Diverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT Aug 2020

Effect of monthly vitamin D on diverticular disease hospitalization: post-hoc analysis of a randomized controlled trial

Clinical Nutrition https://doi.org/10.1016/j.clnu.2020.08.030
Zhenqiang Wu ab JoannaBroadbJohnSluyteraDebbieWaayera Carlos A.Camargo Jr.c Robert Scragg a

Background & aims
Some studies have linked low vitamin D status and high risk of diverticular disease, but the causal relationship between vitamin D and diverticular disease remains unclear; clinical trial data are warranted. The objective was to assess the efficacy of vitamin D3 supplementation on diverticular disease hospitalization.

Methods
Post-hoc analysis of a community-based randomized double-blind placebo-controlled trial (RCT) with 5108 participants randomized to receive monthly 100,000 IU vitamin D (n=2558) or identical placebo (n=2550). The outcome was time to first diverticular disease hospitalization from randomization to the end of intervention (July 2015), including a prespecified subgroup analysis in participants with baseline deseasonalized 25-hydroxyvitamin D (25(OH)D) levels <50 nmol/L.

Results
Over a median of 3.3 years follow-up, 74 participants had diverticular disease hospitalization. There was no difference in the risk of diverticular disease hospitalization between vitamin D supplementation (35/2558=1.4%) and placebo (39/2550=1.5%) groups (adjusted hazard ratio [HR]=0.90; p=0.65), although in participants with deseasonalized 25(OH)D <50 nmol/L (n=1272), the risk was significantly lower in the vitamin D group than placebo (HR=0.08, p=0.02).

Discussion
Monthly 100,000 IU vitamin D3 does not reduce the risk of diverticular disease hospitalization in the general population. Further RCTs are required to investigate the effect of vitamin D supplementation on the diverticular disease in participants with low 25(OH)D levels.

See also web

• Higher Serum Levels of Vitamin D Are Associated With a Reduced Risk of Diverticulitis - Dec 2013
  •  Download the PDF from Vitamin D Life
• Paradigm shift: the Copernican revolution in diverticular disease - Nov 2019
  •  Download the PDF from Vitamin D Life
  • Note: two of the risk factors (Smoking, obesity) are strongly associated with low vitamin D
    • Alcohol may also be associated with low vitamin D
  • 

RCT with 100,000 IU monthly

• Across all 2550 patients - not statistically significant
• For those 1272 who have Vitamin D levels 20ng - 12X improvement

Results would probably have been even better if used a gut-friendly form of Vitamin D

Overview Gut and vitamin D contains gut-friendly information

Gut category listing contains the following

• "Ulcerative Colitis" OR UC 839 items Jan 2020
• "celiac disease" OR CD 1830 items July 2019
• "inflammatory bowel disease" OR "inflammatory bowel symptom" 1630 items as of Jan 2020
• Crohn's 1230 items as of Feb 2019
• Gut-Friendly forms of vitamin D
  such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .

Overview Gut and vitamin D has the following summary

• Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
• Celiac disease has a strong genetic component.
  • Most, but not all, people with celiac disease have a gene variant.
  • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
  • Celiac disease causes poor absorption of nutrients such as vitamin D.
  • Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
  • The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
• Review in Nov 2013 found that Vitamin D helped
  Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
• All items in category gut and vitamin D 169 items