scholarly journals Vitamin D intake and status in a representative sample of Greek adults

2019 ◽  
Author(s):  
Ιωάννης Δημακόπουλος

Παγκοσμίως ο επιπολασμός της έλλειψης βιταμίνης D στον ορό είναι ιδιαίτερα αυξημένος. Υπολογίζεται πως 1 δισεκατομμύριο άνθρωποι έχουν χαμηλή συγκέντρωση βιταμίνης D στον ορό. Ακόμα και σε χώρες της Μεσογείου, όπως η Ελλάδα, όπου η ηλιοφάνεια είναι αυξημένη, παρατηρείται αυξημένος επιπολασμός και χαμηλά επίπεδα βιταμίνης D στον ορό. Ακόμη, σε παγκόσμιο επίπεδο, παρατηρείται χαμηλή πρόσληψη βιταμίνης D από την τροφή καθώς και από συμπληρώματα διατροφής. Η έλλειψη βιταμίνης D μπορεί να επιδράσει σημαντικά στη σκελετική υγεία σε όλες τις ηλικιακές ομάδες, όπως για παράδειγμα με ραχιτισμό στους ανήλικους καθώς επίσης και να αυξήσει την πιθανότητα για οστεομαλακία, οστεοπενία και οστεοπόρωση στους ενήλικες. Επιπρόσθετα, την τελευταία δεκαετία αρκετές μελέτες έχουν συσχετίσει την έλλειψη βιταμίνης D και με άλλες παθήσεις, και η σχέση τους ερευνάται. Παραδείγματα αποτελούν η πιθανή σχέση μεταξύ της βιταμίνης D και χρόνιων ασθενειών όπως η παχυσαρκία, ο σακχαρώδης διαβήτης, τα αυτοάνοσα νοσήματα, τα καρδιαγγειακά νοσήματα και ο καρκίνος. Ακόμη, σχετίζεται με αυξημένη θνησιμότητα ανεξαρτήτου αιτίας. Στόχοι: Δεδομένα από αντιπροσωπευτικό δείγμα του πληθυσμού της Ελλάδας, άνω των 18 ετών, από την Πανελλαδική Μελέτη Διατροφής και Υγείας χρησιμοποιήθηκαν σε αυτή τη διδακτορική διατριβή. Κύριος στόχος της διατριβής ήταν η καταγραφή του επιπολασμού έλλειψης βιταμίνης D στον ορό στον ενήλικο πληθυσμό της Ελλάδας καθώς επίσης και η συσχέτιση του με τους πιθανούς παράγοντες που επηρεάζουν τα επίπεδα της. Δευτερεύων στόχος ήταν η καταγραφή της πρόσληψης βιταμίνης D από την τροφή και η σύγκριση αυτών των επιπέδων με το Estimated Average Requirement καθώς και το Recommended Dietary Intake. Τέλος, διερευνήθηκε πώς ένα θεωρητικό παράδειγμα εμπλουτισμού τροφίμου με βιταμίνη D θα βοηθούσε στην αύξηση διατροφικής πρόσληψης βιταμίνης D καθώς και πως θα βελτιωνόταν η πρόσληψη βιταμίνης D από την τροφή σε σύγκριση με τις συστάσεις. Μεθοδολογία: Αντιπροσωπευτικό δείγμα 3773 ενηλίκων ηλικίας ≥18 ετών από την πλειοψηφία των νομών της χώρας χρησιμοποιήθηκε για αυτή τη μελέτη. Η επιλογή των εθελοντών έγινε τυχαιοποιημένα, σε συνεργασία με την Ελληνική Στατιστική Αρχή μετά από στρωματοποιημένη δειγματοληψία. Η Πανελλαδική Μελέτη Διατροφής και Υγείας εφάρμοσε πληθώρα ερωτηματολογίων στους εθελοντές, τα περισσότερα από τα οποία συμπληρώνονταν με τη βοήθεια ερευνητή. Οι μετρήσεις που πραγματοποιήθηκαν έγιναν από εξειδικευμένο και εκπαιδευμένο με βάση το πρωτόκολλο της μελέτης επιστημονικό προσωπικό. Για τη συγκεκριμένη διδακτορική διατριβή και ανάλυση χρησιμοποιήθηκαν δεδομένα από: (1) Εξετάσεις αίματος (βιταμίνη D, παραθυρεοειδής ορμόνη, ασβέστιο, κτλ.), (2) ερωτηματολόγιο έκθεσης στον ήλιο, (3) Δυο ανακλήσεις 24ώρου ανά εθελοντή με βάση την Automated Multiple-Pass Method και με τη χρήση Computer Assisted Personal Interview, (4) Ερωτηματολόγιο λήψης φαρμάκων και συμπληρωμάτων διατροφής και (5) Ανθρωπομετρικές μετρήσεις. Για την ανάλυση των δεδομένων από τις ανακλήσεις 24ώρου χρησιμοποιήθηκε η διεθνώς αποδεκτή μεθοδολογία για την εκτίμηση των εθελοντών που υπό- ή υπέρ-αναφέρουν τη διατροφική τους πρόσληψη (misreporters) καθώς επίσης και μεθοδολογία για τον υπολογισμό της συνήθους πρόσληψης των εθελοντών (Usual intake estimation). Αποτελέσματα: Η διάμεσος πρόσληψη βιταμίνης D στον ορό ήταν 16.72 ng/ml για το σύνολο του δείγματος, 16.67 ng/ml για του άνδρες και 16.74 ng/ml για τις γυναίκες, χωρίς να παρατηρούνται στατιστικά σημαντικές διαφορές μεταξύ των δυο φύλων (P=0.923). Οι πιθανότητες να έχουν συγκέντρωση 25(ΟΗ)D στον ορό μικρότερη των 20 ng/ml μειωνόταν σημαντικά σε εκείνους που ήταν πολύ δραστήριοι (OR 0.55, 95% CI 0.35, 0.98), που είχαν αυξανόμενη έκθεση στον ήλιο 1-3 ώρες / CI 0.44, 0.80), >3 ώρες / ημέρα (OR 0.36, 95% CI 0.24, 0.55) και χρώμα δέρματος ανοιχτόχρωμο ή μέτρια ανοιχτόχρωμο (OR 0.47, 95% CI 0.24, 0.91), ελαφρώς σκουρόχρωμο (0.34, 95% CI 0.17, 0.67) και σκουρόχρωμο ή πολύ σκούρο χρώμα δέρματος (OR 0.34, 95% CI 0.15, 0.75), σε σύγκριση με τα αντίστοιχα επίπεδα σύγκρισης. Οι πιθανότητες αυξήθηκαν σημαντικά με την παχυσαρκία (OR 1.95, 95% CI 1.24, 3.08) και την άνοιξη ως περίοδο συλλογής δείγματος στο αίμα (OR 1.75, 95% CI 1.22, 2.50). Οι παραπάνω μετρήσεις στον ορό πραγματοποιήθηκαν σε υποδείγμα 1084 ατόμων του ενήλικου πληθυσμού της μελέτης όπου πραγματοποιήθηκαν και οι εξετάσεις αίματος. Η διάμεσος πρόσληψη βιταμίνης D από τα τρόφιμα κυμάνθηκε από 1.16-1.72 mcg/ημέρα και 1.01-1.26 ανάλογα με την ηλικιακή ομάδα και το φύλο. Σημαντικές πηγές της βιταμίνης D από την τροφή ήταν τα ψάρια (46%), το κρέας (15%) και τα δημητριακά (12%). Ωστόσο, το 90% του πληθυσμού σε όλες τις ηλικιακές ομάδες δεν πληρούσε το Estimated Average Requirement για τη βιταμίνη D. Ο εμπλουτισμός τροφίμου/ τροφίμων με βιταμίνη D αποτελεί μια πολιτική υγείας που, αν εφαρμοστεί, θα μπορούσε να μειώσει σημαντικά το ποσοστό εκείνων που προσλαμβάνουν βιταμίνη D από την τροφή λιγότερη από το Estimated Average Requirement και κατά συνέπεια να βελτιώσει και τον επιπολασμό επιπέδων βιταμίνης D <20 ng/ml στον ορό.Συμπεράσματα: Η ανεπάρκεια της βιταμίνης D είναι ιδιαίτερα αυξημένη στον ενήλικο πληθυσμό της Ελλάδας. Σχετικές πολιτικές δημόσιας υγείας συνιστώνται ιδιαίτερα, οι οποίες θα μπορούσαν να περιλαμβάνουν την ενίσχυση της βιταμίνης D καθώς και πρόταση για αυξημένη, αλλά ασφαλή έκθεση στον ήλιο. Οι πολιτικές δημόσιας υγείας για την αύξηση της κατανάλωσης τροφίμων με υψηλή περιεκτικότητα σε βιταμίνη D ή/ και τον εμπλουτισμό των τροφίμων μπορούν να μειώσουν σημαντικά το ποσοστό των ατόμων που δεν πληρούν τις συστάσεις καθώς και εκείνων που έχουν χαμηλά επίπεδα βιταμίνης D στον ορό.

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 790-790
Author(s):  
Sarah Montgomery ◽  
Angella Lee ◽  
Nasime Sarbar ◽  
Deborah Zibrik ◽  
Yvonne Lamers

Abstract Objectives To assess maternal dietary intake and adequacy at postpartum and to determine whether lifestyle characteristics and breastfeeding status are related to nutrient intakes. Methods We analyzed cross-sectional data from a convenience sample of 129 mothers at 18-mo postpartum, whose families were enrolled into a randomized toddler intervention trial, in the Lower Mainland, British Columbia, Canada. The Canadian Diet History Questionnaire II (C-DHQ II) was used to estimate usual dietary intake in the mothers during the preceding 12 months (i.e., between 6- to 18-mo postpartum). Implausible energy intakes were defined as &lt;600 kcal/day or &gt;3500 kcals/day, and excluded from analysis. Demographic and lifestyle characteristic data about the pregnancy and postpartum time period were collected using a questionnaire. Results Maternal mean (SD) age at birth was 33.5 (4.0) years and most women were of European (46%) or Asian (38%) ethnicity, and had Bachelor's degree or higher education (70%). About 75%, 88%, and 89% did not meet their dietary requirements (i.e., intake below the EAR) for fiber, potassium, and vitamin D intakes, from food only, respectively. Considering total dietary intake from food and supplements, the prevalence of dietary vitamin D inadequacy was 25%. Women of European ethnicity had higher vitamin D intake (median (IQR) in mg/1000kcal/day: 19.5 (7.26,101)) compared to Asian women (10.8 (3.87, 21.1); P &lt; 0.05). Dietary vitamin D intake was higher in breastfeeding (i.e., providing breastmilk as primary milk source, i.e., ³2 times/day, to their 18-mo old toddlers) compared to non- or occasionally breastfeeding mothers (20.0 (10.5, 61.1) versus 14.9 (4.28, 26.7) mg/1000kcal/day; P &lt; 0.05). Conclusions While most Canadian mothers in this sample met the EARs for most nutrients, the prevalence of dietary inadequacy was very high for vitamin D, potassium, and fiber. Some population groups may be especially at risk of developing nutrient deficiencies in this period of life characterized by postpartum recovery and transition; targeted public health strategies may be needed to address these deficiencies. Funding Sources This study is supported by The University of British Columbia, and the British Columbia Children's Hospital Research Institute, Canada, and is funded by Société des Produits Nestlé S.A.


2019 ◽  
Vol 150 (3) ◽  
pp. 526-535
Author(s):  
Hassan Vatanparast ◽  
Rashmi Prakash Patil ◽  
Naorin Islam ◽  
Mojtaba Shafiee ◽  
Susan J Whiting

ABSTRACT Background Evidence is lacking to determine whether there have been any changes in dietary or total usual intakes of vitamin D among Canadians, in the light of recent evidence of beneficial health effects beyond bone. Objective We aimed to examine trends in dietary and total usual intake of vitamin D among Canadians aged ≥1 y. Methods This study used nationally representative nutrition data from the Canadian Community Health Survey Cycle 2.2 (CCHS 2004) and CCHS Nutrition in 2015. Dietary intake data were collected with use of two 24-h dietary recalls and dietary supplement use was determined by questionnaire. The National Cancer Institute method was used to estimate the usual intake of vitamin D as well as the prevalence of vitamin D inadequacy among Canadians aged ≥1 y. Results From 2004 to 2015, the usual intake of vitamin D from food significantly decreased (P &lt; 0.05) by 1 μg/d only in vitamin D supplement nonusers. The contribution of Milk and Alternatives food group (i.e., fluid milk, fortified soy beverages, powdered milk, and other milk alternatives) to dietary vitamin D intake significantly decreased (P &lt; 0.05) in both supplement users (by 7.1%) and nonusers (by 5.8%). Prevalence of vitamin D supplement use and percentage contribution of vitamin D from supplemental sources significantly increased (P &lt; 0.05) by 5.0% and 14.9%, respectively, from 2004 to 2015. Total usual intake of vitamin D (food + supplement) significantly increased (P &lt; 0.05) from 15.1 ± 0.3 μg/d in 2004 to 31.5 ± 1.8 μg/d in 2015 in vitamin D supplement users. In contrast to vitamin D supplement nonusers, the prevalence of vitamin D inadequacy significantly decreased (P &lt; 0.05) from 20.6% to 14.1% among users of vitamin D supplements. Conclusions The prevalence of vitamin D supplement use and the percentage contribution of vitamin D from supplemental sources has increased in the Canadian population over an 11-y period.


2010 ◽  
Vol 2010 ◽  
pp. 1-11 ◽  
Author(s):  
S. Karami ◽  
P. Brennan ◽  
M. Navratilova ◽  
D. Mates ◽  
D. Zaridze ◽  
...  

Mediated by binding to the high-affinity vitamin D receptor (VDR), vitamin D forms a heterodimer complex with the retinoid-X-receptor (RXR). Variation in both genes has been shown to modify renal cell carcinoma (RCC) risk. Therefore, we investigated whetherVDRandRXRApolymorphisms modify associations between RCC risk and frequency of dietary intake of vitamin D and calcium rich foods, and occupational ultraviolet exposure among 777 RCC case and 1035 controls from Central and Eastern Europe. A positive association was observed in this population between increasing dietary intake frequency of yogurt, while an inverse association was observed with egg intake frequency.RXRApolymorphisms, located3′of the coding sequence, modified associations between specific vitamin D rich foods and RCC risk, whileRXRApolymorphisms, located in introns 1 and 4, modified associations with specific calcium rich foods. Results suggest that variants in theRXRAgene modified the associations observed between RCC risk and calcium and vitamin D intake.


Author(s):  
Rebecca M. Vearing ◽  
Kathryn H. Hart ◽  
Andrea L. Darling ◽  
Yasmine Probst ◽  
Aminat S. Olayinka ◽  
...  

Abstract Background/Objectives Vitamin D deficiency remains a global public health issue, particularly in minority ethnic groups. This review investigates the vitamin D status (as measured by 25(OH)D and dietary intake) of the African-Caribbean population globally. Subjects/Methods A systematic review was conducted by searching key databases (PUBMED, Web of Science, Scopus) from inception until October 2019. Search terms included ‘Vitamin D status’ and ‘African-Caribbean’. A random effects and fixed effects meta-analysis was performed by combining means and standard error of the mean. Result The search yielded 19 papers that included n = 5670 African-Caribbean participants from six countries. A meta-analysis found this population to have sufficient (>50 nmol/L) 25(OH)D levels at 67.8 nmol/L, 95% CI (57.9, 7.6) but poor dietary intake of vitamin D at only 3.0 µg/day, 95% CI (1.67,4.31). For those living at low latitudes ‘insufficient’ (as defined by study authors) 25(OH)D levels were found only in participants with type 2 diabetes and in those undergoing haemodialysis. Suboptimal dietary vitamin D intake (according to the UK recommended nutrient intake of 10 µg/day) was reported in all studies at high latitudes. Studies at lower latitudes, with lower recommended dietary intakes (Caribbean recommended dietary intake: 2.5 µg/day) found ‘sufficient’ intake in two out of three studies. Conclusions 25(OH)D sufficiency was found in African-Caribbean populations at lower latitudes. However, at higher latitudes, 25(OH)D deficiency and low dietary vitamin D intake was prevalent.


2013 ◽  
Vol 26 ◽  
pp. 64-72 ◽  
Author(s):  
L. G. González-Rodríguez ◽  
P. Estaire ◽  
C. Peñas-Ruiz ◽  
R. M. Ortega ◽  

2020 ◽  
Vol 9 ◽  
Author(s):  
Cecilia Nälsén ◽  
Wulf Becker ◽  
Monika Pearson ◽  
Peter Ridefelt ◽  
Anna Karin Lindroos ◽  
...  

Abstract The study aimed to estimate vitamin D intake and plasma/serum 25-hydroxyvitamin D (25(OH)D) concentrations, investigate determinants of 25(OH)D concentrations and compare two 25(OH)D assays. We conducted two nationwide cross-sectional studies in Sweden with 206 school children aged 10–12 years and 1797 adults aged 18–80 years (n 268 provided blood samples). A web-based dietary record was used to assess dietary intake. Plasma/serum 25(OH)D was analysed by liquid chromatography-mass spectrometry (LC-MS) and immunoassay in adults and LC-MS/MS in children. Most participants reported a vitamin D intake below the average requirement (AR), 16 % of children and 33 % of adults met the AR (7⋅5 μg). In adults, plasma 25(OH)D below 30 and 50 nmol/l were found in 1 and 18 % of participants during the summer period and in 9 and 40 % of participants during the winter period, respectively. In children, serum 25(OH)D below 30 and 50 nmol/l were found in 5 and 42 % of participants (samples collected March–May), respectively. Higher 25(OH)D concentrations were associated with the summer season, vacations in sunny locations (adults), and dietary intake of vitamin D and use of vitamin D supplements, while lower concentrations were associated with a higher BMI and an origin outside of Europe. Concentrations of 25(OH)D were lower using the immunoassay than with the LC-MS assay, but associations with dietary factors and seasonal variability were similar. In conclusion, vitamin D intake was lower than the AR, especially in children. The 25(OH)D concentrations were low in many participants, but few participants had a concentration below 30 nmol/l.


2021 ◽  
Author(s):  
Mateo Amaya-Montoya ◽  
Daniela Duarte-Montero ◽  
Luz D Nieves-Barreto ◽  
Angélica Montaño-Rodríguez ◽  
Eddy C Betancourt-Villamizar ◽  
...  

Data on dietary calcium and vitamin D intake from Latin America are scarce. We explored the main correlates and dietary sources of calcium and vitamin D in a probabilistic, population-based sample from Colombia. We studied 1554 participants aged 18 to 75 from five different geographical regions. Dietary intake was assessed employing a 157-item semi-quantitative food frequency questionnaire and national and international food composition tables. Daily vitamin D intake decreased with increasing age, from 230 IU/day in the 18-39 age group to 184 IU/day in the 60-75 age group (p-trend<0.001). Vitamin D intake was positively associated with socioeconomic status (SES) (196 IU/d in lowest vs 234 in highest SES, p-trend<0.001), and with educational level (176 IU/d in lowest vs 226 in highest education level, p-trend<0.001). Daily calcium intake also decreased with age, from 1376 mg/day in the 18-39 age group to 1120 mg/day in the 60-75 age group (p-trend<0.001). Calcium intake was lowest among participants with only elementary education, but the absolute difference in calcium intake between extreme education categories was smaller than for vitamin D (1107 versus 1274 mg/d, p-trend 0.023). Daily calcium intake did not correlate with SES (p-trend=0.74) Eggs were the main source of vitamin D overall, albeit their contribution decreased with increasing age. Dairy products contributed at least 48% of dietary calcium in all subgroups, mostly from cheese-containing traditional foods. SES and education were key correlates of vitamin D and calcium intake. These findings may contribute to shape public health interventions in Latin American countries.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Honglin Dong ◽  
Viktorija Asmolovaite ◽  
Nareen Marseal ◽  
Maryam Mearbon

Purpose Vitamin D deficiency is prevalent worldwide. This paper aims to investigate the vitamin D status and dietary intake in young university students. Design/methodology/approach Forty-one healthy students aged 18–29 years from Coventry University UK were recruited during January-February 2019, including white Caucasians (n = 18), African-Caribbeans (n = 14) and Asians (n = 9). Plasma 25(OH)D concentrations were measured and dietary vitamin D intake was determined. Chi-square and simple linear regression were used to analyse the data. Findings The plasma 25(OH)D concentrations were (36.0 ± 22.2) nmol/L in all subjects, (46.5 ± 25.3) nmol/L in white Caucasians, (22.6 ± 7.4) nmol/L in African-Caribbeans and (37.4 ± 21.7 nmol/L) in Asians. The majority (85.7%) of African-Caribbeans were vitamin D deficient compared with 22.2% of white Caucasians and 33.3% of Asians (p = 0.001). Overweight/obese subjects showed a significant higher proportion of vitamin D deficiency (65%) than normal weight subjects (28.6%) (p = 0.04). The average dietary vitamin D intake in all subjects was (4.6 ± 3.9) µg/day. Only 12.1% of the subjects met the recommended dietary vitamin D intake of 10 µg/day. Dietary vitamin D intake (p = 0.04) and ethnicity (p = 0.01) were significant predictors of 25(OH)D levels and accounted for 13% and 18.5% of 25(OH)D variance, respectively. Research limitations/implications This small-scale study showed an alarmingly high prevalence of vitamin D deficiency among subjects from African-Caribbean origin during wintertime. Education programs and campaigns are urgently needed to fight the vitamin D deficiency in this population. Originality/value The targeted population were in a critical period of transition from adolescence toward adulthood involving in changes in behaviours and nutrition.


Proceedings ◽  
2020 ◽  
Vol 61 (1) ◽  
pp. 1
Author(s):  
María Correa-Rodríguez ◽  
Gabriela Pocovi-Gerardino ◽  
Irene Medina-Martínez ◽  
Sara Del Olmo-Romero ◽  
Norberto Ortego-Centeno ◽  
...  

Systemic lupus erythematosus (SLE) is a chronic disease characterized by inflammatory response and abnormal autoimmune disease. Vitamin D is essential in phosphorus-calcium metabolism, has immunosuppressive properties, and is considered a therapeutic option. Controversy exists about the role of this vitamin in the pathogenesis of SLE. Thus, the aim of this study was to investigate the influence of the dietary intake of vitamin D and its supplementation in a cohort of patients with SLE. A cross-sectional study including a total 285 patients with SLE was conducted (248 females and 26 males; mean age 46.99 ± 12.89 years). The SLE disease activity index (SLEDAI-2K) and the SLICC/ACR damage index (SDI) were used to assess disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; mol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL), among other biochemical markers, were measured. The dietary intake of vitamin D and the intake of vitamin D supplement were obtained via a 24-h patient diary. A share of 57.1% of the patients took vitamin D supplements and the average of dietary vitamin D was 2.08 ± 2.94 μg/day. Note that 98.2% of patients did not reach the recommended dietary intakes for vitamin D intake. Multivariate regression analysis revealed that clinical and laboratory variables are not significantly affected by vitamin D intake levels after adjusting for age, gender, energy intake, and medical treatment (immunosuppressants, corticosteroids, and antimalarials). Patients with SLE who took vitamin D supplements had significantly higher serum complement C3 levels compared to patients who did not take them after adjusting for covariates (110.28 ± 30.93 vs. 107.38 ± 24.18; p = 0.018). Our findings suggest a potential impact of supplementation of vitamin D on the activity of SLE. Future longitudinal research on SLE patients, including intervention trials, are required to validate these preliminary data.


Nutrition ◽  
2020 ◽  
Vol 72 ◽  
pp. 110641
Author(s):  
Ioannis Dimakopoulos ◽  
Emmanuella Magriplis ◽  
Anastasia-Vasiliki Mitsopoulou ◽  
Dimitra Karageorgou ◽  
Ioanna Bakogianni ◽  
...  

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