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Vitamin D Supplementation in Underway Submariners

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Abstract:

Duplessis CA, Harris EB, Watenpaugh DE, Horn WG. Vitamin D supplementation in underway submariners. Aviat Space Environ Med 2005; 76:569–575.

Introduction: We assessed the efficacy of vitamin D supplementation in maintaining normal calcium and bone homeostasis in underway submariners deprived of sunlight. Methods: Serum 25-hydroxycholecalciferol (25(OH)D), 1,25-dihydroxycholecalciferol (1,25(OH)2D), calcium, parathyroid hormone (PTH), phosphate, osteocalcin, bone specific alkaline phosphatase, and urinary levels of N-telopeptide were examined in 51 subjects aboard a submarine. These levels were obtained prior to a 76-d deployment, before and after a 6-d liberty period (deployment day 49 and 55), and on return to homeport. There were 26 subjects who received 400-IU of vitamin D daily supplementation, and 25 who received placebo. Results: Both groups exhibited significant reductions in 25(OH)D levels in the initial submergence (a decrease from 28.3 ± 15 ng·ml−1 to 24.1 ± 10 ng·ml−1 in the experimental group and 26.3 ± 10 ng·ml−1 to 20.7 ± 9 ng·ml−1 in the controls), an increase in 25(OH)D levels not significantly different from baseline during the liberty period, and decrements in 25(OH)D on repeat submergence (22.8 ± 10 ng·ml−1 in experimental and 21.4 ± 10 ng·ml−1 in controls). Both groups exhibited an increase in post-liberty osteocalcin (20.4 ± 6 ng·ml−1 to 24.5 ± 5 ng·ml−1 for experimental and 18.3 ± 6 to 23.5 ± 7 ng·ml−1 for controls), and stable serum calcium levels throughout the patrol. Conclusions: 400-IU daily vitamin D supplementation was insufficient in maintaining serum vitamin D levels in underway submariners, engendering biochemical evidence of bone resorption and turnover. Six d sunlight exposure compensated for 49 d sunlight absence, supporting the enormous capacity of UV-B mediated vitamin D production.

Keywords: depression; risks for autoimmune disease; risks for malignancy; submariners; ultraviolet light; vitamin D deficiency; vitamin D supplementation

Document Type: Research Article

Publication date: 2005-06-01

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