Vitamin D supplementation and central adiposity in male shift workers: a randomized clinical trial on metabolic health

BACKGROUND: Vitamin D deficiency is common among individuals with obesity; however, the association between low 25-hydroxyvitamin D [25(OH)D] concentrations and adiposity remains unclear. Shift workers are at increased risk for both vitamin D deficiency and metabolic disorders, making this population particularly relevant for investigating this relationship. OBJECTIVES: This study aimed to evaluate the effect of cholecalciferol supplementation on central adiposity, assessed by waist circumference (WC) and waist-to-height ratio (WHtR), among male shift workers. DESIGN AND SETTING: Randomized, double-blind, placebo-controlled clinical trial involving 198 male shift workers employed by an iron ore extraction company in Minas Gerais, Brazil. METHODS: Participants with 25(OH)D concentrations <30 ng/mL and at least one metabolic abnormality, including metabolic syndrome, impaired fasting glucose, dyslipidemia, elevated blood pressure, or increased WC, were randomly assigned to receive placebo, cholecalciferol 14,000 IU/week, or cholecalciferol 28,000 IU/week for 4 months. Plasma 25(OH)D concentrations, WC, and WHtR were evaluated at baseline and post-intervention. RESULTS: After 4 months, no significant differences in WC or WHtR were observed between the vitamin D supplementation groups (14,000 IU/week and 28,000 IU/week) and the placebo group. Nevertheless, serum 25(OH)D concentrations increased significantly in the supplementation groups: +6.23 ng/mL (p25 = 0.58; p75 = 10.61) in the 14,000 IU/week group and +15.25 ng/mL (p25 = 10.57; p75 = 19.68) in the 28,000 IU/week group. In contrast, the placebo group showed a decrease of -0.50 ng/mL (p25 = -1.03; p75 = 2.71). Despite these increases, supplementation produced no significant effect on central adiposity outcomes (p > 0.05). CONCLUSION: Although vitamin D supplementation effectively increased serum 25(OH)D concentrations, it did not reduce central adiposity among male shift workers. These findings indicate that vitamin D supplementation alone is unlikely to improve obesity-related outcomes in this high-risk occupational population and underscore the need for comprehensive strategies targeting metabolic health in shift workers. CLINICAL TRIAL OR SYSTEMATIC REVIEW REGISTRATION: This study was registered in the Brazilian Registry of Clinical Trials (ReBEC) under identifier RBR-6CS352 on October 25, 2017.