The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans

S R Khan; M Claeson; A Khan; R E Neale

doi:10.1016/j.puhip.2024.100495

The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans

Public Health Pract (Oxf). 2024 Mar 30:7:100495. doi: 10.1016/j.puhip.2024.100495. eCollection 2024 Jun.

Authors

S R Khan¹, M Claeson^{2

3}, A Khan⁴, R E Neale^{3

5

6}

Affiliations

¹ Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia.
² Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.
³ Population Health Program, QIMR Berghofer Medical Research Institute, Herston, QLD, 4029, Australia.
⁴ School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
⁵ School of Public Health, The University of Queensland, Herston, QLD, 4029 Australia.
⁶ Sunshine Coast University Hospital, Birtinya, QLD, 4575, Australia.

Abstract

Objectives: Cross-sectional studies demonstrate a positive association between higher physical activity and serum 25-hydroxyvitamin D (25(OH)D) concentration. However, whether this association is causal is unclear. We conducted a systematic review to identify intervention studies that examined the effect of physical activity on serum 25(OH)D concentration in humans.

Study design: Systematic review and meta-analysis.

Methods: We searched PubMed, Scopus and Web of Science to identify full-text peer-reviewed articles published in English from inception until January 2023. Eligible studies were randomised controlled trials or quasi-experimental studies. We used random effects meta-analysis to calculate the weighted mean difference (WMD) in the change in 25(OH)D concentration between physical activity and control groups. We used the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) to assess the methodological quality of included studies.

Results: We included 32 articles in the systematic review and 24 in the meta-analysis. The intervention varied from resistance and weight-bearing exercises (n = 13) to aerobic exercises (n = 10), moderate and moderate-to-vigorous exercises (n = 5), aquatic exercise (n = 2), and multicomponent traditional exercises (n = 2) (Tai Chi and Yijinjing). The WMD in 25(OH)D in the physical activity and control groups was 9.51 and 4.87, respectively (between-group mean difference 4.64, p = 0.002). However, the difference was only evident in studies that implemented the intervention outdoors (n = 3; between-group mean difference 17.33, p < 0.0001); when the intervention was indoors there was no significant effect of physical activity on 25(OH)D (n = 16; between-group mean difference 1.80, p = 0.113).

Conclusions: This meta-analysis of physical activity interventions in humans showed that physical activity does not lead to increased 25(OH)D independently of time outdoors. However, most studies were under-powered, in many the exercise was low intensity, and vitamin D was not the primary outcome.

Keywords: 25(OH)D; Meta-analysis; Physical activity; Systematic review; Vitamin D.

Publication types

Review