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

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.

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

2014 ◽  
Vol 18 (2) ◽  
pp. 208-217 ◽  
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.

Vitamin D Status in Irish Children and Adolescents

2014 ◽  
Vol 53 (14) ◽  
pp. 1345-1351 ◽  
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.

scholarly journals Determinants of changes in vitamin D status postpartum in Swedish women

2015 ◽  
Vol 115 (3) ◽  
pp. 422-430 ◽  
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.

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

2013 ◽  
Vol 17 (4) ◽  
pp. 772-779 ◽  
Author(s):  
Sarah C Wallingford ◽  
Glenville Jones ◽  
Lindsay C Kobayashi ◽  
Anne Grundy ◽  
Qun Miao ◽  
...  
Keyword(s):  
Vitamin D ◽  
White Women ◽  
Full Time ◽  
Institute Of Medicine ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Supplement Use ◽  
Tanning Bed ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

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.

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

Nutrients ◽  
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.

Using Activities of Daily Living Assessments to Measure the Effectiveness of Vitamin D Supplements in Elderly Long-Stay Patients

1987 ◽  
Vol 50 (2) ◽  
pp. 60-62 ◽  
Author(s):  
D Corless ◽  
M Ellis ◽  
E Dawson ◽  
F Fraser ◽  
S Evans ◽  
...  
Keyword(s):  
Vitamin D ◽  
Elderly Patients ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Controlled Trial ◽  
Double Blind ◽  
Hydroxyvitamin D ◽  
Low Concentrations ◽  
25 Hydroxyvitamin D ◽  
Vitamin D Supplements

Selected activities of daily living were used to measure improvement in independence of long-stay elderly patients known to have low concentrations of plasma 25-hydroxyvitamin D. This was a double-blind random controlled trial lasting between 8 and 40 weeks. No significant changes were found in either group.

scholarly journals COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1714
Author(s):  
Habiba AlSafar ◽  
William B. Grant ◽  
Rafiq Hijazi ◽  
Maimunah Uddin ◽  
Nawal Alkaabi ◽  
...  
Keyword(s):  
Vitamin D ◽  
United Arab Emirates ◽  
Blood Levels ◽  
Vitamin D Status ◽  
Hospital Visit ◽  
Serum Samples ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
Multiethnic Population ◽  
25 Hydroxyvitamin D

Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D’s plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.

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

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1801 ◽  
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.

scholarly journals Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data

2016 ◽  
Vol 20 (10) ◽  
pp. 1857-1864 ◽  
Author(s):  
Sonali Rajan ◽  
Tom Weishaar ◽  
Bryan Keller
Keyword(s):  
Vitamin D ◽  
Body Weight ◽  
Skin Colour ◽  
Vitamin D Status ◽  
Epidemiological Investigation ◽  
Dietary Recommendations ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Nationally Representative ◽  
The Impact

AbstractObjectiveCurrent US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample.DesignWe calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression.SettingNational Health and Nutrition Examination Survey (31 934 unweighted cases).SubjectsIndividuals aged 1 year and older.ResultsThere were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight.ConclusionsVitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

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