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服用维生素D补充剂会更长寿吗?【系列2】

本视频由Michael Greger医生于 2016 年 7 月 1 日发布,来自NutritionFacts.org — 能救命的营养学。


   如何从各种相互矛盾的有关营养与疾病的信息中找到靠谱的信息?(点击了解)

 

Michael Greger 医生是畅销书《How Not to Die》一书作者,中文译本:繁体版书名为《食疗圣经》。简体版书名为《救命》,将于今年5月底出版。




还没有看过维生素D【系列1】视频的朋友,请先补充看一下:

维生素D补充剂对糖尿病、减肥和血压有帮助吗?【系列1】




服用维生素D补充剂会更长寿吗?【系列2】

Will You Live Longer If You Take Vitamin D Supplements?






摘要56个随机临床试验涉及年龄在18107岁之间, 近10万人的研究结果显示维生素D对寿命有何影响呢?

What do 56 randomized clinical trials involving nearly 100,000 people between the ages of 18 and 107 show vitamin D can do to our lifespan?



1822年,波兰医生是首位发布阳光照射可以治愈的维生素D缺乏症:佝偻病。

In 1822, a Polish physician was the first to publish that sunlight could cure the vitamin D deficiency disease rickets.

 

他的研究成果被主流医学忽视了一个世纪,没有被广泛使用,直到20世纪,当时紧贴楼房的钢丝笼才能使婴儿能够受益于太阳。

His work was ignored by mainstream medicine for a century, not coming into widespread use until the 20th century, when wire cages were affixed to tenement buildings so babies could benefit from the sun.

 


我们现在是否也是有类似的情况呢?就是说专业医务人员未能赶上科学的进步。

Are we in a similar situation now, where the medical profession has just not caught up with the science?

 

研究人员已经记录了各种好东西与较高维生素D水平之间的相关性 甚至到了看维生素D补充剂是否可减少地震的不利影响的地步。维生素D似乎有助于一切,为什么不呢? 实际上并不像听起来那么愚蠢。 像自然灾害这样的创伤性事件会对心理产生重大影响,这可能会受到维生素D状况的影响。

Researchers have documented correlations between all sorts of good things and higher vitamin D levels — even to the point of seeing whether vitamin D supplementation might reduce the adverse effects of earthquakes. Seems to help with everything else, so why not? It’s actually not as silly as it sounds. Traumatic events like natural disasters can have a significant psychological impact, which may be affected by vitamin D status.

 

但是当研究人员对补充剂进行测试时,声称的相关性通常不会出现。

But when researchers put supplements to the test, the purported links often didn’t pan out.

 

这种“”的缺乏可能存在,部分原因是维生素D水平低可能只是年老、肥胖、吸烟和缺乏运动等因素的标志。(译注:此处的“果”指的是 cause and effect 中的 effect即:因果关系中的“果”,“相关性”并不能证明有“因果关系”。下同。)

This lack of effect may exist, in part, because low vitamin D levels may just be a marker for things like aging, obesity, smoking, and inactivity.

 

或者低维生素D没有导致疾病,而也许是疾病导致低维生素D。炎症可以降低体内D水平。 所以,仅仅因为低D水平和疾病似乎相关并不意味着维生素D缺乏是“”。(译注:此处的“因”亦指 cause and effect,即:因果关系中的“因”。)

Or maybe low vitamin D didn’t lead to disease, but maybe disease led to low vitamin D. Inflammation can drop D levels within the body. So, just because low D levels and disease seem to be correlated doesn’t mean that vitamin D deficiency is the cause.



尽管大多数观察性研究可能会显示出相关性,这些研究只需测量维生素D水平和疾病发病率,但在少数情况下,有介入研究证明维生素D是有效的 — 这样的研究可以给予人D补充剂或安慰剂, 来看看会发生什么。 但维生素D补充剂似乎真正起作用的其中一个情况是帮助延长寿命。

While the majority of observational studies may show a link, where you just measure vitamin D levels and disease rates, in only a handful of conditions have interventional studies proven vitamin D to be effective — where you give people D supplements or placebos, and see what happens. But one of those conditions for which vitamin D supplements appear to genuinely work is helping to prevent mortality.

 

56项随机临床试验涉及近10万名年龄介于18107岁之间的人,其中大部分是女性,随机分配到四年的维生素D补充剂或安慰剂的研究。 把所有的研究放在一起,那些给予维生素D补充剂的寿命更长,也特别降低了死于癌症的风险。 请注意,这种“”似乎仅限于维生素D3,不过,这种D3类型来源于植物和动物 不是来自酵母和蘑菇的维生素D2

56 randomized clinical trials, involving nearly 100,000 people between the ages of 18 and 107, mostly women, randomized to four years of vitamin D supplements or sugar pills. Put all the studies together, and those given vitamin D supplements lived longer, also specifically lowering the risk of dying from cancer. Note this effect appeared limited to vitamin D3, though, the type derived from plants and animals — not vitamin D2, the type derived from yeast and mushrooms.

 


这一“”有多大呢?需要150人服用维生素D补充剂五年才能挽救一个生命,所以如果我们在谈论一种药物,那么就必须权衡给这么多人施药的成本和副作用。但是当我们谈论像维生素D补充品一样安全和便宜的东西时,这对我来说似乎是很划算的。

How large an effect was it? It would take 150 people taking vitamin D supplements for five years to save one life, and so if we were talking about a drug, you’d have to weigh that against the cost and side effects of dosing so many people. But when we’re talking about something as safe and cheap as vitamin D supplements, it seems like a bargain to me.

 

一个类似的分析认为,在降低总死亡率方面,益处为11 这是相当可观的,可能提供与运动相当的寿命延长益处。虽然没有,但似乎并没有减少地震的不利影响。

A similar analysis pegged the benefit at 11% in terms of reduction of total mortality — which is pretty substantial, potentially offering a life extension benefit on par with exercise. Though no, it does not seem to reduce the adverse effects of earthquakes.


 

唯一的担心是,人们可能会认为获得了许可,例如购买过多的甜甜圈或其他东西。我们仍然必须吃得健康 任何维生素D的长寿益处都只是健康生活方式的一小部分。

The only concern that was raised is that it may give people license to, like, order an extra doughnut or something. We still have to eat healthy — any longevity benefit from vitamin D would just be a small adjunct to a healthy lifestyle.

 

但对于我们这些想要得到所有帮助的人来说,问题就演变为“可以服用”,我们应该服用多少维生素D呢?请听我下回分解。

But for those of us who want all the help they can get, the question then becomes okay, how much should we take? The question I’ll address next.


(翻译及字幕制作:老玉米 Karen Chou)


参考文献:

  1. S Slow, C M Florkowski, S T Chambers, P C Priest, A W Stewart, L C Jennings, J H Livesey, C A Camargo Jr, R Scragg, D R Murdoch. Effect of monthly vitamin D3 supplementation in healthy adults on adverse effects of earthquakes: randomised controlled trial. BMJ. 2014 Dec 15;349:g7260.

  2. J P Ekwaru, J D Zwicker, M F Holick, E Giovannucci, P J Veugelers. The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. PLoS One. 2014 Nov 5;9(11):e111265.

  3. G Bjelakovic, L L Gluud, D Nikolova, K Whitfield, J Wetterslev, R G Simonetti, M Bjelakovic, C Gluud. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2014 Jan 10;1:CD007470.

  4. P Welsh, N Sattar. Vitamin D and chronic disease prevention. BMJ. 2014 Apr 1;348:g2280.

  5. E Theodoratou, I TzoulakI, L Zgaga, J P Ioannidis. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014 Apr 1;348:g2035.

  6. J C Seida, J Mitri, I N Colmers, S R Majumdar, M B Davidson, A L Edwards, D A Hanley, A G Pittas, L Tjosvold, J A Johnson. Clinical review: Effect of vitamin D3 supplementation on improving glucose homeostasis and preventing diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014 Oct;99(10):3551-60.

  7. L A Beveridge, A D Struthers, F Khan, R Jorde, R Scragg, H M Macdonald, J A Alvarez, R S Boxer, A Dalbeni, A D Gepner, N M Isbel, T Larsen, J Nagpal, W G Petchey, H Stricker, F Strobel, V S Tangpricha, L Toxqui, M P Vaquero, L Wamberg, A Zittermann, M D Witham; D-PRESSURE Collaboration. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data. JAMA Intern Med. 2015 May;175(5):745-54.

  8. J Wierzbicka, A Piotrowska, M A Żmijewski. The renaissance of vitamin D. Acta Biochim Pol. 2014;61(4):679-86.

  9. R Chowdhury, S Kunutsor, A Vitezova, C Oliver-Williams, S Chowdhury, J C Kiefte-de-Jong, H Khan, C P Baena, D Prabhakaran, M B Hoshen, B S Feldman, A Pan, L Johnson, F Crowe, F B Hu, O H Franco. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ. 2014 Apr 1;348:g1903.

  10. W B Grant. An estimate of the global reduction in mortality rates through doubling vitamin D levels. Eur J Clin Nutr. 2011 Sep;65(9):1016-26.

  11. P Autier, M Boniol, C Pizot, P Mullie. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014 Jan;2(1):76-89.

  12. W. Mozolowski. Jędrzej Sniadecki (1768-1838) on the Cure of Rickets. Article in Nature 143:121 · December 1938 with 32 Reads.

  13. A F Hess. The Prevention and Cure of Rickets by Sunlight. Am J Public Health (N Y). 1922 Feb;12(2):104-7.






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