Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial

Duarte Romero, Briony L.; Armstrong, Bruce K.; Baxter, Catherine; English, Dallas R.; Ebeling, Peter R.; Hartel, Gunter; Kimlin, Michael G.; Na, Renhua; McLeod, Donald S. A.; Pham, Hai; Ross, Tanya; van der Pols, Jolieke C.; Venn, Alison J.; Webb, Penelope M.; Whiteman, David C.; Neale, Rachel E.; Waterhouse, Mary

doi:10.3390/nu18020357

Open AccessArticle

Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial

by

Briony L. Duarte Romero

¹

,

Bruce K. Armstrong

²

,

Catherine Baxter

¹,

Dallas R. English

^3,4

,

Peter R. Ebeling

⁵

,

Gunter Hartel

^1,6,7

,

Michael G. Kimlin

^8,9,

Renhua Na

^1,10

,

Donald S. A. McLeod

^1,11,

Hai Pham

^1,10

,

Tanya Ross

^1,10

,

Jolieke C. van der Pols

¹²,

Alison J. Venn

¹³,

Penelope M. Webb

^1,10

,

David C. Whiteman

^1,10

,

Rachel E. Neale

^1,10,*,†

and

Mary Waterhouse

^1,†

¹

Population Health Program, QIMR Berghofer, Brisbane 4006, Australia

²

School of Public Health, University of Sydney, Sydney 2050, Australia

³

Melbourne School of Population Health, University of Melbourne, Melbourne 3053, Australia

⁴

Cancer Epidemiology Division, Cancer Council Victoria, Melbourne 3002, Australia

⁵

Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne 3168, Australia

⁶

Griffith Institute for Biomedicine and Glycomics, Griffith University, Gold Coast 4215, Australia

⁷

School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane 4059, Australia

⁸

School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane 4059, Australia

⁹

Faculty of Medicine and Medical Sciences, Bond University, Gold Coast 4226, Australia

¹⁰

School of Public Health, The University of Queensland, Brisbane 4006, Australia

¹¹

Department of Endocrinology and Diabetes, Royal Brisbane and Women’s Hospital, Brisbane 4029, Australia

¹²

School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane 4059, Australia

¹³

Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia

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^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Nutrients 2026, 18(2), 357; https://doi.org/10.3390/nu18020357

Submission received: 27 October 2025 / Revised: 11 December 2025 / Accepted: 18 December 2025 / Published: 22 January 2026

(This article belongs to the Special Issue Fat-Soluble Vitamins for Disease Prevention and Management (2nd Edition))

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Abstract

Background/Objectives: Observational studies have found inverse associations between 25-hydroxyvitamin D concentration and risk of hypertension, hypercholesterolemia and type 2 diabetes (T2D). More robust evidence from large-scale randomized controlled trials, however, is limited or inconclusive. Methods: The D-Health Trial (N = 21,315) is a randomized, double-blind, placebo-controlled trial of supplementation with monthly doses of 60,000 international units of oral vitamin D₃, conducted in Australians aged 60–84 years. Commencing treatment with anti-hypertensive, lipid-modifying, or anti-diabetic drugs was used as a surrogate for incident hypertension, hypercholesterolemia, and T2D, respectively. Outcomes were ascertained via linkage with the Australian Pharmaceutical Benefits Scheme database. Follow-up began 6 months after randomization; we excluded participants without linked data, and those who were prevalent cases or who died prior to start of follow-up. Flexible parametric survival models were used to estimate the effect of vitamin D supplementation on each outcome. Results: We included 10,964 participants (vitamin D, n = 5456 [49.8%]; placebo, n = 5508 [50.2%]) in the analysis of hypertension, 12,126 participants (vitamin D, n = 6038 [49.8%]; placebo, n = 6088 [50.2%]) in the analysis of hypercholesterolemia, and 17,846 (vitamin D, n = 8931 [50.0%]; placebo, n = 8915 [50.0%]) in the analysis of T2D. Over a median follow-up of 4.6 years, 2672 (24.4%), 2554 (21.1%), and 779 (4.4%) participants developed hypertension, hypercholesterolemia, and T2D, respectively. Vitamin D supplementation had no material effect on the incidence of any of hypertension (HR 1.00; 95% CI 0.93 to 1.08), hypercholesterolemia (HR 1.05; 95% CI 0.97 to 1.13), or T2D (HR 0.97; 95% CI 0.84 to 1.12). Conclusions: Monthly supplements of vitamin D did not alter the incidence of any of the three conditions in older, largely vitamin D-replete Australians.

Keywords: vitamin D; diabetes; hypertension; hypercholesterolemia

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MDPI and ACS Style

Duarte Romero, B.L.; Armstrong, B.K.; Baxter, C.; English, D.R.; Ebeling, P.R.; Hartel, G.; Kimlin, M.G.; Na, R.; McLeod, D.S.A.; Pham, H.; et al. Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial. Nutrients 2026, 18, 357. https://doi.org/10.3390/nu18020357

AMA Style

Duarte Romero BL, Armstrong BK, Baxter C, English DR, Ebeling PR, Hartel G, Kimlin MG, Na R, McLeod DSA, Pham H, et al. Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial. Nutrients. 2026; 18(2):357. https://doi.org/10.3390/nu18020357

Chicago/Turabian Style

Duarte Romero, Briony L., Bruce K. Armstrong, Catherine Baxter, Dallas R. English, Peter R. Ebeling, Gunter Hartel, Michael G. Kimlin, Renhua Na, Donald S. A. McLeod, Hai Pham, and et al. 2026. "Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial" Nutrients 18, no. 2: 357. https://doi.org/10.3390/nu18020357

APA Style

Duarte Romero, B. L., Armstrong, B. K., Baxter, C., English, D. R., Ebeling, P. R., Hartel, G., Kimlin, M. G., Na, R., McLeod, D. S. A., Pham, H., Ross, T., van der Pols, J. C., Venn, A. J., Webb, P. M., Whiteman, D. C., Neale, R. E., & Waterhouse, M. (2026). Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial. Nutrients, 18(2), 357. https://doi.org/10.3390/nu18020357

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Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults—Results from the Randomized Controlled D-Health Trial

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