LungVITamin D and OmegA-3 Trial (lungVITAL) (lungVITAL)

LungVITamin D and OmegA-3 Trial

The VITamin D and OmegA-3 TriaL (VITAL; NCT 01169259) is an ongoing randomized clinical trial in 25,871 U.S. men and women investigating whether taking daily dietary supplements of vitamin D3 (2000 IU) or omega-3 fatty acids (Omacor® fish oil, 1 gram) reduces the risk of developing cancer, heart disease, and stroke in people who do not have a prior history of these illnesses.

This ancillary study is being conducted among participants in VITAL and will examine whether vitamin D or fish oil reduces respiratory morbidity, including COPD and asthma exacerbations, the risk of pneumonia, and airflow obstruction/decline of pulmonary function; and whether either of these interventions improves asthma control.

Study Overview

• Status: Active, not recruiting
• Conditions: Pneumonia; Asthma; COPD; Pulmonary Function
• Intervention / Treatment: Dietary supplement: Vitamin D3; Dietary supplement: fish oil; Dietary supplement: Fish oil placebo; Dietary supplement: Vitamin D3 placebo

Detailed Description

Chronic obstructive lung disease (COPD) and pneumonia are leading causes of death in United States and worldwide. COPD, which is also a significant source of disability, is increasing in prevalence. Approximately 14 million adults have asthma, which leads to approximately 12 million missed work days per year in the United States. In adults, COPD and asthma often coexist. Treatment options for COPD are limited, and prevalence of vitamin D deficiency is high. COPD lung disease (COPD, asthma, airflow obstruction), and most COPD additional co-morbidities responsible for COPD progression (e.g., respiratory infections/pneumonia, muscle weakness, cardiac failure) may benefit from vitamin D supplementation therapy, but this requires rigorous testing. Marine omega-3 fatty acids work through different pathways from vitamin D to affect inflammation. Observational studies and clinical trials suggest that consumption of fish and/or fish oil may protect against COPD, asthma or pneumonia, but the data are not consistent. Thus, there is a compelling need for a clinical trial to evaluate the potential benefits or risks of vitamin D and fish oil supplementation on COPD and asthma exacerbations, airflow obstruction and decline of lung function, and risk of pneumonia.

The primary outcomes of interest in Lung VITAL are COPD exacerbations; airflow obstruction and decline of pulmonary function; and pneumonia. Asthma exacerbations and asthma control are secondary outcomes. A tertiary goal is to assess whether the effects of the interventions differ by baseline dietary intake or baseline blood levels of the nutrients.

Depending on the primary outcome, Lung VITAL will be conducted among all participants in VITAL (NCT 01169259), or in subsets of the VITAL population who were followed by detailed respiratory questionnaire and/or lung function testing.

• Study Type: Interventional
• Enrollment (Actual): 25871
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Brigham and Women's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

• This study is open to all VITAL participants (NCT 01169259). Population includes men 50 years of age or older and women 55 years of age or older in the United States
• Participants who live in selected metropolitan areas of the U.S. (where we set up the infrastructure for clinic or home visits), are eligible for pulmonary function measurements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Triple

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Vitamin D3 + fish oil; Dietary Supplement: vitamin D3 Drug: omega-3 fatty acids (fish oil)	Dietary supplement: Vitamin D3; Other Names: Vitamin D3 (cholecalciferol), 2000 IU per day. Other Name: cholecalciferol; Dietary supplement: fish oil; Other Names: Omacor; 1 g per day as a fish oil capsule, containing 840 milligrams of marine omega-3 fatty acids (460 mg of eicosapentaenoic acid [EPA] and 380 mg of docosahexaenoic acid [DHA]).
Active Comparator: Vitamin D3 + fish oil placebo; Dietary Supplement: vitamin D3 Dietary Supplement: fish oil placebo	Dietary supplement: Vitamin D3; Other Names: Vitamin D3 (cholecalciferol), 2000 IU per day. Other Name: cholecalciferol; Dietary supplement: Fish oil placebo
Active Comparator: Vitamin D3 placebo + fish oil; Drug: omega-3 fatty acids (fish oil) Dietary Supplement: vitamin D3 placebo	Dietary supplement: fish oil; Other Names: Omacor; 1 g per day as a fish oil capsule, containing 840 milligrams of marine omega-3 fatty acids (460 mg of eicosapentaenoic acid [EPA] and 380 mg of docosahexaenoic acid [DHA]).; Dietary supplement: Vitamin D3 placebo
Placebo Comparator: Vitamin D3 placebo + fish oil placebo; Dietary Supplement: vitamin D3 placebo Dietary Supplement: fish oil placebo	Dietary supplement: Fish oil placebo; Dietary supplement: Vitamin D3 placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
COPD Exacerbations Expressed as Cumulative Rate/Year Over 5 Years	The primary questionnaire-based outcome was COPD respiratory exacerbations, defined for those with COPD as the number of episodes in the past 12 months of a flare-up of chest trouble treated with additional antibiotic or steroid medication at home, or resulting in hospitalization	5 years
Change Between Pre-randomization and 2-year Follow-up in Level of Measures of Pulmonary Function Representing Air Flow/Airflow Obstruction (Forced Expiratory Volume in One Second (FEV1))	In a sub-group of study participants change in pulmonary function (FEV1) will be measured between pre-randomization and 2 years of follow-up	pre-randomization and after 2 years follow-up
Change Between Pre-randomization and 2-year Follow-up in Level of Measures of Pulmonary Function Representing Air Flow/Airflow Obstruction (Forced Expiratory Volume in One Second (FEV1)/ Forced Vital Capacity (FVC))	In a sub-group of study participants change in pulmonary function (FEV1/FVC) will be measured between pre-randomization and 2 years of follow-up	2 years
Pneumonia	The rate of pneumonia incidence per year	5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Asthma Exacerbations Expressed as Cumulative Rate/Year Over 5 Years	The secondary questionnaire-based outcome was asthma respiratory exacerbations, defined for those with asthma (by questionnaire report) as the number of episodes in the past 12 months of a flare-up of chest trouble treated with additional antibiotic or steroid medication at home, or resulting in hospitalization	5 years

Collaborators and Investigators

• Sponsor: Brigham and Women's Hospital
• Collaborators: National Cancer Institute (NCI); National Heart, Lung, and Blood Institute (NHLBI); National Center for Complementary and Integrative Health (NCCIH); Harvard School of Public Health (HSPH)
• Investigators: Principal Investigator: Diane R Gold, MD, MPH, Brigham and Women's Hospital

Publications and helpful links

General Publications

• Gold DR, Litonjua AA, Carey VJ, Manson JE, Buring JE, Lee IM, Gordon D, Walter J, Friedenberg G, Hankinson JL, Copeland T, Luttmann-Gibson H. Lung VITAL: Rationale, design, and baseline characteristics of an ancillary study evaluating the effects of vitamin D and/or marine omega-3 fatty acid supplements on acute exacerbations of chronic respiratory disease, asthma control, pneumonia and lung function in adults. Contemp Clin Trials. 2016 Mar;47:185-95. doi: 10.1016/j.cct.2016.01.003. Epub 2016 Jan 16.
• Gold DR, Carey VJ, Hersh CP, Wan E, Camargo CA Jr, Lee IM, Cook NR, Nassikas N, Buring JE, Manson JE, Luttmann-Gibson H. Vitamin D Supplementation, Chronic Obstructive Lung Disease and Asthma Exacerbations, and Lung Function Decline. J Nutr. 2025 May;155(5):1417-1428. doi: 10.1016/j.tjnut.2025.02.003. Epub 2025 Feb 6.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2010
• Primary Completion (Actual): October 11, 2018
• Study Completion (Estimated): November 1, 2027

Study Registration Dates

• First Submitted: October 25, 2012
• First Submitted That Met QC Criteria: November 13, 2012
• First Posted (Estimated): November 20, 2012

Study Record Updates

• Last Update Posted (Actual): August 7, 2026
• Last Update Submitted That Met QC Criteria: July 16, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: COPD; asthma; pneumonia; pulmonary function
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Immune System Diseases; Respiratory Tract Infections; Infections; Respiratory Tract Diseases; Lung Diseases; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Pathological Conditions, Signs and Symptoms; Pulmonary Disease, Chronic Obstructive; Asthma; Pneumonia; Fatty Acids; Lipids; Polycyclic Compounds; Steroids; Fused-Ring Compounds; Eicosanoids; Fatty Acids, Unsaturated; Oils; Dietary Fats; Fats; Fatty Acids, Omega-3; Dietary Fats, Unsaturated; Cholestenes; Cholestanes; Sterols; Vitamin D; Secosteroids; Membrane Lipids; Cholecalciferol; Eicosapentaenoic Acid; Docosahexaenoic Acids; Fish Oils; Omacor
• Other Study ID Numbers: 2010-P-000622; U01CA138962 (U.S. NIH Grant/Contract); R01CA138962 (U.S. NIH Grant/Contract); R01HL101932 (U.S. NIH Grant/Contract); R01AT011729 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No