vitamin D (4000 IU/day) or matching placebo for 24 weeks. Between weeks 12 and 24, all participants completed multi-modal exercise three days per week while continuing with vitamin D/placebo. Mean changes in physical function (primary outcome: gait speed), body composition and biochemical parameters at weeks 12 and 24 were compared between groups. RESULTS: Vitamin D supplementation, with or without exercise, had no effect on gait speed. From baseline to week 12, vitamin D supplementation increased serum 25(OH)D levels (placebo: 2.5 ± 14.7 nmol/L; treatment: 43.4 ± 18.4 nmol/L; P < 0.001) and reduced stair climb times (placebo: 0.3 ± 1.0 s; treatment: - 0.2 ± 1.0 s; P = 0.046). From 12 to 24 weeks, vitamin D supplementation combined with exercise decreased waist circumference (placebo: 1.3 ± 7.3 cm; treatment: - 3.0 ± 6.1 cm; P = 0.02) and waist-to-hip ratio (placebo: 0.01 ± 0.05; treatment: - 0.03 ± 0.05; P = 0.01) relative to placebo. Vitamin D supplementation, with or without exercise, had no effect on other physical function, body composition or metabolic health outcomes. CONCLUSION: Vitamin D supplementation had no effect on most physical function, body composition or metabolic health parameters when taken alone, or during exercise, in overweight or obese older adults with vitamin D deficiency. Vitamin D-related improvements in stair climb times and waist circumference suggest that future trials should explore the effects of vitamin D on muscle power, and its effects on body composition when combined with exercise, in populations with moderate or severe vitamin D deficiency.
目的：维生素 D 补充剂可能对骨骼以外的健康有益，并增强运动反应能力，尤其是在维生素 D 水平较低的人群中。我们旨在确定与安慰剂相比，在 12 周的运动计划之前和期间补充维生素 D 是否能改善超重和肥胖的维生素 D 缺乏老年人的身体机能、身体成分或代谢健康。
方法：招募了 50 名超重或肥胖的老年人（平均年龄 ± 标准差：60 ± 6 岁；BMI 30.6 ± 5.7 kg/m²），他们存在维生素 D 缺乏（25-羟维生素 D [25(OH)D] < 50 nmol/L）。参与者被随机分配接受维生素 D（4000 IU/天）或匹配的安慰剂治疗 24 周。在第 12 至 24 周期间，所有参与者在继续服用维生素 D/安慰剂的同时，每周进行三天多模式运动。比较两组在第 12 周和第 24 周时身体机能（主要结局：步态速度）、身体成分和生化参数的变化。
结果：无论是否进行运动，维生素 D 补充均对步态速度无影响。从基线到第 12 周，维生素 D 补充增加了血清 25(OH)D 水平（安慰剂：2.5 ± 14.7 nmol/L；治疗组：43.4 ± 18.4 nmol/L；P < 0.001），并减少了爬楼梯时间（安慰剂：0.3 ± 1.0 秒；治疗组：-0.2 ± 1.0 秒；P = 0.046）。从第 12 周到第 24 周，维生素 D 补充联合运动降低了腰围（安慰剂：1.3 ± 7.3 cm；治疗组：-3.0 ± 6.1 cm；P = 0.02）和腰臀比（安慰剂：0.01 ± 0.05；治疗组：-0.03 ± 0.05；P = 0.01），与安慰剂相比。无论是否进行运动，维生素 D 补充对大多数身体机能、身体成分或代谢健康参数均无影响。
结论：在超重或肥胖的维生素 D 缺乏老年人中，单独服用或在运动期间补充维生素 D 对大多数身体机能、身体成分或代谢健康参数均无影响。与维生素 D 相关的爬楼梯时间和腰围改善表明，未来的试验应探讨维生素 D 对肌肉力量的影响，以及在中重度维生素 D 缺乏人群中与运动结合使用时对身体成分的影响。
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