Effect of vitamin D and/or omega‐3 fatty acid supplementation on stroke outcomes: A randomized trial

Abstract

Background and purpose Among stroke patients, low serum 25‐hydroxyvitamin D predicts poor outcomes. In mice, higher omega‐3 (n‐3) fatty acid intake diminishes brain damage after stroke. In this study, we tested whether vitamin D or n‐3 fatty acids supplementation prior to stroke reduces the risk of functional limitations and physical disability after stroke. Methods We used data from VITAL (the VITamin D and OmegA‐3 TriaL) which randomized middle‐aged and older men and women without cardiovascular disease to vitamin D3 (2000 IU/day) and/or marine n‐3 fatty acids (1 g/day) and followed them for incident stroke events. Individuals experiencing a non‐fatal stroke were mailed questionnaires assessing functional limitations (the physical performance scale adapted from Nagi) and physical disability (the modified Katz Activities of Daily Living and Rosow‐Breslau Functional Health scales). We used logistic regression to analyze associations between randomized treatment and limitations on each scale. Results A total of 290 individuals experienced their first stroke during the trial, of whom 197 stroke survivors completed the stroke outcomes questionnaire a median of 1.4 years after diagnosis. We observed no associations between randomized treatment to vitamin D and functional limitations (odds ratio [OR] 1.01, 95% confidence interval [CI] 0.52, 1.97) or physical disability (Rosow‐Breslau scale: OR 0.92, 95% CI 0.50, 1.67; Katz scale: OR 1.03, 95% CI 0.31, 3.42). Those randomized to n‐3 fatty acids had a non‐significantly lower risk of functional limitations (OR 0.55, 95% CI 0.28, 1.09) and physical disability (Rosow‐Breslau scale: OR 0.56, 95% CI 0.31, 1.02; Katz sclae: OR 0.32, 95% CI 0.50, 1.67). Conclusion Vitamin D or omega‐3 fatty acid supplementation prior to stroke did not result in significantly improved post‐stroke outcomes.

A systematic review and meta‐analysis of the linkage between low vitamin D and the risk as well as the prognosis of stroke

“…This may be explaining why low concentration vitamin D level raise the risk of ischemic stroke and the risk of poor prognosis of stroke. No consistent phenomenon was found in a clinical trial, and vitamin D supplementation did not lead to a importantly amelioration in outcomes after stroke (Rist et al., 2021). Experiments conducted on animals have demonstrated that the presence of a diminished level of vitamin D did not pose as a risk element towards the negative prognosis associated with stroke (Evans et al., 2018).…”

Effects of Omega-3 Fatty Acid Supplementation on Skeletal Muscle Mass and Strength in Adults: A Systematic Review

“…Clinical intervention studies have suggested that the consumption of EPA and DHA in the diet or pure form, has several health benefits in older adults [ 9 ] and patients with sarcopenic conditions [ 10 11 ], whereas some studies have reported no advantage of omega-3 on skeletal muscle health [ 12 13 ]. A well-known health advantage of EPA and DHA consumption is that they enhance cognitive function and attenuate cardiovascular and inflammation-related diseases [ 14 15 ]. Based on this evidence, DHA and EPA are consumed as functional food products and are added to several commercially available food products, such as foods for medical purposes and nutrient-fortified foods [ 16 17 ] which are usually supplied as alternatives to the main diet for off hospitalized patients or care-center-dwelling older adults [ 18 ].…”

A linkage among 25 (OH) D and post-stroke cognitive impairment and the prognosis of stroke

“…An expanding body of research has associated insu cient vitamin D levels with heightened vulnerabilities of various psychiatric conditions including anxiety, depression and sleep disorders [12]. Despite links between 1,25-dihydroxyvitamin D de ciency, mental disorders [13], along with stroke outcomes [14], the effectiveness of supplementing with vitamin D in improving post-stroke prognosis has yielded mixed results, with a recent trial reporting negligible bene ts [15]. While the function of 1,25-dihydroxyvitamin D in the context of stroke prognosis remains debated, severe de ciency appears to predict poorer survival after ischemic stroke based on recent evidence [16].…”

“…These results suggest vitamin D 3 alleviates cognitive impairment by downregulating nuclear factor-κB signaling pathway proteins inhibitor kappa B and p65[35].Divergent outcomes have been documented about the in uence of supplementation with 25(OH)D on post-stroke outcomes. An instance of a clinical trial found that the supplementation of 25(OH)D did not yield signi cant enhancements in post-stroke outcomes [15]…”