Efficacy of intermittent versus daily vitamin D supplementation on improving circulating 25(OH)D concentration: a Bayesian network meta-analysis of randomized controlled trials

Yan Zhuang; Zhe Zhu; Peihan Chi; Haibo Zhou; Zhicheng Peng; Haoyue Cheng; Xing Xin; Wenliang Luo; Shuting Si; Minjia Mo; Danqing Chen; Hui Liu; Yunxian Yu

doi:10.3389/fnut.2023.1168115

Efficacy of intermittent versus daily vitamin D supplementation on improving circulating 25(OH)D concentration: a Bayesian network meta-analysis of randomized controlled trials

Front Nutr. 2023 Aug 24:10:1168115. doi: 10.3389/fnut.2023.1168115. eCollection 2023.

Authors

Yan Zhuang^{1

2}, Zhe Zhu³, Peihan Chi^{1

2}, Haibo Zhou^{1

2}, Zhicheng Peng^{1

2}, Haoyue Cheng^{1

2}, Xing Xin^{1

2}, Wenliang Luo^{1

2}, Shuting Si^{1

2}, Minjia Mo^{1

2}, Danqing Chen⁴, Hui Liu⁵, Yunxian Yu^{1

2}

Affiliations

¹ Department of Public Health, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
² Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
³ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁴ Department of Obstetrics and Gynecology, Woman's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
⁵ Central Lab, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Abstract

Background: Vitamin D deficiency is a widespread issue globally, resulting in increased use of vitamin D supplements. However, it is unclear whether intermittent (weekly or monthly) vitamin D supplementation is as effective as daily supplementation in improving circulating 25-hydroxyvitamin D [25(OH)D] levels.

Methods: Three databases including Medline, EMBASE, and the Cochrane Library were systematically searched up to 10 November 2020. The risk of bias was evaluated according to Cochrane Collaboration's tool for rating methodological quality assessment. Direct and indirect comparisons between interventions and controls were performed by a Bayesian network meta-analysis (NMA), where the mean difference (MD) and its 95% confidence interval (CI) were used to indicate the efficacy.

Results: This NMA analysis included 116 RCTs with a total of 11,376 participants. Generally, we observed that 25(OH)D concentrations were significantly elevated regardless of vitamin D supplementation frequency. Although the findings of SUCRA indicated that daily vitamin D supplementation had a higher rank value than intermittent supplementation when the supplement dosage was similar, no statistically significant pooled mean differences of 25(OH)D concentration were noted between the daily supplementation group and intermittent supplementation group. Additionally, weekly supplementation with a total of 600,000 IU vitamin D supplementation during 3 months had the best efficacy in elevating 25(OH)D concentration (pooled MD = 63 nmol/L, 95%CI: 49-77). To achieve optimal 25(OH)D concentration (>75 nmol/L), we recommend 60,000 IU vitamin D supplementation monthly (~2,000 IU/day).

Conclusion: The efficacy of intermittent vitamin D supplementation was similar to daily supplementation. Coupled with its convenience, the frequency and dosage of intermittent vitamin D supplements were recommended to reach the optimal 25(OH)D level.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257257, PROSPERO CRD42021257257.

Keywords: 25(OH)D concentration; daily supplementation; intermittent supplementation; network meta-analysis; vitamin D.

Publication types

Review