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Health News Archive 269 - Congestive Heart Failure
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Vitamin D Supplements Show Anti-inflammatory Benefit for Congestive Heart Failure

High-dose vitamin D supplements inhibit pro-inflammatory and boost anti-inflammatory molecules and could help people with heart failure, says a German clinical trial.

“We showed for the first time that a daily supplement of 2000 IU vitamin D for nine months is able to increase serum concentrations of the anti-inflammatory cytokine IL-10 and to prevent an increase in serum concentrations of the pro-inflammatory cytokine TNF-alpha in CHF patients,” wrote lead author Stefanie Schleithoff from the University of Bonn, Germany.

The cause of CHF is not understood, but recent theories involve increased levels of pro-inflammatory cytokines, such as tumor necrosis factor alpha (TNF-alpha).

The randomized placebo-controlled trial, published in the April 2006 issue of the American Journal of Clinical Nutrition, followed the effects of a high-dose vitamin D3 supplement (50 micrograms, equivalent to 2000 International Units) on cytokine levels and heart pumping ability of 123 patients with CHF. Both placebo and vitamin D supplement groups were also given 500 milligrams of calcium daily.

After nine months the researchers reported that serum levels of 25-hydroxyvitamin D, the non-active ‘storage' form of the vitamin in the body, increased by 26.8 nanograms per millilitre (ng/mL) from the start of the study for the supplemented group, while the placebo group's levels decreased by 3.6 ng/mL.

Levels of TNF-alpha increased by 12 percent in the placebo group, but held steady after supplementation with vitamin D. Interleukin 10 (IL-10) levels increased by an impressive 43 per cent in the supplemented group, but did not change in the placebo group.

No significant difference was observed in heart function, as measured by left ventricular ejection fraction (LVEF), for either of the groups; a result that differs from a previous study with lower vitamin D doses (400 IU) that reported improvements in LVEF, but no improvement in cytokine levels.

An accompanying editorial by Reinhold Vieth and Samantha Kimball from the University of Toronto, said that the study offered two important insights: “First, the article confirms previous evidence that vitamin D supplementation affects immune-modulating cytokines in desirable ways. Second, it points to a higher dose requirement for achieving this.”

Vitamin D has been reported to improve muscular function, control blood pressure, and improve glucose tolerance, all of which underlying causes of CHF, said Vieth and Kimball.

“The more realistic question raised by researcher Schleithoff is whether the use of an appropriate dose of vitamin D, as one part of a nutritional strategy, could help in the primary prevention of CHF,” concluded the editorial.

The results of this clinical trial appear to be in line with a study published in the Journal of the American College of Cardiology (2003, Vol. 41, pp. 105-112) which reported that heart disease was linked to vitamin D deficiency.

Source: American Journal of Clinical Nutrition 2006 April (Vol. 83, pp. 754-759)

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