UV and dietary predictors of serum 25-hydroxyvitamin D concentrations among young shift-working nurses and implications for bone density and skin cancer

AbstractObjectiveIn 2011, the US Institute of Medicine updated the definition of vitamin D inadequacy to serum 25-hydroxyvitamin D (25(OH)D) concentration of 30–<50 nmol/l and of deficiency to serum 25(OH)D < 30 nmol/l. We describe the prevalence of these conditions according to these definitions, seasonal variation in 25(OH)D and predictors of serum 25(OH)D concentrations among working, white women.DesignParticipants recorded lifestyle factors and dietary intake and provided fasting blood samples for measurement of serum 25(OH)D in both summer and winter. Predictors of serum 25(OH)D variation were analysed using linear regression and generalized linear mixed models.SettingKingston General Hospital in Kingston, Ontario, Canada, from April 2008 to July 2009.SubjectsFemale premenopausal nurses (n83) working full-time rotating shifts.ResultsDeficient or inadequate vitamin D status was observed in 9 % of participants following summer/autumn and in 13 % following winter/spring. Predictors of serum 25(OH)D concentration were vitamin D supplement use, tanning bed use and season. Tanning bed use increased serum 25(OH)D by 23·24 nmol/l (95 % CI 8·78, 37·69 nmol/l,P= 0·002) on average.ConclusionsAccording to the 2011 Institute of Medicine bone health guidelines, over 10 % of nurses had deficient or inadequate vitamin D status following winter. Higher serum concentrations were associated with use of tanning beds and vitamin D supplements. As health promotion campaigns and legal restrictions are successful in reducing tanning bed use among women, our data suggest that increased prevalence of vitamin D inadequacy and deficiency may be a consequence, and that low vitamin D status will need to be countered with supplementation.

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Vitamin D Status and Seasonal Variation among Danish Children and Adults: A Descriptive Study

Nutrients ◽

10.3390/nu10111801 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1801 ◽

Cited By ~ 20

Author(s):

Louise Hansen ◽

Anne Tjønneland ◽

Brian Køster ◽

Christine Brot ◽

Rikke Andersen ◽

...

Keyword(s):

Vitamin D ◽

Seasonal Variation ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Supplement Use ◽

Wide Range ◽

Adults And Children ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplement ◽

Very High

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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Unzureichende Vitamin-D-Versorgung im Alter: Konsequenzen und Lösungsansätze für die Praxis

Aktuelle Ernährungsmedizin ◽

10.1055/a-1560-1998 ◽

2021 ◽

Vol 46 (06) ◽

pp. 397-400

Author(s):

Armin Zittermann

Keyword(s):

Vitamin D ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplements

ZusammenfassungVitamin D ist eine für den Menschen essenzielle Substanz, die eine zentrale Rolle bei der Regulation des Kalzium- und Phosphathaushalts spielt, aber auch für eine normale Immunfunktion und Zellteilung wichtig ist. Als essenzielle Substanz muss Vitamin D dem Körper lebenslang in ausreichender Menge zur Verfügung gestellt werden. In Deutschland liegt bei Senioren ähnlich wie in der jüngeren Allgemeinbevölkerung der Blutspiegel an 25-Hydroxyvitamin D (Indikator des Vitamin-D-Status) zu über 50 % im defizitären/insuffizienten Bereich (< 50 nmol/L), wobei die unzureichende Versorgungslage deutliche saisonale Schwankungen aufweist (41 % am Ende des Sommers und 75 % am Ende des Winters). Im klinischen Bereich können Vitamin-D-Supplemente bei Personen mit defizitärer Vitamin-D-Versorgung zu einer Reduktion des Risikos von osteoporotischen Frakturen und akuten Atemwegsinfekte beitragen sowie möglicherweise bei einigen Erkrankungen wie Asthma und chronisch obstruktiver Lungenerkrankung die Krankheitsschübe reduzieren. Ein Vitamin-D-Mangel kann in der Regel durch die tägliche Einnahme eines Vitamin-D-Supplements in Höhe von 800–1000 IE (20–25 µg) effektiv verhindert werden. Von hochdosierten, intermittierenden Vitamin-D-Gaben, die zu 25OHD-Spiegeln > 125 nmol/L führen, ist abzuraten. Vitamin-D-Tests werden im klinischen Bereich häufig zur Beurteilung der Versorgungslage von Einzelpersonen durchgeführt. Hier sind sie zur Bestätigung eines Verdachts auf eine Vitamin-D-Intoxikation hilfreich. Ansonsten sind sie aber als Screening auf einen Vitamin-D-Mangel meist unnötig und manchmal verunsichernd.

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Insufficient autumn vitamin D intake and low vitamin D status in 7-year-old Icelandic children

Public Health Nutrition ◽

10.1017/s1368980013003558 ◽

2014 ◽

Vol 18 (2) ◽

pp. 208-217 ◽

Cited By ~ 6

Author(s):

Adda Bjarnadottir ◽

Asa Gudrun Kristjansdottir ◽

Hannes Hrafnkelsson ◽

Erlingur Johannsson ◽

Kristjan Thor Magnusson ◽

...

Keyword(s):

Vitamin D ◽

Cardiorespiratory Fitness ◽

Sunlight Exposure ◽

Vitamin D Status ◽

Blood Samples ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

School Based ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplements

AbstractObjectiveThe aim was to investigate autumn vitamin D intake and status in 7-year-old Icelanders, fitting BMI and cardiorespiratory fitness as predictors.DesignThree-day food records and fasting blood samples were collected evenly from September to November, and cardiorespiratory fitness was measured with an ergometer bike. Food and nutrient intakes were calculated, and serum 25-hydroxyvitamin D (s-25(OH)D) and serum parathyroid hormone were analysed. Suboptimal vitamin D status was defined s-25(OH)D <50 nmol/l, and deficient status as s-25(OH)D <25 nmol/l.SettingSchool-based study in Reykjavik, Iceland in 2006.SubjectsOf the 7-year-olds studied (n 265), 165 returned valid intake information (62 %), 158 gave blood samples (60 %) and 120 gave both (45 %).ResultsRecommended vitamin D intake (10 μg/d) was reached by 22·4 % of the children and 65·2 % had s-25(OH)D <50 nmol/l. Median s-25(OH)D was higher for children taking vitamin D supplements (49·2 nmol/l v. 43·2 nmol/l, respectively; P < 0·0 0 1). Median s-25(OH)D was lower in November (36·7 nmol/l) than in September (59·9 nmol/l; P < 0·001). The regression model showed that week of autumn accounted for 18·9 % of the variance in s-25(OH)D (P < 0·001), vitamin D intake 5·2 % (P < 0·004) and cardiorespiratory fitness 4·6 % (P < 0·005).ConclusionsA minority of children followed the vitamin D recommendations and 65 % had suboptimal vitamin D status during the autumn. Week of autumn was more strongly associated with vitamin D status than diet or cardiorespiratory fitness, which associated with vitamin D status to a similar extent. These results demonstrate the importance of sunlight exposure during summer to prevent suboptimal vitamin D status in young schoolchildren during autumn in northern countries. An increased effort is needed for enabling adherence to the vitamin D recommendations and increasing outdoor activities for sunlight exposure.

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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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Vitamin D and Bone Health—Discussion Points Following the Recent Institute of Medicine Recommendations

US Endocrinology ◽

10.17925/use.2011.07.02.137 ◽

2011 ◽

Vol 07 (02) ◽

pp. 137 ◽

Cited By ~ 1

Author(s):

Robert P Heaney ◽

Keyword(s):

Vitamin D ◽

Bone Health ◽

Calcium Absorption ◽

Institute Of Medicine ◽

Vitamin D Status ◽

Extensive Experience ◽

Hydroxyvitamin D ◽

Daily Amount ◽

Fracture Risk Reduction ◽

25 Hydroxyvitamin D

The 2011 Institute of Medicine recommendations for vitamin D—both the recommended daily amount (RDA) and the vitamin D status judged adequate for bone health—are too low. Calcium absorption, osteoporotic fracture risk reduction, and healing of histological osteomalacia all require values above 30 ng/ml, and probably even 40 ng/ml. Furthermore, the proposed RDA (600 international units per day up to the age of 70) is not compatible with the blood level of 25-hydroxyvitamin D (i.e., 20 ng/ml) recommended in the same report. Concerns regarding adverse consequences of higher intakes or status levels can be dismissed, in view of our extensive experience with outdoor summer workers (who regularly have values of 60 ng/ml or more) and the virtual certainty that human physiology evolved in—and is attuned to—an environment providing 10,000 IU/day or more.

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Vitamin D in pregnancy at high latitude in Scotland

British Journal Of Nutrition ◽

10.1017/s0007114512002255 ◽

2012 ◽

Vol 109 (5) ◽

pp. 898-905 ◽

Cited By ~ 27

Author(s):

Paul Haggarty ◽

Doris M. Campbell ◽

Susan Knox ◽

Graham W. Horgan ◽

Gwen Hoad ◽

...

Keyword(s):

Vitamin D ◽

Dietary Intake ◽

High Latitude ◽

Maternity Hospital ◽

Hydroxyvitamin D ◽

Supplement Use ◽

The North ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplements ◽

In Pregnancy

The aims of the present study were to determine compliance with current advice on vitamin D and to assess the influence of season, dietary intake, supplement use and deprivation on vitamin D status in pregnant mothers and newborns in the north of Scotland where sunlight exposure is low. Pregnant women (n 1205) and their singleton newborns were studied in the Aberdeen Maternity Hospital (latitude 57°N) between 2000 and 2006. Plasma 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 were measured at 19 weeks of gestation in mothers and at delivery in newborns. During pregnancy, 21·0 (95 % CI 18·5, 23·5) % of women took vitamin D supplements. The median intake was 5 μg/d and only 0·6 (95 % CI 0·1, 1·0) % took the recommended 10 μg/d. Supplement use, adjusted for season, dietary intake and deprivation, significantly increased maternal 25-hydroxyvitamin D (25(OH)D) by 10·5 (95 % CI 5·7, 15·2) nmol/l (P< 0·001); however, there was no significant effect on cord 25(OH)D (1·4 (95 % CI − 1·8, 4·5) nmol/l). The biggest influence on both maternal and cord 25(OH)D was season of birth (P< 0·001). Compared with the least deprived women (top three deciles), the most deprived pregnancies (bottom three deciles) were characterised by a significantly lower seasonally adjusted 25(OH)D ( − 11·6 (95 % CI − 7·5, − 15·7) nmol/l in the mother and − 5·8 (95 % CI − 2·3, − 9·4) nmol/l in the cord), and a lower level of supplement use (10 (95 % CI 4, 17) v. 23 (95 % CI 20, 26) %). More should be done to promote vitamin D supplement use in pregnancy but the critical importance of endogenous vitamin D synthesis, and known adaptations of fat metabolism specific to pregnancy, suggest that safe sun advice may be a useful additional strategy, even at high latitude.

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Vitamin D Status in Irish Children and Adolescents

Clinical Pediatrics ◽

10.1177/0009922814541999 ◽

2014 ◽

Vol 53 (14) ◽

pp. 1345-1351 ◽

Cited By ~ 10

Author(s):

Aoife Carroll ◽

Chike Onwuneme ◽

Malachi J. McKenna ◽

Philip D. Mayne ◽

Eleanor J. Molloy ◽

...

Keyword(s):

Vitamin D ◽

Cross Sectional Study ◽

Healthy Children ◽

Vitamin D Status ◽

Formula Milk ◽

Cross Sectional ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

The Mean ◽

Vitamin D Supplements

Background. Vitamin D has important skeletal and extraskeletal roles but those living at northerly latitudes are at risk of suboptimal levels because of reduced sunlight exposure. Aim. To describe the vitamin D status of Irish children and identify factors predictive of vitamin D status. Methods. A prospective cross sectional study was undertaken over a 12 month period. Two hundred and fifty two healthy children attending for minor medical or surgical procedures were recruited. All had 25-hydroxyvitamin D (25OHD), parathyroid hormone and bone profiles measured. Results. The mean (standard deviation) for 25OHD was 51(25) nmol/L (20.4 (10) ng/mL). Forty-five percent had levels >50 nmol/L (20 ng/mL). The following variables were significantly associated with 25OHD levels >50 nmol/L (20 ng/mL): sample drawn in April-September, use of vitamin D supplements, consumption of formula milk, and non-African ethnicity. Conclusion. More than half of the children in this study had 25OHD levels less than 50 nmol/L (20 ng/mL). Vitamin D status was significantly improved by augmented oral vitamin D intake.

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Determinants of changes in vitamin D status postpartum in Swedish women

British Journal Of Nutrition ◽

10.1017/s0007114515004560 ◽

2015 ◽

Vol 115 (3) ◽

pp. 422-430 ◽

Cited By ~ 5

Author(s):

Petra Brembeck ◽

Anna Winkvist ◽

Mari Bååth ◽

Linnea Bärebring ◽

Hanna Augustin

Keyword(s):

Vitamin D ◽

Sun Exposure ◽

Activity Level ◽

Vitamin D Status ◽

Maternal Vitamin ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Food Diaries ◽

Main Determinants ◽

Vitamin D Supplements

AbstractLow vitamin D status has been associated with unfavourable health outcomes. Postpartum, it is speculated that maternal vitamin D status decreases due to transfer of vitamin D from mother to child through breast milk. A few studies have investigated changes in maternal vitamin D postpartum and possible determinants. Thus, the aims of the present study were to determine changes in serum concentrations of 25-hydroxyvitamin D (25(OH)D) between 2 weeks and 12 months postpartum in Swedish women and to evaluate lactation and other determinants for changes in 25(OH)D concentration postpartum. In total, seventy-eight women were studied at 2 weeks, 4 months and 12 months postpartum. Data collection included measurements of weight and height as well as information about lactation, sun exposure, use of oestrogen contraceptives and physical activity level. Blood samples were collected and serum 25(OH)D levels were analysed using liquid chromatography-tandem MS. Dietary intake of vitamin D was recorded using 4-d food diaries. For all the women studied, mean serum 25(OH)D did not change between 2 weeks and 12 months postpartum (67 (sd 23) v. 67 (sd 19) nmol/l). No association was found between lactation and changes in serum 25(OH)D concentration postpartum. Significant determinants for postpartum changes in 25(OH)D concentration were use of vitamin D supplements (P=0·003), use of oestrogen contraceptives (P=0·013) and season (P=0·005). In conclusion, no changes were observed in 25(OH)D concentrations during the 1st year postpartum in these women and no association was found between lactation and changes in 25(OH)D concentration postpartum. The main determinants for the variation in changes in 25(OH)D concentrations postpartum were use of vitamin D supplements, use of oestrogen contraceptives and season.

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Racial and seasonal differences in 25-hydroxyvitamin D detected in maternal sera frozen for over 40 years

British Journal Of Nutrition ◽

10.1017/s0007114508981460 ◽

2008 ◽

Vol 101 (2) ◽

pp. 278-284 ◽

Cited By ~ 44

Author(s):

Lisa M. Bodnar ◽

Janet M. Catov ◽

Katherine L. Wisner ◽

Mark A. Klebanoff

Keyword(s):

Vitamin D ◽

White Women ◽

Vitamin D Status ◽

Linear Regression Models ◽

Fetal Origins ◽

Hydroxyvitamin D ◽

Cohort Differences ◽

Significant Difference ◽

25 Hydroxyvitamin D ◽

Confounder Adjustment

Serum banks from large, decades-old epidemiological studies provide a valuable opportunity to explore the contributions ofin uterovitamin D exposure to fetal origins of adult diseases. We compared 25-hydroxyvitamin D (25(OH)D) by race and season (two powerful predictors of vitamin D status) in sera frozen for ≥ 40 years with sera frozen for ≤ 2 years to determine whether 25(OH)D is stable enough to test vitamin D-related hypotheses. Data and sera came from seventy-nine pregnant women at 29–32 weeks' gestation in the Boston Collaborative Perinatal Project (CPP; 1959–66) and 124 women at 20–36 weeks' gestation in a 2003–2006 Pittsburgh cohort study. Multivariable linear regression models were used to test main and joint effects of race and season after confounder adjustment. In both cohorts, serum 25(OH)D levels were lower among black than white women (CPP 33·3v.46·7 nmol/l,P < 0·01; Pittsburgh 47·1v.89·6 nmol/l;P < 0·0001) and in winter than summer (CPP 32·7v.47·6 nmol/l,P < 0·0001; Pittsburgh 66·7v.89·8 nmol/l,P < 0·001), with no evidence of a race × season interaction in either cohort. Differences remained significant after confounder adjustment. When CPP and Pittsburgh results were compared, there was no significant difference in the race or season effects. The similarity in the relative change in 25(OH)D in these cohorts by two powerful predictors of vitamin D status suggests that, even if 25(OH)D deteriorated somewhat, it did so similarly across samples. Therefore, trends could be obtained from the decades-old serum data that would be relevant in exploring vitamin D-related hypotheses in future studies.

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Comparison of Vitamin D and 25-Hydroxyvitamin D Concentrations in Human Breast Milk between 1989 and 2016–2017

Nutrients ◽

10.3390/nu13020573 ◽

2021 ◽

Vol 13 (2) ◽

pp. 573

Author(s):

Naoko Tsugawa ◽

Mayu Nishino ◽

Akiko Kuwabara ◽

Honami Ogasawara ◽

Maya Kamao ◽

...

Keyword(s):

Vitamin D ◽

Breast Milk ◽

Sun Exposure ◽

Stepwise Multiple Regression ◽

Human Breast Milk ◽

Vitamin D Status ◽

Human Breast ◽

Hydroxyvitamin D ◽

Lactating Mothers ◽

25 Hydroxyvitamin D

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D3 concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.

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