Vitamin D
has limited benefits in asthma treatment
Washington:
A study has revealed that adding vitamin D to asthma treatment to improve
breathing only appears to benefit patients who achieve sufficient levels of the
supplement in the blood.
According
to new research at Washington University School of Medicine in St. Louis,
overall, the ability to control asthma did not differ between a study group
that received vitamin D supplements and a group that received placebo.
In
the study, all patients took an inhaled steroid daily to control their asthma,
and all had rescue inhalers in the event of an asthma attack.
The
patients were randomly assigned to one of two groups. The treatment group
received a loading dose of 100,000 international units of vitamin D3 followed
by daily doses of 4,000 units, and the placebo group received identical looking
but inactive capsules.
The
investigators found no differences between the two groups in all major measures
of asthma control. The groups showed no significant differences in the number
of treatment failures requiring patients to take more medication, no difference
in the number of asthma attacks and no difference in their need for emergency
care. Patients taking vitamin D did not report improved quality of life, based
on questionnaires.
One
way the groups differed, however, was in how successfully they were able to
reduce their daily dosages of inhaled steroids. After the first 12 weeks of the
study, if the patient's asthma was well-controlled, the investigators cut in
half the daily dose of inhaled steroid, reducing it from 320 micrograms per day
to 160. Then, after eight more weeks, if the disease remained controlled, they
cut the dose in half again. While both groups were able to taper off their
doses of inhaled steroid, the vitamin D group was able to reduce its medication
more.
By
the end of the 28-week study, the vitamin D group was taking an average of 111
micrograms per day, and the placebo group was taking an average of 126.
Compared
with placebo, the patients in the treatment group that achieved vitamin D
sufficiency in the blood (with an average of 42 nanograms of vitamin D per
milliliter) did show improved asthma control. They had 40 percent fewer
treatment failures that required more medication and half the number of asthma
attacks.
The
study has been published online in JAMA.
19.05.2014
Vitamin C supplements may improve
lung function in newborns of smoking women
Washington:
Researchers have suggested that supplemental vitamin C taken by pregnant
smokers improved measures of lung function for newborns and decreased the
incidence of wheezing for infants through 1 year.
Cindy
T. McEvoy, M.D., M.C.R., of Oregon Health and Science University, Portland, and
colleagues randomly assigned pregnant smokers to receive vitamin C (500 mg/d)
(n = 89) or placebo (n = 90).
One
hundred fifty-nine newborns of pregnant smokers (76 vitamin C treated and 83
placebo treated) and 76 newborns (reference group) of pregnant nonsmokers were
studied with newborn PFTs (performed within 72 hours of age).
The
researchers found that newborns of women randomized to vitamin C, compared with
those randomized to placebo, had improved measures of pulmonary function.
Offspring
of women randomized to vitamin C had significantly decreased wheezing through
age 1 year (15/70 [21 percent] vs 31/77 [40 percent]. There were no significant
differences in the 1-year PFT results between the vitamin C and placebo groups.
"Although
smoking cessation is the foremost goal, most pregnant smokers continue to
smoke, supporting the need for a pharmacologic intervention," the authors
write. Other studies have demonstrated that reduced pulmonary function in
offspring of smokers continues into childhood and up to age 21 years.
"This emphasizes the important opportunity of in-utero
intervention.Individuals who begin life with decreased PFT measures may be at
increased risk for chronic obstructive pulmonary disease."
"
Vitamin C supplementation in pregnant smokers may be an inexpensive and simple
approach (with continued smoking cessation counseling) to decrease some of the
effects of smoking in pregnancy on newborn pulmonary function and ultimately
infant respiratory morbidities, but further study is required," the
researchers conclude.
The
study has been published in JAMA.
19.05.2014
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