Nutrient supplementation for prevention of viral respiratory tract infections
in healthy subjects: a systematic review and meta-analysis
Allergy. 2021 Oct 9. doi: 10.1111/all.15136
Berber Vlieg-Boerstra 1, Nicolette de Jong 2 3, Rosan Meyer 4, Carlo Agostoni 5 6, Valentina De Cosmi 5 6, Kate Grimshaw 7, Gregorio Paolo Milani 5 6, Antonella Muraro 8, Hanneke Oude Elberink 9, Isabella Pali-Schöll 10 11, Caroline Roduit 12 13 14, Mari Sasaki 15, Isabel Skypala 16, Milena Solokowska 17, Marloes van Splunter 2, Eva Untersmayr 11, Carina Venter 18, Liam O'Mahony 19, Bright I Nwaru 20
It remains uncertain as to whether nutrient supplementation for the general population considered healthy could be useful in the prevention of RTIs, such as COVID-19. In this systematic review and meta-analysis the evidence was evaluated for primary prevention of any viral respiratory tract infection (RTI) such as SARS-CoV-2, through supplementation of nutrients with a recognized role in immune function: multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long chain polyunsaturated fatty acids.
The search produced 15,163 records of which 93 papers (based on 115 studies) met the inclusion criteria, resulting in 199,055 subjects (191,636 children and 7,419 adults) from 37 countries.
Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately.
By stratifying the meta-analysis by world regions, only studies performed in Asia showed a significant, but
heterogeneous protective effect of zinc supplementation on RTIs (RR 0.86, 95%CI 0.7-0.96, I2=79.1%, p=0.000).
Vitamin D supplementation in adults significantly decreased the incidence of RTI
- (RR 0.89, 95%CI 0.79-0.99, p=0.272), particularly in
- North America (RR 0.82 95%CI 0.68-0.97),
- but not in Europe or Oceania.
Supplementation of nutrients in the general population has either no, or at most a very limited effect on prevention of RTIs. Zinc supplementation appears protective for children in Asia, while vitamin D may protect adults in the USA and Canada. In 10/115 (8.7%) studies post-hoc analyses based on stratification for nutritional status was performed. In only one study zinc supplementation was found to be more effective in children with low zinc serum as compared to children with normal zinc serum levels.
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Items in both categories Breathing and Zinc:
- Zinc, respiratory tract infections and COVID-19 – July 2020
- Review of common cold (42 billion dollars) prevention and treatment - Zinc works – Feb 2014
- Common cold prevented and treated by Vitamin D, Vitamin C, Zinc, and Echinacea – review April 2018
- Loss of smell may be related to low Zinc or perhaps low vitamin D
- Infant wheezing 40 percent less likely if mother supplemented with vitamin D, vitamin E, or Zinc – meta-analysis Aug 2015
- Overview Colds and flu and Vitamin D
Items in both categories Breathing and Meta-analysis:
- Small doses of Vitamin D do not reduce childhood breathing allergies – meta-analysis Oct 2022
- Asthma treated by Vitamin D - 13th Meta-analysis – July 2022
- COPD treated by Vitamin D – meta-analysis March 2022
- Small amounts of Vitamin D reduce Influenza risk by 22 percent (loading dose is far better) – meta-analysis Jan 2022
- Asthma reduced by Vitamin D, even for those using corticosteroids - meta-analysis 2021
- Small vitamin D doses provide small benefits for acute respiratory infections – Meta-analysis March 2021
- Respiratory Tract Infection risk reduced 2X by Vitamin D loading doses – meta-analysis Jan 2021
- Small vitamin D doses given during pregnancy do not reduce childhood asthma – meta-analysis Dec 2020
- Acute viral respiratory infections (RTI) reduced by Vitamin D - 20 reviews - Aug 2020
- Asthmatics less able to breathe if low vitamin D – meta-analysis Nov 2019
- Asthma is 20 percent more likely with a poor Vitamin D Receptor gene – meta-analysis Oct 2019
- Pneumonia 6X more likely if very low vitamin D – meta-analysis Sept 2019
- Asthma supplementation by Vitamin D (any amount) reduced attacks by 25 percent – meta-analysis April 2019
- Respiratory infections reduced only 20 percent by Vitamin D (ignored dose size, duration, type, etc) – meta-analysis Jan 2019
- Breath better if higher level of Vitamin D – meta-analysis March 2018
- Asthma risk reduced by 67 percent with Vitamin D supplementation if level was initially low– meta-analysis Nov 2017
- Pneumonia patients 3 X more likely to die if low vitamin D – meta-analysis Sept 2017
- Acute respiratory tract infections prevented by vitamin D (even when ignoring the dose size – Meta-analysis Feb 2017
- Asthma exacerbations in children decrease by 60 percent with vitamin D supplementation – meta-analysis – 2015
- Vitamin D during pregnancy reduces risk of childhood asthma by 13 percent – meta-analysis Dec 2016
- Childhood asthma about 1.3 times more likely if poor Vitamin D Receptor – meta-analysis Aug 2016
- COPD 2.8 times more likely to be severe if low vitamin D – meta-analysis Oct 2016
- Lower respiratory tract infections in children associated with Low Vitamin D – meta-analysis May 2016
- Asthma medicines not helped by vitamin D (if only a small amount of D is taken) – meta-analysis Dec 2015
- Asthma not helped by less than 2,000 IU of vitamin D - meta-analysis Aug 2015
- COPD strongly associated with Vitamin D Binding Protein problems – meta-analysis Aug 2015
- COPD severity is associated with Vitamin D deficiency – meta-analyses 2015, 2019
- Infant wheezing 40 percent less likely if mother supplemented with vitamin D, vitamin E, or Zinc – meta-analysis Aug 2015
- Gene makes COPD 2.6X more likely unless get more vitamin D – meta-analysis Dec 2014
- Asthma reduced 60 percent with vitamin D supplementation – meta-analysis 2014, 2015
- Acute Lower Respiratory Infections in Children - associated with low vitamin D – meta-analysis Dec 2014
- Asthma is strongly associated with low vitamin D (but not COPD) – meta-analysis Feb 2014
- Vitamin D and Respiratory Tract Infections – meta-analysis with charts June 2013
- Vitamin D reduces respiratory tract infections by 40 percent– meta-analysis Dec 2012
- Acute respiratory infection treated by vitamin D in 6 of 12 clinical trials – review Nov 2012
Items in both categories Breathing and Virus:
- Newly diagnosed Asthma increased 13% if COVID vaccination (200,000 US children) – Sept 2024
- France has injected 200,000 infants with RSV vaccine, based on no long-term data - Here we go again - Dec 2023
- Vitamin D energizes the innate and adaptive immune systems to fight lung inflammation – Sept 2022
- Calcifediol (semi-activated Vitamin D) might treat Respiratory Diseases such as COVID - July 2022
- Croup (due to viruses) has surged with Omicron - March 2022
- Compare symptoms of Omicron, Flu and Colds
- Small amounts of Vitamin D reduce Influenza risk by 22 percent (loading dose is far better) – meta-analysis Jan 2022
- Italians entering hospital for breathing problems had low vitamin D (with and without COVID), Vitamin D should help – Nov 2021
- Superspreaders appear to have viscous lung fluids or be obese
- COVID-19 lung death 4X more likely in Iran if less than 25 ng of vitamin D – Oct 30, 2020
- Acute viral respiratory infections (RTI) reduced by Vitamin D - 20 reviews - Aug 2020
- COVID ARDS deaths 2X more likely if less than 10 ng of Vitamin D – Aug 8, 2020
- Respiratory viral infection (RSV) and low vitamin D - many studies
- Zinc, respiratory tract infections and COVID-19 – July 2020
- Vitamin D reduces viral respiratory infections – editorial April 18, 2020
- Viral infection wheezing 24X more likely if less than 15 ng of Vitamin D – Dec 2019
- Ultraviolet light kills cold and flu viruses, and generates Vitamin D in the skin
- Respiratory Virus risk reduced 35 percent by Vitamin D (14,000 IU weekly) – RCT Oct 2018
- Common cold prevented and treated by Vitamin D, Vitamin C, Zinc, and Echinacea – review April 2018
- Half the risk of Influenza -A in infants taking 1200 IU of vitamin D for 4 months – RCT Jan 2018
- Loss of smell may be related to low Zinc or perhaps low vitamin D
- Severe Pertussis is 1.5 times more likely if poor vitamin D receptor – Feb 2016
- Immune response to respiratory viruses – vitamin D connection – review May 2015
- Overview Colds and flu and Vitamin D
- Influenza reduced by 1.7 with 1200 IU D3, also reduced related asthma by 6X – RCT May 2010
VitaminDWiki pages containing RESPIRATORY or RTI in title (76 as of Oct 2021)
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