Vitamin D supplementation and musculoskeletal injury risk in young men undergoing arduous training: a randomised placebo-controlled trial

Carswell, AT ORCID: 0000-0002-7922-5549, Swinton, P, O’Leary, TJ ORCID: 0000-0002-1120-8777, Jackson, S, Tang, JCY, Oliver, SJ, Wentz, LM, Izard, RM, Taylor, N, Allan, D, Rhodes, LE, Walsh, NP ORCID: 0000-0002-3681-6015, Fraser, WD and Greeves, JP (2026) Vitamin D supplementation and musculoskeletal injury risk in young men undergoing arduous training: a randomised placebo-controlled trial. British Journal of Nutrition. ISSN 0007-1145

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Abstract

In 250 men (21·4 (sd 2·9) years; BMI 24·2 (sd 3·0) kg·m–2) commencing arduous military training during winter, we investigated the effect of 12 weeks of vitamin D supplementation on lower body (pelvic girdle, sacrum, coccyx and lower limb) overuse musculoskeletal injury risk in a randomised, placebo-controlled trial. Participants received either simulated sunlight (1·3 × standard erythemal dose in T-shirt and shorts, three times per week for 4 weeks and then once per week for 8 weeks), oral vitamin D3 (1000 IU · d–1 for 4 weeks and then 400 IU · d–1 for 8 weeks) or placebo for each intervention. Serum vitamin D metabolites and bone metabolism biomarkers were measured at baseline, week 5 and week 12. At baseline, 29 % of participants were vitamin D sufficient (25-hydroxyvitamin D ≥ 50 nmol·L–1). Vitamin D supplementation achieved vitamin D sufficiency in 95 % of participants after 4 weeks. During 6 months of training and subsequent 3 years of military service, 100 lower body overuse musculoskeletal injuries were diagnosed by clinicians. Frailty models indicated no difference in injury risk between vitamin D and placebo during military training (HR placebo:vitamin D = 1·23 (95 % CI 0·57, 2·66), P = 0·597) or military service (HR placebo:vitamin D = 0·94 (95 % CI 0·60, 1·46), P = 0·782). Both safe simulated sunlight and oral vitamin D3 were effective in achieving and maintaining vitamin D sufficiency in almost all. There was no clear evidence that vitamin D affects the risk of lower body overuse musculoskeletal injury during 6 months of military training or subsequent 3 years of military service.

Item Type:	Article
Uncontrolled Keywords:	Bone; Exercise; Muscle; Nutrition; Simulated sunlight; Bone; Exercise; Muscle; Nutrition; Simulated sunlight; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Complementary and Integrative Health; Clinical Trials and Supportive Activities; Dietary Supplements; Prevention; Clinical Research; Physical Injury - Accidents and Adverse Effects; Nutrition; 6.1 Pharmaceuticals; 6.7 Physical; 3 Good Health and Well Being; 0702 Animal Production; 0908 Food Sciences; 1111 Nutrition and Dietetics; Nutrition & Dietetics; 3003 Animal production; 3006 Food sciences; 3210 Nutrition and dietetics
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Sport and Exercise Sciences
Publisher:	Cambridge University Press
Date of acceptance:	27 March 2026
Date of first compliant Open Access:	11 June 2026
Date Deposited:	11 Jun 2026 08:54
Last Modified:	11 Jun 2026 08:54
DOI or ID number:	10.1017/S0007114526107107
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28806

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