Editorial: Vitamin D and IBD: Can We Get Over the “Causation” Hump?

Abstract

Vitamin D defi ciency is common in patients with infl ammatory bowel diseases and may even precede the disease onset contributing to an increased risk. Using comprehensive data from a large, referral IBD cohort, Kabbani et al. establish that low vitamin D levels are associated with greater disease activity, increased risk of surgery and hospitalizations, and lower health-related quality of life in patients with IBD. This expands the evidence base supporting such an association. However, there is a need for this fi eld to evolve to interventional studies with vitamin D supplementation to confi rm that vitamin D has a true therapeutic role for treating disease activity in IBD.

The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status

“…A South African cohort study on Crohn’s disease found a relation between low levels of vitamin D and increased activity of the disease [19]. In two other studies, it has been shown that low levels of vitamin D are common in IBD patients, which has been associated with mortality and severity of the disease as well as the early onset of it, which could indicate the importance of the role of this vitamin in the improvement of these patients [19, 22]. Another study showed that levels of 35 ng/mL or less of serum vitamin D during the treatment period would increase the risk of recurrence of UC [21].…”

“…Several studies have been conducted to evaluate the efficacy of vitamin D in IBD patients and in some of them a link between vitamin D deficiency and disease activity, mortality and severity of the disease, its early onset and risk of recurrence was found [17–22]; however, the optimum dosage for supplementation has not yet been elucidated. Thus, we designed this study to determine the effects of two dosages of vitamin D supplementation on serum vitamin D, total antioxidant capacity (TAC), total oxidant status (TOS), quality of life, and disease activity index in patients with UC.…”

Switching to a Healthy Diet Prevents the Detrimental Effects of Western Diet in a Colitis-Associated Colorectal Cancer Model

“…Our group has also shown that feeding a low vitamin D diet increased tumorigenesis in an AOM/DSS mouse model but simultaneously decreased expression of Ki67 in untransformed colonic mucosa [64]. The severity of IBD seems to correlate with vitamin D deficiency [65] and low levels of vitamin D are a feature of Western diet [66]. However, it is probably never a single nutrient of importance, but the interaction among several nutrients is more effective in counteracting IBD and tumorigenesis.…”

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“…Pappa HM et al [4] in a pediatric group of patients with IBD after supplementation of vitamin D at the dose of 2000IU/d observed a lower level of C-reactive protein and interleukin-6. However, more interventional studies are required to confirm the therapeutic efficacy of vitamin D supplementation in IBD [14]. A target of vitamin D levels between 30 and 50 ng/mL appears to be both safe and have benefits for IBD disease course.…”