Predictors of vitamin D-containing supplement use in Australia and associations between dose and vitamin D status

The aim of the present study was to describe vitamin D status and seasonal variation in the general Danish population. In this study, 3092 persons aged 2 to 69 years (2565 adults, 527 children) had blood drawn twice (spring and autumn) between 2012 and 2014. A sub-sample of participants had blood samples taken monthly over a year. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by liquid chromatography mass spectrometry, and information on supplement use was assessed from questionnaires. Seasonal variations in 25(OH)D concentrations were evaluated graphically and descriptively, and status according to age, sex, and supplement use was described. It was found that 86% of both adults and children were vitamin D-sufficient in either spring and or/autumn; however, many had a spring concentration below 50 nmol/L. A wide range of 25(OH)D concentrations were found in spring and autumn, with very low and very high values in both seasons. Among adults, women in general had higher median 25(OH)D concentrations than men. Furthermore, vitamin D supplement use was substantial and affected the median concentrations markedly, more so during spring than autumn. Seasonal variation was thus found to be substantial, and bi-seasonal measurements are vital in order to capture the sizable fluctuations in vitamin D status in this Nordic population.

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Vitamin D status in Greenland is influenced by diet and ethnicity: a population-based survey in an Arctic society in transition

British Journal Of Nutrition ◽

10.1017/s0007114512002097 ◽

2012 ◽

Vol 109 (5) ◽

pp. 928-935 ◽

Cited By ~ 22

Author(s):

Stig Andersen ◽

Peter Laurberg ◽

Bodil Hvingel ◽

Kent Kleinschmidt ◽

Lene Heickendorff ◽

...

Keyword(s):

Vitamin D ◽

Population Based ◽

The Arctic ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Supplement Use ◽

Median Plasma ◽

Dietary Transition ◽

Societal Changes ◽

Item Scores

Vitamin D status as measured by plasma 25-hydroxyvitamin D (25(OH)D) is important to human health. Circumpolar people rely on dietary sources and societal changes in the Arctic are having profound dietary effects. The objective of the present study was to determine plasma 25(OH)D status and factors important to plasma 25(OH)D in populations in Greenland. Inuit and non-Inuit aged 50–69 years in the capital in West Greenland (latitude 64°15′N) and in a major town and remote settlements in East Greenland (latitude 65°35′N) were surveyed. Supplement use and lifestyle factors were determined by questionnaires. Inuit food scores were computed from a FFQ of seven traditional Inuit and seven imported food items. 25(OH)D2 and 25(OH)D3 levels were measured in the plasma. We invited 1 % of the population of Greenland, and 95 % participated. 25(OH)D3 contributed 99·7 % of total plasma 25(OH)D. Non-Inuit had the lowest median plasma 25(OH)D of 41 (25th–75th percentile 23–53) nmol/l compared with 64 (25th–75th percentile 51–81) nmol/l in Inuit (P< 0·001). Plasma 25(OH)D was below 20 and 50 nmol/l in 13·8 and 60·1 % of participants, respectively, with Inuit food item scores below 40 % (P< 0·001), and in 0·2 and 25·0 % of participants, respectively, with higher scores (P< 0·001). The Inuit diet was an important determinant of plasma 25(OH)D (P< 0·001) and its effect was modified by ethnicity (P= 0·005). Seal (P= 0·005) and whale (P= 0·015) were major contributors to plasma 25(OH)D. In conclusion, a decrease in the intake of the traditional Inuit diet was associated with a decrease in plasma 25(OH)D levels, which may be influenced by ethnicity. The risk of plasma 25(OH)D deficiency in Arctic populations rises with the dietary transition of societies in Greenland. Vitamin D intake and plasma 25(OH)D status should be monitored.

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The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use

American Journal of Clinical Nutrition ◽

10.3945/ajcn.111.013268 ◽

2011 ◽

Vol 94 (1) ◽

pp. 128-135 ◽

Cited By ~ 150

Author(s):

Susan J Whiting ◽

Kellie A Langlois ◽

Hassanali Vatanparast ◽

Linda S Greene-Finestone

Keyword(s):

Vitamin D ◽

Vitamin D Status ◽

Supplement Use ◽

Dietary Reference Intakes

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Geographical differences in vitamin D status, with particular reference to European countries

Proceedings of The Nutrition Society ◽

10.1079/pns2003297 ◽

2003 ◽

Vol 62 (4) ◽

pp. 813-821 ◽

Cited By ~ 133

Author(s):

Lars Ovesen ◽

Rikke Andersen ◽

Jette Jakobsen

Keyword(s):

Vitamin D ◽

Low Frequency ◽

The Elderly ◽

Food Sources ◽

Natural Food ◽

Food Fortification ◽

Vitamin D Status ◽

Geographical Differences ◽

Hydroxyvitamin D ◽

Supplement Use

Vitamin D is produced endogenously when the skin is exposed to sunlight and can be obtained exogenously from a few natural food sources, from food fortification and from supplements. Generally, vitamin D intake is low ≤2–3 μg/d in Europe. Casual exposure to sunlight is thought to provide most of the vitamin D requirement of the human population. However, skin synthesis of vitamin D may not compensate for the low nutritional intake in Europe, even in countries with high supplies from food fortification and supplements. For assessment of vitamin D nutritional status the concentration of 25-hydroxyvitamin D (25(OH)D) in serum is considered to be an accurate integrative measure reflecting an individual's dietary intake and cutaneous production. A substantial percentage of the elderly and adolescents in Europe have a low concentration of 25(OH)D; in the elderly this percentage ranges from approximately 10 in the Nordic countries to approximately 40 in France. Low vitamin D status seems to be aggravated by disease and immobility, and by a low frequency of supplement use.

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The Association between 25-Hydroxyvitamin D Concentration and Disability Trajectories in Very Old Adults: The Newcastle 85+ Study

Nutrients ◽

10.3390/nu12092742 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2742 ◽

Cited By ~ 1

Author(s):

Sarah Hakeem ◽

Nuno Mendonca ◽

Terry Aspray ◽

Andrew Kingston ◽

Carmen Ruiz-Martin ◽

...

Keyword(s):

Vitamin D ◽

Cognitive Status ◽

Vitamin D Status ◽

Very Old ◽

Old Adults ◽

Hydroxyvitamin D ◽

Supplement Use ◽

Major Predictor ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplement

Background: Low vitamin D status is common in very old adults which may have adverse consequences for muscle function, a major predictor of disability. Aims: To explore the association between 25-hydroxyvitamin D [25(OH)D] concentrations and disability trajectories in very old adults and to determine whether there is an ‘adequate’ 25(OH)D concentration which might protect against a faster disability trajectory. Methodology: A total of 775 participants from the Newcastle 85+ Study for who 25(OH)D concentration at baseline was available. Serum 25(OH)D concentrations of <25 nmol/L, 25–50 nmol/L and >50 nmol/L were used as cut-offs to define low, moderate and high vitamin D status, respectively. Disability was defined as difficulty in performing 17 activities of daily living, at baseline, after 18, 36 and 60 months. Results: A three-trajectory model was derived (low-to-mild, mild-to-moderate and moderate-to-severe). In partially adjusted models, participants with 25(OH)D concentrations <25 nmol/L were more likely to have moderate and severe disability trajectories, even after adjusting for sex, living in an institution, season, cognitive status, BMI and vitamin D supplement use. However, this association disappeared after further adjustment for physical activity. Conclusions: Vitamin D status does not appear to influence the trajectories of disability in very old adults.

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Cross-sectional evaluation of the relationship between vitamin D status and supplement use across levels of kidney function in adults

BMJ Open ◽

10.1136/bmjopen-2018-022471 ◽

2019 ◽

Vol 9 (2) ◽

pp. e022471 ◽

Cited By ~ 1

Author(s):

Linda W Moore ◽

Wadi N Suki ◽

Keri E Lunsford ◽

Omaima M Sabek ◽

Richard J Knight ◽

...

Keyword(s):

Vitamin D ◽

Kidney Function ◽

Secondary Outcome ◽

Intact Parathyroid Hormone ◽

Vitamin D Status ◽

Cross Sectional ◽

Specific Alkaline Phosphatase ◽

Bone Specific Alkaline Phosphatase ◽

Supplement Use ◽

25Ohd Concentration

ObjectivesThe objective of this study was to assess vitamin D status of US non-pregnant adults using a standardised assay across 15 mL/min/1.73 m2increments of kidney function, report the use of dietary supplements containing vitamin D and assess relationships between vitamin D and markers of bone resorption.DesignThis study is a cross-sectional evaluation.SettingThe study is from the US National Health and Nutrition Evaluation Survey in 2001–2012.ParticipantsThe participants were non-institutionalised, non-pregnant adults, age ≥20 years.Primary and secondary outcome measuresThe primary outcome measure was serum 25OHD evaluated using liquid chromatography-tandem mass spectroscopy traceable to international reference standards. Secondary outcome measures were use of dietary supplements containing vitamin D and the serum intact parathyroid hormone and bone-specific alkaline phosphatase in a subset of participants.ResultsThe median 25OHD concentration in 27 543 US non-pregnant adults was 25.7 ng/mL (range, 2.2–150.0 ng/mL). Vitamin D supplements were used by 38.0%; mean (SE)=757 (43) international units/day. The range of 25OHD concentration across groups, stratified by kidney function, was 23.0–28.1 ng/mL. The lowest concentration of 25OHD observed was in people with higher kidney function (23.0 ng/mL for estimated glomerular filtration rate >105 mL/min/1.73 m2). Only 24% of people not taking a dietary supplement had a 25OHD concentration >30 ng/mL. Serum intact parathyroid hormone inversely correlated with 25OHD within all kidney function groups. Bone-specific alkaline phosphatase was also negatively associated with 25OHD concentration.ConclusionsThese data indicate that 25OHD concentrations and supplement use may be suboptimal in a significant proportion of the population, across all kidney function levels. The response of bone resorption markers further suggests that 25OHD levels could be improved. Together, these data support a re-evaluation of the 25OHD concentration associated with health in adults.

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Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study

British Journal Of Nutrition ◽

10.1017/s0007114509297236 ◽

2009 ◽

Vol 102 (6) ◽

pp. 876-881 ◽

Cited By ~ 152

Author(s):

Valerie A. Holmes ◽

Maria S. Barnes ◽

H. Denis Alexander ◽

Peter McFaul ◽

Julie M. W. Wallace

Keyword(s):

Vitamin D ◽

Longitudinal Study ◽

Pregnant Women ◽

Hypovitaminosis D ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Maternal Vitamin ◽

Hydroxyvitamin D ◽

Supplement Use

Maternal vitamin D insufficiency is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes. Whilst maternal vitamin D insufficiency is common in mothers with highly pigmented skin, little is known about vitamin D status of Caucasian pregnant women. The aim was to investigate vitamin D status in healthy Caucasian pregnant women and a group of age-matched non-pregnant controls living at 54–55°N. In a longitudinal study, plasma 25-hydroxyvitamin D (25(OH)D) was assessed in ninety-nine pregnant women at 12, 20 and 35 weeks of gestation, and in thirty-eight non-pregnant women sampled concurrently. Plasma 25(OH)D concentrations were lower in pregnant women compared to non-pregnant women (P < 0·0001). Of the pregnant women, 35, 44 and 16 % were classified as vitamin D deficient (25(OH)D < 25 nmol/l), and 96, 96 and 75 % were classified as vitamin D insufficient (25(OH)D < 50 nmol/l) at 12, 20 and 35 weeks gestation, respectively. Vitamin D status was higher in pregnant women who reported taking multivitamin supplements at 12 (P < 0·0001), 20 (P = 0·001) and 35 (P = 0·001) weeks gestation than in non-supplement users. Vitamin D insufficiency is evident in pregnant women living at 54–55°N. Women reporting use of vitamin D-containing supplements had higher vitamin D status, however, vitamin D insufficiency was still evident even in the face of supplement use. Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture.

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Vitamin D status and intake of lactating Inuit women living in the Canadian Arctic

Public Health Nutrition ◽

10.1017/s1368980017004189 ◽

2018 ◽

Vol 21 (11) ◽

pp. 1988-1994 ◽

Cited By ~ 1

Author(s):

Jessy El Hayek Fares ◽

Hope A Weiler

Keyword(s):

Vitamin D ◽

First Nations ◽

Late Summer ◽

The Arctic ◽

Vitamin D Status ◽

Traditional Foods ◽

Remote Communities ◽

International Polar Year ◽

Cross Sectional ◽

Supplement Use

AbstractObjectiveTo determine the prevalence and correlates of healthy vitamin D status in lactating Inuit women living in remote regions of the Arctic.DesignCross-sectional.SettingHouseholds were selected randomly in thirty-six communities of Nunavut, Nunatsiavut and Inuvialuit Settlement Region. Dietary intake was assessed using a 24 h recall and an FFQ. Anthropometric measurements, household living conditions, supplement use and health status were assessed. In fasting samples, serum 25-hydroxyvitaimn D (25(OH)D) was measured using a chemiluminescent assay (LIAISON; Diasorin Inc.).SubjectsLactating Inuit women participating in the 2007–2008 International Polar Year Inuit Health Survey conducted in the months of August to October.ResultsAmong participants (n34), 8·8, 26·5 and 50·0 % had 25(OH)D concentrations at or above 75, 50 and 40 nmol/l, respectively. More than one-third of participants did not consume traditional foods during the previous day and only 11·3 % of total energy intake was derived from traditional foods. Only 14·7 % of the sample consumed the daily number of milk servings recommended by Canada’s Food Guide (two servings) for First Nations, Inuit and Métis. Using multivariable logistic regression to examine 25(OH)D≥40 nmol/l, only higher body fat was inversely correlated with 25(OH)D concentration.ConclusionsThe present study is the first to assess simultaneously vitamin D status and other known factors that affect it among lactating Inuit women living in remote communities in the Arctic. Healthy maternal vitamin D status was observed in 25 % of participants during the late summer and early autumn. This requires further assessment in a larger sample spanning more seasons.

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The association between maternal body weight and vitamin D status in early pregnancy: findings from the MO-VITD study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120005352 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Raghad Alhomaid ◽

Maria Mulhern ◽

Laura Cassidy ◽

Eamon Laird ◽

Martin Healy ◽

...

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Early Pregnancy ◽

Normal Weight ◽

Mass Spectrometry Data ◽

Total Serum ◽

Vitamin D Status ◽

Double Blind ◽

Supplement Use ◽

Health And Social Care

AbstractMaternal BMI has been shown to be inversely correlated with vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations) during pregnancy. Pregnant women with obesity and with vitamin D deficiency are at risk of many adverse health outcomes in pregnancy.The aim of this study was to examine differences in maternal vitamin D status across normal weight, overweight and obese pregnant women in early pregnancy.Data collected at baseline from a double-blind randomised vitamin D intervention study (MO-VITD) were used. Pregnant women without pregnancy complications, aged > 18 years and having a singleton pregnancy were recruited between January 2016 and August 2017 at antenatal clinics in the Western Health and Social Care Trust, Northern Ireland. Non-fasting blood samples were collected at 12 weeks gestation and analysed for total serum 25(OH)D, using liquid chromatography tandem mass spectrometry. Data from 239 pregnant women (80 normal weight, 79 overweight, 80 obese) were included in the current analysis.The mean ± SD 25(OH)D concentration of all pregnant women at 12 weeks gestation was 52.0 ± 21.6 nmol/L. Women classed as obese or overweight had significantly lower 25(OH)D concentrations compared to women of normal weight (48.8 ± 20.3 vs 49.8 ± 20.4 vs. 57.5 ± 23.1 nmol/L, P = 0.019; obese, overweight, normal weight respectively). A total of 45% of all pregnant women were found to be either vitamin D deficient (25(OH)D < 25nmol/L; 13%) or insufficient (25–50 nmol/L; 32%) in early pregnancy. BMI was significantly negatively correlated with 25(OH)D concentrations (r = -0.168; P = 0.009). Regression analyses showed that BMI (β = -0.165; P = 0.006), season (β = 0.220; P = < 0.0001), supplement use (β = -0.268; P < 0.0001) and a sun holiday within the previous 6 months (β = -0.180; P = 0.010) were significant predictors of 25(OH)D concentrations. In early pregnancy, 62% of pregnant women reported using a supplement containing vitamin D and 38% reported no supplement use. Supplement users had a significantly higher vitamin D status than non-supplement users in all BMI categories but overall, 37% of supplement users were still classified as vitamin D insufficient. Vitamin D status was significantly lower in winter months compared to summer months. In early pregnancy, especially during winter months, pregnant women with obesity, particularly non-supplement users, are at higher risk of low vitamin D status. Based on the lower vitamin D status observed in early pregnancy in obese women, the effect of BMI on vitamin D supplementation throughout pregnancy needs to be examined.

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OSTEOSARCOPENIC OBESITY AND VITAMIN D IN U.S. ADULTS AGES 50 AND OLDER: A CROSS-SECTIONAL STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.1789 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S481-S481

Author(s):

Barbara S Saltzman ◽

Kevin C Kenney

Keyword(s):

Older Adults ◽

Vitamin D ◽

Multinomial Logistic Regression ◽

Serum Vitamin ◽

Vitamin D Status ◽

Mineral Density ◽

Cross Sectional ◽

Serum Vitamin D ◽

Supplement Use ◽

Osteosarcopenic Obesity

Abstract Osteosarcopenic Obesity (OSO) is the concurrent presence of obesity (excess body fat), sarcopenia (low muscle mass) and osteoporosis (low bone mineral density). Low levels of serum vitamin D (vitD) have been associated with each disease and their simultaneous presence. We examined this association in adults aged ≥50 years from the 2001-2006 survey cycles of the National Health and Nutrition Examination Survey (NHANES) (N=3791). SAS v9.4 complex survey procedures were used. Demographics and vitD status were compared across OSO components (0,1,2,3) by chi-squared tests and ANOVAs. Odds ratios and 95% confidence intervals for the association between vitD status and increasing number of OSO components were calculated using multinomial logistic regression (alpha=0.05). The mean age was 65.0 years (30% were older adults ≥ 65), 45.6% were female, and prevalences for obesity, osteoporosis, sarcopenia and OSO were 84.7%, 8.0%, 16.3%, and 1.8%, respectively. Additionally, 30.9% of the sample was vitD deficient. After adjusting for supplement use, and race, women with 1 or 2, and men with 1,2 or 3 OSO components were more likely to be vitD deficient than sufficient, compared to those with none [women: 2.8(1.4-5.7), 2.1(1.4-6.8), and men: 2.3 (1.5-3.6), 3.5(2.1-5.9) and 6.3(1.0-38.5), respectively]. Vitamin D status was associated with having one or two OSO components in women, and OSO and components in men, after adjusting for supplement use, sex, and race. These results suggest it is important to consider obesity, osteoporosis, and sarcopenia jointly with respect to vitamin D status in the chronic disease management of aging and older adults.

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