Novel Phototherapy Kiosk Shows Promise as a Treatment Option for Low Vitamin D.

INTRODUCTION: The purpose of this study was to demonstrate the feasibility of a phototherapy kiosk (PK) to engage community adults in health promotion and to stimulate production of circulating 25-hydroxyvitamin (OH)D as effectively as a vitamin D3 oral supplement (OS). Although optimal production of vitamin D comes from sun exposure, ultraviolet B radiation with a wavelength of 290 to 320 nm penetrates exposed skin and may produce vitamin D3 using a PK. MATERIALS AND METHODS: A prospective study was conducted with adults randomized to either six PK treatments or D3 OS for 10 weeks. Serum 25(OH)D was drawn at baseline, 10 weeks, and 14 weeks. Primary outcome was serum 25(OH)D level. Mann-Whitney test was used to assess continuous data and Chi squared test for pairwise comparisons of categorical data. Significance was set at P < .05. RESULTS: With 18% attrition, final sample size was 88; OS, n = 45, PK, n = 43. Sample was mostly female (60%), median age 35 years, with no differences observed between groups for age, race/ethnicity, marital status, military affiliation, or season of enrollment. Median daily intake of calcium and vitamin D was well below the recommended daily allowance for each nutrient, and group. Baseline median serum 25(OH)D levels were similar. By 10 weeks, PK median level was 30 ng/mL (interquartile range [IQR] 25.8-37.0) and OS was 26 ng/mL (IQR 21.5-30.5), P = .02. The difference in 25(OH)D levels persisted at 14 weeks; the PK group returned to baseline, 27 ng/mL (IQR 22.0-32.5), and OS group declined to 21 ng/mL (IQR 17.0-30.0), P = .02. CONCLUSION: Programmed ultraviolet B phototherapy appears to be an efficacious alternative to oral vitamin D supplementation with consistent use.

A Prospective Cohort Study of Vitamin D Supplementation in AD Soldiers: Preliminary Findings.

PURPOSE: To explore response to vitamin D supplementation in active duty (AD) warfighters and translate findings into evidence-based health policy. BACKGROUND: Soldiers are at risk for musculoskeletal injuries and metabolic dysfunction that impact physical performance and military readiness; the link with low vitamin D status is unclear. METHODS: This prospective trial enrolled 152 soldiers; baseline 25 hydroxyvitamin (OH) D level determined assignment to a no-treatment control (CG) or treatment group (TG) receiving a vitamin D3 supplement for 90 days. Symptoms, diet, sun exposure, and blood biomarkers obtained at baseline (T1) and 3 months (T2). RESULTS: Cohort was predominantly white (58%) with a significant difference in racial distribution for vitamin D status. Mean (SD) 25(OH)D levels were 37.8 (5.6) ng/mL, 22.2 (5.0) ng/mL, and 22.9 (4.7) ng/mL for the CG, low dose TG, and high-dose TG at T1, respectively. Following three months of treatment, one-way ANOVA indicated a statistically significant difference between groups (F5,246 = 44.37; p < 0.0001). Vitamin D intake was 44% of Recommended Dietary Allowance throughout the first phase of the trial. Patient-Reported Outcomes Measurement Information System scores improved in TG for fatigue and sleep, p < 0.01. CONCLUSIONS: Vitamin D deficiency is widespread in AD soldiers. Clinicians must intervene early in preventable health conditions impacting warfighter performance and readiness and recommend appropriate self-care strategies.

Health promotion research in active duty army soldiers: The road to a fit and ready force.

BACKGROUND: In the last decade the Military Health System has changed its paradigm to focus on health promotion and disease prevention. PURPOSE: This paper reviews a decade of research exploring the effects of military life on nutritional status and bone health of Army soldiers. METHOD: Descriptive and experimental approaches have assessed occupational demands on soldiers in variable environments that require optimal nutrition status and physical health. DISCUSSION: The prevalence of overweight and obesity in the military has risen dramatically and the implications for health, readiness, productivity, and cost demands attention. The related nutritional deficits such as suboptimal vitamin D status likely contribute to musculoskeletal injuries which have a greater impact on the performance and readiness of soldiers than any other medical condition in peacetime or conflict. CONCLUSION: The greatest challenge in our system for health is optimizing the performance of all soldiers while minimizing health risks and long-term disability resulting from occupational hazards, particularly those inherent to war.

A Randomized Controlled Trial of Nurse Coaching vs. Herbal Supplementation for Weight Reduction in Soldiers.

The number of overweight and obese service members has tripled since the beginning of Overseas Contingency Operations.1 Overwhelming evidence suggesting links between obesity and increased risk for conditions such as musculoskeletal injuries, type II diabetes, and cardiovascular disease,2 poses a threat to the strength and performance of our current and future fighting force. OBJECTIVE: The purpose of the study was to test nurse health coaching (NHC) and/or herbal supplementation for weight reduction in Soldiers during a 12-week intervention. METHODS: Body composition, biomarkers, adherence, and motivation were measured at three time points. The NHC provided a weekly scripted interaction. Change scores were compared across study groups using general linear models. RESULTS: Sample demographics (N = 435): mean age 30 ± 8.2 years, 73.4% men, predominantly white (70.1%) and non-Hispanic (80%), 71% married, and 91% enlisted. Results represent the 3 NHC groups compared to control group. Beneficial intervention effects were observed for heel bone mineral density (d = 0.3), 25-Hydroxyvitamin D (d = 0.43), and fasting blood sugar (d = -0.4), but were not significant following application of a 10% false discovery rate. There were no significant findings for any other comparisons. CONCLUSION: Weight loss proved difficult for all groups; there was no advantage of NHC over an herbal supplement as adjuncts to Army MOVE! for weight reduction. Highly motivated Soldiers were unable to sustain weight loss or body composition changes.