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

Authors

Keywords:

Shift Work Schedule, Circadian Rhythm, Calcitriol, Obesity, Vitamin D, Calciferol, Adiposity, Clinical Trial

Abstract

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.

Downloads

Download data is not yet available.

Author Biographies

Luiz Menezes Junior, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Professor, Programa de Pós-Graduação em Saúde e Nutrição (PPGSN), Escola de Nutrição (ENUT), Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

Virgínia Capistrano Fajardo, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil

PhD. Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

Fernando Luiz Pereira de Oliveira, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Associate Professor, Instituto de Ciências Exatas e Biológicas (ICEB), Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

George Luiz Lins Machado Coelho, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Associate Professor, Programa de Pós-Graduação em Saúde e Nutrição (PPGSN), Escola de Medicina, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

Fausto Aloisio Pedrosa Pimenta, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Associate Professor, Escola de Medicina, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

Raimundo Marques do Nascimento Neto, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Associate Professor, Escola de Medicina, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

Sílvia Nascimento de Freitas, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil

PhD. Associate Professor, Programa de Pós-Graduação em Saúde e Nutrição (PPGSN), Escola de Nutrição (ENUT), Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil.

References

1. Hruby A, Hu FB. The epidemiology of obesity: a big picture. Pharmacoeconomics. 2015 Jul;33(7):673–89. https://doi.org/10.1007/s40273-014-0243-x.

2. Sousa TM, Silva LES, Rodrigues LC, Caldeira TCM, Cardoso LO, Claro RM. Time trend of Vigitel Brasil operation indicators (2006 to 2023). Rev Saude Publica. 2025 Jun;59:e20. https://doi.org/10.11606/s1518-8787.2025059006369.

3. Bandeira F, Griz L, Dreyer P, Eufrazino C, Bandeira C, Freese E. Vitamin D deficiency: a global perspective. Arq Bras Endocrinol Metabol. 2006 Aug;50(4):640–6. https://doi.org/10.1590/S0004-27302006000400009.

4. Vimaleswaran KS, Berry DJ, Lu C, et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 2013 Feb;10(2):e1001383. https://doi.org/10.1371/journal.pmed.1001383.

5. Barrea L, Savastano S, Di Somma C, Savanelli MC, Nappi F, Albanese L, et al. Low serum vitamin D-status, air pollution and obesity: a dangerous liaison. Rev Endocr Metab Disord. 2017 Jun;18(2):207–14. https://doi.org/10.1007/s11154-016-9388-6.

6. Zittermann A, Ernst JB, Gummert JF, Börgermann J. Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: a systematic review. Eur J Nutr. 2014 Mar;53(2):367–74. https://doi.org/10.1007/s00394-013-0634-3.

7. Wamberg L, Kampmann U, Stødkilde-Jørgensen H, Rejnmark L, Pedersen SB, Richelsen B. Effects of vitamin D supplementation on body fat accumulation, inflammation, and metabolic risk factors in obese adults with low vitamin D levels - results from a randomized trial. Eur J Intern Med. 2013 Oct;24(7):644–9. https://doi.org/10.1016/j.ejim.2013.03.005.

8. Sowah D, Fan X, Dennett L, Hagtvedt R, Straube S. Vitamin D levels and deficiency with different occupations: a systematic review. BMC Public Health. 2017 Jun;17(1):519. https://doi.org/10.1186/s12889-017-4436-z.

9. Batista AP, Ambrosim TV, Neto RM, et al. Hypovitaminosis D is associated with visceral adiposity, high levels of low-density lipoprotein and triglycerides in alternating shift workers. J Endocrinol Metab. 2016 Jun;6(3):80–9. https://doi.org/10.14740/jem.v6i3.340.

10. Fajardo VC, Oliveira FLP, Machado-Coelho GLL, Pimenta FAP, Freitas SN, Ribeiro ALP, et al. Effects of vitamin D supplementation on cardiovascular risk factors in shift workers: study protocol for randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore). 2019 May;98(18):e15417. https://doi.org/10.1097/MD.0000000000015417.

11. World Health Organization (WHO). Obesity, preventing and managing the global epidemic. Geneva: WHO; 2000. 266 p. (WHO Technical Report Series; no. 894).

12. World Health Organization (WHO), editor. Physical status: the use and interpretation of anthropometry: report of a WHO Expert Committee. Geneva: WHO; 1995. 452 p. (WHO Technical Report Series; no. 854).

13. Alberti KGMM, Zimmet P, Shaw J. The metabolic syndrome: a new worldwide definition. Lancet. 2005 Sep;366(9491):1059–62. https://doi.org/10.1016/S0140-6736(05)67402-8.

14. Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev. 2010 Dec;23(2):247–69. https://doi.org/10.1017/S0954422410000144.

15. Maeda SS, Borba VZC, Camargo MBR, Silva DMW, Borges JLC, Bandeira F, et al. Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D. Arq Bras Endocrinol Metabol. 2014 Jul;58(5):411–33. https://doi.org/10.1590/0004-2730000003388.

16. Pereira-Santos M, Costa PRF, Assis AMO, Santos CAST, Santos DB. Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev. 2015 Apr;16(4):341–9. https://doi.org/10.1111/obr.12239.

17. Cheng S, Massaro JM, Fox CS, Larson MG, Keyes MJ, McCabe EL, et al. Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study. Diabetes. 2010 Jan;59(1):242–8. https://doi.org/10.2337/db09-1011.

18. Shafinaz IS, Moy FM. Vitamin D level and its association with adiposity among multi-ethnic adults in Kuala Lumpur, Malaysia: a cross sectional study. BMC Public Health. 2016 Mar;16:232. https://doi.org/10.1186/s12889-016-2924-1.

19. McGill AT, Stewart JM, Lithander FE, Strik CM, Poppitt SD. Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutr J. 2008 Jan;7:4. https://doi.org/10.1186/1475-2891-7-4.

20. Chandler PD, Wang L, Zhang X, Sesso HD, Moorthy MV, Obi O, et al. Effect of vitamin D supplementation alone or with calcium on adiposity measures: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2015 Sep;73(9):577–93. https://doi.org/10.1093/nutrit/nuv012.

21. Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population: analysis using multi-frequency bioimpedance. Kidney Blood Press Res. 2015 Apr;40(3):223–30. https://doi.org/10.1159/000368498.

22. Zhang M, Li P, Zhu Y, Chang H, Wang X, Liu W, et al. Higher visceral fat area increases the risk of vitamin D insufficiency and deficiency in Chinese adults. Nutr Metab (Lond). 2015 Nov;12:50. https://doi.org/10.1186/s12986-015-0046-x.

23. Kim YJ, Park JW, Kim JW, Park CS, Gonzalez JPS, Lee SH, et al. Computerized automated quantification of subcutaneous and visceral adipose tissue from computed tomography scans: development and validation study. JMIR Med Inform. 2016 Feb;4(1):e2. https://doi.org/10.2196/medinform.4923.

24. Smith KB, Smith MS. Obesity statistics. Prim Care. 2016 Mar;43(1):121–35. https://doi.org/10.1016/j.pop.2015.10.001.

25. Jamka M, Woźniewicz M, Jeszka J, Mardas M, Bogdański P, Stelmach-Mardas M. The effect of vitamin D supplementation on insulin and glucose metabolism in overweight and obese individuals: systematic review with meta-analysis. Sci Rep. 2015 Nov;5:16142. https://doi.org/10.1038/srep16142.

26. Sadiya A, Ahmed SM, Carlsson M, Tesfa Y, George M, Ali SH, et al. Vitamin D3 supplementation and body composition in persons with obesity and type 2 diabetes in the UAE: a randomized controlled double-blinded clinical trial. Clin Nutr. 2016 Feb;35(1):77–82. https://doi.org/10.1016/j.clnu.2015.02.017.

27. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911–30. https://doi.org/10.1210/jc.2011-0385

28. Jeong H, Hong S, Heo Y, Chun H, Kim D, Park J, et al. Vitamin D status and associated occupational factors in Korean wage workers: data from the 5th Korea national health and nutrition examination survey (KNHANES 2010-2012). Ann Occup Environ Med. 2014 Sep;26:28. https://doi.org/10.1186/s40557-014-0028-x

29. Bachhel R, Singh NR, Sidhu JS. Prevalence of vitamin D deficiency in north-west Punjab population: a cross-sectional study. Int J Appl Basic Med Res. 2015 Jan;5(1):7–11. https://doi.org/10.4103/2229-516X.149220.

30. Cembranel F, González-Chica DA, d'Orsi E. Inadequate dietary micronutrient intake in men and women in southern Brazil: the EpiFloripa Adults Study, 2012. Cad Saude Publica. 2016 Aug;32(8):e00164015. https://doi.org/10.1590/0102-311X00164015.

Downloads

Published

2026-09-17

How to Cite

1.
Menezes Junior L, Fajardo VC, Oliveira FLP de, Coelho GLLM, Pimenta FAP, Nascimento Neto RM do, Freitas SN de. Vitamin D supplementation and central adiposity in male shift workers: a randomized clinical trial on metabolic health. Sao Paulo Med J [Internet]. 2026 Sep. 17 [cited 2026 Sep. 19];144(4):1-9. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2955

Issue

Section

Original Article