Raadpleeg ook literatuurlijsten niet-toxische middelen en behandelingen als preventie van arts-bioloog drs. engelbert Valstar.

21 november 2020: JAMA online 18 november 2020

Vitamine D-suppletie geeft een vermindering van het ontstaan van gevorderde uitgezaaide vormen van kanker. De sterkste afname werd waargenomen bij mensen met een normaal gewicht, volgens een studie die online is gepubliceerd op 18 november online bij JAMA Network Open.

Paulette D. Chandler, MD, MPH, van de Harvard Medical School in Boston, en collega's hebben een follow-up uitgevoerd naar de mogelijke vermindering van het aantal sterfgevallen door kanker die werd gezien in de vitamine D- en omega-3-studie (zie dit artikel) om te onderzoeken of vitamine D de incidentie van gevorderde kanker verminderde en mogelijke beïnvloeding door een body mass index (BMI). De primaire uitkomst voor deze analyse was een samengestelde incidentie van uitgezaaide en fatale invasieve vormen van kanker.

De onderzoekers ontdekten dat deelnemers die willekeurig werden toegewezen aan of vitamine D of een placebo een statistisch significante vermindering van gevorderde vormen van kanker hadden bij de dianose (uitgezaaid of fataal); 1,7 procent van de 12.927 patiënten uit de vitamine D groep hadden een uitgezaaide vorm van kanker of overlden aan hun kanker, versus 2,1 procent van de 12.944 patiënten uit de placebogroep; hazard ratio, 0,83) .

Bij stratificatie op basis van het BMI werd de afname van incidentele uitgezaaide of fatale kanker gezien voor de vitamine D groep onder degenen met een normale BMI (BMI <25 kg / m2: hazard ratio, 0,62), maar niet statistisch significant bij degenen met overgewicht of obesitas.

Uit het studierapport: 

Findings  In this secondary analysis of a randomized clinical trial with 25 871 patients, supplementation with vitamin D3 reduced the incidence of advanced (metastatic or fatal) cancer in the overall cohort, with strongest risk reduction in individuals with normal weight and no reduction among individuals with overweight or obesity.

Het studierapport is gratis in te zien in JAMA online, hier het abstract van de studie: 

November 18, 2020

Effect of Vitamin D3 Supplements on Development of Advanced CancerA Secondary Analysis of the VITAL Randomized Clinical Trial

Paulette D. Chandler, MD, MPH1; Wendy Y. Chen, MD, MPH2,3; Oluremi N. Ajala, MD, MPH1; et alAditi Hazra, PhD, MPH1; Nancy Cook, ScD1; Vadim Bubes, PhD1; I-Min Lee, MBBS, ScD1; Edward L. Giovannucci, MD, ScD3,4,5; Walter Willett, MD, DrPH3,4,5; Julie E. Buring, ScD1,5; JoAnn E. Manson, MD, DrPH1,3,5; for the VITAL Research Group
Author Affiliations Article Information
JAMA Netw Open. 2020;3(11):e2025850. doi:10.1001/jamanetworkopen.2020.25850

Key Points

Question  Does vitamin D3 supplementation reduce the risk of developing advanced (metastatic or fatal) cancer among adults without a diagnosis of cancer at baseline?

Findings  In this secondary analysis of a randomized clinical trial with 25 871 patients, supplementation with vitamin D3 reduced the incidence of advanced (metastatic or fatal) cancer in the overall cohort, with strongest risk reduction in individuals with normal weight and no reduction among individuals with overweight or obesity.

Meaning  These findings suggest that vitamin D3 may reduce the risk of developing advanced cancer among adults without a diagnosis of cancer at baseline; this protective effect is apparent for those who have normal but not elevated body mass index.

Abstract

Importance  Epidemiologic and trial data suggest that vitamin D supplementation may reduce metastatic cancer and cancer mortality, reflecting shared biological pathways.

Objective  To follow up on the possible reduction in cancer death in the Vitamin D and Omega-3 Trial (VITAL) with an evaluation of whether vitamin D reduces the incidence of advanced (metastatic or fatal) cancer and an examination possible effect modification by body mass index.

Design, Setting, and Participants  VITAL is a randomized, double-blind, placebo-controlled, 2 × 2 factorial clinical trial of vitamin D3 (cholecalciferol, 2000 IU/d) and marine omega-3 fatty acids (1 g/d). This multicenter clinical trial was conducted in the United States; participants included men aged 50 years or older and women aged 55 years or older who were free of cancer and cardiovascular disease at baseline. Randomization took place from November 2011 through March 2014, and study medication ended on December 31, 2017. Data for this secondary analysis were analyzed from November 1, 2011, to December 31, 2017.

Interventions  Vitamin D3 (cholecalciferol, 2000 IU/d) and marine omega-3 fatty acids (1 g/d) supplements.

Main Outcomes and Measures  For the present analysis, the primary outcome was a composite incidence of metastatic and fatal invasive total cancer, because the main VITAL study showed a possible reduction in fatal cancer with vitamin D supplementation and effect modification by body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) for total cancer incidence reduction for individuals with normal BMI, but not for individuals with overweight or obesity. Secondary analyses included examination of BMI (<25, 25 to < 30, and ≥30) as effect modifiers of the observed associations.

Results  Among 25 871 randomized VITAL participants (51% female; mean age, 67.1 [7.1] years), 1617 were diagnosed with invasive cancer over a median intervention period of 5.3 years (range, 3.8-6.1 years). As previously reported, no significant differences for cancer incidence by treatment arm were observed. However, a significant reduction in advanced cancers (metastatic or fatal) was found for those randomized to vitamin D compared with placebo (226 of 12 927 assigned to vitamin D [1.7%] and 274 of 12 944 assigned to placebo [2.1%]; HR, 0.83 [95% CI, 0.69-0.99]; P = .04). When stratified by BMI, there was a significant reduction for the vitamin D arm in incident metastatic or fatal cancer among those with normal BMI (BMI<25: HR, 0.62 [95% CI, 0.45-0.86]) but not among those with overweight or obesity (BMI 25-<30: HR, 0.89 [95% CI, 0.68-1.17]; BMI≥30: HR, 1.05 [95% CI, 0.74-1.49]) (P = .03 for interaction by BMI).

Conclusions and Relevance  In this randomized clinical trial, supplementation with vitamin D reduced the incidence of advanced (metastatic or fatal) cancer in the overall cohort, with the strongest risk reduction seen in individuals with normal weight.

Trial Registration  ClinicalTrials.gov Identifier: NCT01169259

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preventie, vitamin D3 (cholecalciferol, 2000 IU/d), visolie, uitgezaaide vormen van kanker, obese, BMI, JAMA, placebo gecontroleerde studie


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