Autoimmune diseases (ADs) such as rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease and psoriasis, are a major cause of morbidity and mortality as people age. Few effective treatments are available for AD, but some preclinical studies have indicated that supplements, including vitamin D and omega-3 (or n-3) fatty acids, may have beneficial effects. In a new study published in bmj, Investigators at Brigham and Women’s Hospital evaluated whether taking vitamin D and/or omega fatty acid supplements might affect rates of AD. The team tested this extensively in the Vitamin D and Omega-3 Trial (VITAL), a randomized study in which participants were followed for about five years. The investigators found that those who took vitamin D, or vitamin D and omega-3 fatty acids, had significantly lower rates of AD than those who took a placebo.
“It is exciting to have these new and positive results for nonsteroidal vitamins and supplements that prevent potentially highly morbid diseases,” said senior author Karen Costenbader, MD, MPH, of the Brigham Division of Rheumatology, Inflammation and Immunity. “This is the first direct evidence we have that daily supplementation can reduce the incidence of AD, and the more pronounced effect appears to be two years after vitamin D supplementation. We look forward to honoring and expanding our findings and to professionals and professionals.” encourage societies to consider these results and emerging data when developing future guidelines for the prevention of autoimmune diseases in midlife and older adults.”
Now, when my patients, colleagues, or friends ask me what vitamins or supplements I would recommend to take to reduce the risk of autoimmune disease, I have more questions for women 55 years of age and older and women 50 years and older. There are new evidence-based recommendations for older men. I recommend vitamin D – 2000 IU a day and marine omega-3 fatty acids (fish oil), 1000 mg a day; The dosage used in Vital.”
Karen Costenbader, study senior author, MD, MPH, Brigham Division of Rheumatology, Inflammation and Immunity
VITAL is a randomized, double-blind, placebo-controlled research study of 25,871 men (50 years of age and older) and women (55 years of age and older) across the US, conducted to investigate whether vitamin D 3 (2000 IU) daily dietary supplement. or omega-3 fatty acids (Omacor® fish oil, 1 g) may reduce the risk of cancer, heart disease, and stroke in people who do not have a prior history of these diseases. Participants were randomized to receive vitamin D along with an omega-3 fatty acid supplement; Vitamin D with a placebo; omega-3 fatty acids with a placebo; Or only placebo. Prior to the launch of VITAL, the investigators determined that they would also look at rates of AD among participants as part of an adjunctive study.
“Given the benefits of vitamin D and omega-3s for reducing inflammation, we were particularly interested in whether they might protect against autoimmune diseases,” says Joanne Manson, MD, DRPH, co-author said the author and director of critical testing of parents at Brigham. ,
Participants answered questionnaires about newly diagnosed diseases, including rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis and inflammatory bowel disease, with space to write in all other new-onset AD. Trained physicians reviewed the patients’ medical records to confirm the reported diagnosis.
“Autoimmune diseases are common in older adults and negatively affect health and life expectancy. Until now, we have no proven way to prevent them, and now, for the first time, we do,” said first author, Jill. Hahn, ScD, a post-doctoral fellow at Brigham. “It will be exciting if we can proceed to verify similar preventive effects in younger individuals.”
Of the patients who were randomized to receive vitamin D, 123 participants in the treatment group and 155 in the placebo group were diagnosed with confirmed AD (a 22 percent reduction). Among those in the fatty acid arm, confirmed AD occurred in 130 participants in the treatment group and 148 in the placebo group. The incidence of AD was not significantly reduced with omega-3 fatty acids alone, but the study found evidence of an increased effect after a longer period of supplementation.
The VITAL study included a large and diverse sample of participants, but all participants were older and results may not generalize to younger individuals who experience AD earlier in life. The trial tested only one dosage and one formulation of each supplement. The researchers note that longer follow-up may be more informative for assessing whether the effects are long-lasting.
Brigham and Women’s Hospital
Hahn J., and others, (2022) Vitamin D and murine n-3 fatty acid supplementation and incidence of autoimmune disease in the vital randomized controlled trial. BMJ. doi.org/10.1136/bmj-2021-066452