Vitamin D status of British African-Caribbean residents: analysis of the UK Biobank cohort

The vitamin D status of the United Kingdom (UK) African-Caribbean (AC) population remains under-researched, despite an increased risk of vitamin D deficiency due to darker skin phenotypes and living at a high latitude. This cross-sectional study explored the vitamin D status and intake of AC individuals (n = 4046 with a valid serum 25(OH)D measurement) from the UK Biobank Cohort, aged ≥40 years at baseline (2006–2010). Over one third of the population were deficient (<25 nmol/L), 41.1% were insufficient (25–50 nmol/L) and 15.9% were sufficient (>50 nmol/L). Median (IQR) 25(OH)D was 30.0 (20.9) nmol/L. Logistic regression showed that brown/black skin phenotype, winter blood draw, not consuming oily fish and not using vitamin D supplements predicted increased odds of vitamin D deficiency, whilst older age and a summer or autumn blood draw were significantly associated with reduced odds of vitamin D deficiency. Vitamin D deficiency and insufficiency were prevalent in this AC population and is of considerable concern given the individual and societal implications of increased morbidity. Public health messaging for this group should focus on year-round vitamin D supplementation and increasing intakes of culturally appropriate vitamin D-rich foods. These data also support the urgent requirement for a revised vitamin D RNI for ethnic groups.

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Prospective associations between vitamin D and depression in middle-aged adults: findings from the UK Biobank cohort

Psychological Medicine ◽

10.1017/s0033291720003657 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Amy Ronaldson ◽

Jorge Arias de la Torre ◽

Fiona Gaughran ◽

Ioannis Bakolis ◽

Stephani L. Hatch ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D Status ◽

Uk Biobank ◽

Middle Aged ◽

Wide Range ◽

The Uk ◽

Middle Aged Adults ◽

New Onset

Abstract Background A possible role of vitamin D in the pathophysiology of depression is currently speculative, with more rigorous research needed to assess this association in large adult populations. The current study assesses prospective associations between vitamin D status and depression in middle-aged adults enrolled in the UK Biobank. Methods We assessed prospective associations between vitamin D status at the baseline assessment (2006–2010) and depression measured at the follow-up assessment (2016) in 139 128 adults registered with the UK Biobank. Results Amongst participants with no depression at baseline (n = 127 244), logistic regression revealed that those with vitamin D insufficiency [adjusted odds ratio (aOR) = 1.14, 95% confidence interval (CI) = 1.07–1.22] and those with vitamin D deficiency (aOR = 1.24, 95% CI 1.13–1.36) were more likely to develop new-onset depression at follow-up compared with those with optimal vitamin D levels after adjustment for a wide range of relevant covariates. Similar prospective associations were reported for those with depression at baseline (n = 11 884) (insufficiency: aOR = 1.11, 95% CI 1.00–1.23; deficiency: aOR = 1.30, 95% CI 1.13–1.50). Conclusions The prospective associations found between vitamin D status and depression suggest that both vitamin D deficiency and insufficiency might be risk factors for the development of new-onset depression in middle-aged adults. Moreover, vitamin D deficiency (and to a lesser extent insufficiency) might be a predictor of sustained depressive symptoms in those who are already depressed. Vitamin D deficiency and insufficiency is very common, meaning that these findings have significant implications for public health.

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Distribution of vitamin D status in the UK: a cross-sectional analysis of UK Biobank

BMJ Open ◽

10.1136/bmjopen-2020-038503 ◽

2021 ◽

Vol 11 (1) ◽

pp. e038503

Author(s):

Liang-Yu Lin ◽

Liam Smeeth ◽

Sinead Langan ◽

Charlotte Warren-Gash

Keyword(s):

Public Health ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Uk Biobank ◽

Cross Sectional ◽

Serum Vitamin D ◽

The Uk

ObjectiveNo recent large studies have described the distribution of vitamin D status in the UK. Understanding the epidemiology of vitamin D deficiency is important to inform targeted public health recommendations. This study aimed to investigate the distribution of factors associated with serum vitamin D status in a large national cohort.DesignA cross-sectional study.SettingThe UK Biobank, a prospective cohort study following the health and well-being of middle-aged and older adults recruited between 2006 and 2010.ParticipantsA total of 449 943 participants aged 40–69 years with measured serum vitamin D status were eligible for the analysis. Participants completed a questionnaire about sex, age, ethnic background, vitamin D supplementation, smoking, drinking and socioeconomic status.Primary and secondary outcome measuresWe investigated the distribution of serum vitamin D status and the association between demographic factors and vitamin D deficiency or insufficiency. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level <25 nmol/L. Multivariable logistic regression was used to assess the association between demographic factors and vitamin D status.ResultsAsian (n=4297/8000, 53.7%) and black (n=2459/7046, 34.9%) participants had a higher proportion of vitamin D deficiency than white participants (n=50 920/422 907, 12%). During spring and winter, the proportion of vitamin D deficiency was higher across the UK and higher in the north than in the south. Male sex, abnormal body mass index, non-white ethnic backgrounds, smoking and being more socioeconomically deprived were associated with higher odds of vitamin D deficiency. Increasing age, taking vitamin D supplements and drinking alcohol were associated with lower odds of deficiency.ConclusionsVitamin D status varied among different ethnic groups and by season and geographical area within the UK. Taking supplements was associated with a lower risk of vitamin D deficiency. These findings support the vitamin D supplementation recommendations of Public Health England.

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Vitamin D Status and Risk of All-Cause and Cause-Specific Mortality in a Large Cohort: Results From the UK Biobank

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa432 ◽

2020 ◽

Vol 105 (10) ◽

pp. e3606-e3619 ◽

Cited By ~ 3

Author(s):

Xikang Fan ◽

Jiayu Wang ◽

Mingyang Song ◽

Edward L Giovannucci ◽

Hongxia Ma ◽

...

Keyword(s):

Vitamin D ◽

Cancer Mortality ◽

Lower Risk ◽

Premature Death ◽

Inverse Association ◽

Vitamin D Status ◽

Uk Biobank ◽

Hydroxyvitamin D ◽

Specific Mortality ◽

The Uk

Abstract Context Although an inverse association between vitamin D status and mortality has been reported in observational studies, the precise association shape and optimal vitamin D status remain undetermined. Objective To investigate the association between vitamin D status and risk of all-cause and cause-specific mortality and estimate optimal serum 25-hydroxyvitamin D [25(OH)D] concentrations. Design Prospective cohort study. Setting UK Biobank. Participants 365 530 participants who had serum 25(OH)D measurements and no history of cardiovascular disease (CVD), cancer, or diabetes at baseline (2006-2010). Main outcome measures All-cause and cause-specific mortality. Results During a median follow-up of 8.9 (interquartile range: 8.3-9.5) years, 10 175 deaths occurred, including 1841 (18.1%) due to CVD and 5737 (56.4%) due to cancer. The multivariate analyses revealed nonlinear inverse associations, with a decrease in mortality risk appearing to level off at 60 nmol/L of 25(OH)D for all-cause and CVD deaths and at 45 nmol/L for cancer deaths. Compared to participants with 25(OH)D concentrations below the cutoffs, those with higher concentrations had a 17% lower risk for all-cause mortality (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.79-0.86), 23% lower risk for CVD mortality (HR: 0.77, 95% CI: 0.68-0.86), and 11% lower risk for cancer mortality (HR: 0.89, 95% CI: 0.84-0.95). Conclusions Higher 25(OH)D concentrations are nonlinearly associated with lower risk of all-cause, CVD, and cancer mortality. The thresholds of 45 to 60 nmol/L might represent an intervention target to reduce the overall risk of premature death, which needs further confirmation in large clinical trials.

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Baseline Vitamin D Status, Sleep Patterns, and the Risk of Incident Type 2 Diabetes in Data From the UK Biobank Study

Diabetes Care ◽

10.2337/dc20-1109 ◽

2020 ◽

Vol 43 (11) ◽

pp. 2776-2784

Author(s):

Mengying Wang ◽

Tao Zhou ◽

Xiang Li ◽

Hao Ma ◽

Zhaoxia Liang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Vitamin D ◽

Vitamin D Status ◽

Uk Biobank ◽

Sleep Patterns ◽

Incident Type ◽

Incident Type 2 Diabetes ◽

The Uk

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Vitamin D status of the African-Caribbean population globally: A Systematic Review and Meta-Analysis

10.26226/morressier.5ef37080b2a27f760262bb26 ◽

2020 ◽

Author(s):

Rebecca Vearing

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Meta Analysis ◽

Vitamin D Status ◽

African Caribbean ◽

Caribbean Population

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Implementation Strategies for Improving Vitamin D Status and Increasing Vitamin D Intake in the UK: Current Controversies and Future Perspectives. Proceedings of the 2nd Rank Prize Funds Forum on Vitamin D

British Journal Of Nutrition ◽

10.1017/s0007114521002555 ◽

2021 ◽

pp. 1-60

Author(s):

J.L. Buttriss ◽

S.A. Lanham-New ◽

S. Steenson ◽

L. Levy ◽

G.E. Swan ◽

...

Keyword(s):

Vitamin D ◽

Age Groups ◽

Implementation Strategies ◽

Vitamin D Status ◽

Cost Information ◽

Hydroxyvitamin D ◽

Minority Ethnic Groups ◽

Modelling Studies ◽

Clinical Consequences ◽

The Uk

Abstract A multi-disciplinary expert group met to discuss vitamin D deficiency in the UK, and strategies for improving population intakes and status. Changes to UK Government advice since the 1st Rank Forum on Vitamin D (2009) were discussed, including rationale for setting a RNI (10µg/day;400IU/day) for adults and children (4+ years). Current UK data show inadequate intakes among all age groups, and high prevalence of low vitamin D status among specific groups (e.g. pregnant women and adolescent males/females). Evidence of widespread deficiency within some minority ethnic groups, resulting in nutritional rickets (particularly among Black and South Asian infants), raised particular concern. It is too early to establish whether population vitamin D status has altered since Government recommendations changed in 2016. Vitamin D food fortification was discussed as a potential strategy to increase population intakes. Data from dose-response and dietary modelling studies indicate dairy products, bread, hens’ eggs and some meats as potential fortification vehicles. Vitamin D3 appears more effective than vitamin D2 for raising serum 25-hydroxyvitamin D concentration, which has implications for choice of fortificant. Other considerations for successful fortification strategies include: i) need for ‘real-world’ cost information for use in modelling work; ii) supportive food legislation; iii) improved consumer and health professional understanding of vitamin D’s importance; iv) clinical consequences of inadequate vitamin D status; v) consistent communication of Government advice across health/social care professions, and via the food industry. These areas urgently require further research to enable universal improvement in vitamin D intakes and status in the UK population.

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925Ethnic differences and determinants of vitamin D deficiency in the UK Biobank

International Journal of Epidemiology ◽

10.1093/ije/dyab168.641 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Joshua Sutherland ◽

Ang Zhou ◽

Matthew Leach ◽

Elina Hyppönen

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Asian Population ◽

European Ancestry ◽

Uk Biobank ◽

Mixed Ancestry ◽

Black African ◽

Hydroxyvitamin D ◽

The Uk ◽

Summer Time

Abstract Background While controversy remains regarding optimal vitamin D status, the public health relevance of true vitamin D deficiency is undisputed. There are few contemporary cross-ethnic studies investigating the prevalence and determinants of very low 25-hydroxyvitamin D [25(OH)D] concentrations. Methods We used data from 440,581 UK Biobank participants, of which 415,903 identified as white European, 7,880 Asian, 7,602 black African, 1,383 Chinese, and 6,473 of mixed ancestry. 25(OH)D concentrations were measured by DiaSorin Liaison XL and deficiency defined as ≤ 25 nmol/L 25(OH)D. Results The prevalence of 25(OH)D deficiency was highest among participants of Asian ancestry (57.2% in winter/spring and 50.8% in summer/autumn; followed by black African [38.47%/30.78%], mixed ancestry [36.53%/22.48%], Chinese [33.12%/20.68%] and white European [17.45%/5.90%], P < 1.0E-300). Participants with higher socioeconomic deprivation were more likely to have 25(OH)D deficiency compared to less deprived (P < 1.0E-300 for all comparisons), with the pattern being more apparent among those of white European ancestry and in summer (Pinteraction<6.4E-5 for both). In fully-adjusted analyses, regular consumption of oily fish was effective in mitigating ≤25 nmol/L 25(OH)D deficiency across all ethnicities, whilst outdoor-summer time was less effective for black Africans than white Europeans (OR: 0.89; 95% CI: 0.70, 1.12 and OR: 0.40; 95% CI: 0.38, 0.42, respectively). Conclusions Vitamin D deficiency remains an issue throughout the UK, particularly in lower socioeconomic areas and the UK Asian population, half of whom have vitamin D deficiency across seasons. Key messages The prevalence of 25(OH)D deficiency in the UK is alarming, with certain ethnic and socioeconomic groups considered particularly vulnerable.

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Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database

Nutrients ◽

10.3390/nu12061868 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1868

Author(s):

Wim Calame ◽

Laura Street ◽

Toine Hulshof

Keyword(s):

Vitamin D ◽

Daily Intake ◽

Serum Levels ◽

Vitamin D Status ◽

Nutrition Survey ◽

Breakfast Cereals ◽

Vitamin D Intake ◽

The Uk ◽

The Impact ◽

The Relationship

Vitamin D status is relatively poor in the general population, potentially leading to various conditions. The present study evaluates the relationship between vitamin D status and intake in the UK population and the impact of vitamin D fortified ready-to-eat cereals (RTEC) on this status via data from the National Diet and Nutrition Survey (NDNS: 2008–2012). Four cohorts were addressed: ages 4–10 (n = 803), ages 11–18 (n = 884), ages 19–64 (n = 1655) and ages 65 and higher (n = 428). The impact of fortification by 4.2 μg vitamin D per 100 g of RTEC on vitamin D intake and status was mathematically modelled. Average vitamin D daily intake was age-dependent, ranging from ~2.6 (age range 4–18 years) to ~5.0 μg (older than 64 years). Average 25(OH)D concentration ranged from 43 to 51 nmol/L, the highest in children. The relationship between vitamin D intake and status followed an asymptotic curve with a predicted plateau concentration ranging from 52 in children to 83 nmol/L in elderly. The fortification model showed that serum concentrations increased with ~1.0 in children to ~6.5 nmol/L in the elderly. This study revealed that vitamin D intake in the UK population is low with 25(OH)D concentrations being suboptimal for general health. Fortification of breakfast cereals can contribute to improve overall vitamin D status.

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