Serum 25-hydroxyvitamin D levels among Mexican children ages 2 y to 12 y: A national survey

ObjectiveThe aim of this study was to assess the vitamin D status in preschool and school-age children in Mexico.Methods25-hydroxyvitamin D (25-OH-D) serum concentrations were measured using a direct enzyme-linked immunosorbent assay commercial kit in a nationally representative sample of 1025 Mexican children ages 2 y to 12 y who participated in the 2006 Mexican National Health and Nutrition Survey.ResultsMean serum 25-OH-D concentration was 94.6 ± 47 nmol/L. Concentrations were lower in preschool children (2–5 y; 78.3 ± 37 nmol/L) than in school-aged children (6–12 y; 105.8 ± 51 nmol/L; P < 0.001). Children living in urban areas had lower levels (89.8 ± 36 nmol/L) than children from rural areas (108.1 ± 75 nmol/L; P < 0.05). Twenty-four percent of preschool children had vitamin D deficiency (25-OH-D < 50 nmol/L) compared with 10% of school-aged children (P < 0.05). Thirty percent of preschool children had vitamin D insufficiency (25-OH-D 50–74.9 nmol/L) compared with 18% of school-aged children (P < 0.05). In urban areas, 18% of children had vitamin D deficiency and 25% had insufficiency compared with 10% and 16% of children in rural areas, respectively (P < 0.05). Prevalence of severe vitamin D deficiency (25-OH-D < 20 nmol/L) was extremely low (0.3%).ConclusionsVitamin D deficiency and insufficiency are important public health problems in Mexican children.     

Low Vitamin D Status Among Obese Adolescents: Prevalence and Response to Treatment

PurposeTo explore the prevalence of low vitamin D status among obese adolescents and to examine the effect of current management of low vitamin D status in these patients.MethodsA retrospective chart review of obese adolescents who had been screened for vitamin D status by serum total 25-hydroxyvitamin D (25(OH)D) level. Vitamin D deficiency was defined as 25(OH)D level of <20 ng/mL, vitamin D insufficiency as 25(OH)D level of 20–30 ng/mL, and vitamin D sufficiency as 25(OH)D level of >30 ng/mL. Adolescents with vitamin D deficiency were treated with 50,000 IU of vitamin D once a week for 6–8 weeks, whereas adolescents with vitamin D insufficiency were treated with 800 IU of vitamin D daily for 3 months. Repeat 25(OH)D was obtained after treatment.ResultsThe prevalence rate of low vitamin D status among 68 obese adolescents (53% females, 47% males, age: 17 ± 1 years, body mass index: 38 ± 1 kg/m², Hispanic: 45%, African American: 40%, Caucasian: 15%) was 100% in females and 91% in males. Mean (±SE) 25(OH)D level was significantly higher in summer (20 ± 8 ng/mL) than in spring (14 ± 4 ng/mL, p < .02), and significantly lower in winter (15 ± 7 ng/mL) than in fall (25 ± 15 ng/mL, p < .05). Although there was a significant (p < .00001) increase in mean 25(OH)D after the initial course of treatment with vitamin D, 25(OH)D levels normalized in only 28% of the participants. Repeat courses with the same dosage in the other 72% did not significantly change their low vitamin D status.ConclusionsIncreased surveillance and possibly higher vitamin D doses are warranted for obese adolescents whose total 25(OH)D levels do not normalize after the initial course of treatment.     

Elevated systolic blood pressure of children in the United States is associated with low serum 25-hydroxyvitamin D concentrations related to body mass index: National Health and Examination Survey 2007-2010

A negative association between serum 25-hydroxyvitamn D (25[OH]D) concentrations and blood pressure has been found in adults; whether a similar relationship exists in children remains unclear. We hypothesized that serum 25(OH)D concentrations of children would negatively correlate with blood pressure. Using a nationally representative sample of children aged 8 to 18 years from the National Health and Nutrition Examination Survey 2007-2010 (n = 2908), we compared serum 25(OH)D levels with diastolic and systolic blood pressure by vitamin D nutritional status categories. A high percentage of children were either vitamin D deficient (28.8%) or vitamin D insufficient (48.8%). Prehypertension was defined as blood pressure as ≥90th to <95th percentile and hypertension as ≥95th percentile by age, height, and sex national blood pressure percentile norms for children. Vitamin D–deficient children aged 8 to 13 years had higher systolic blood pressure (104.8 ± 0.7 mm Hg) than did vitamin D–sufficient children (102.3 ± 0.6 mmHg; P < .05). Controlling for age, sex, race/ethnicity, and income, systolic blood pressure was inversely associated with serum 25(OH)D concentrations (P < .03), but not when also controlling for body mass index (P = .63). A higher percentage of vitamin D–deficient and vitamin D–insufficient children (1.7%) vs vitamin D–sufficient children (0.6%) had prehypertension or hypertension. In conclusion, the association of low serum 25(OH)D concentrations with elevated systolic blood pressure in children is likely related to body weight and markers of adiposity.     

Higher concentrations of vitamin D in Canadian children with juvenile idiopathic arthritis compared to healthy controls are associated with more frequent use of vitamin D supplements and season of birth

A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA).  The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n= 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n=4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation.     

Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial

BackgroundDespite substantial evidence that vitamin D deficiency is highly prevalent among infants born extremely preterm (≤28 weeks’ of gestation), several consensus statements do not recommend vitamin D doses >400 IU/day for these infants. Safety remains a concern.ObjectiveThe study aim was to determine safety and efficacy profiles of enteral vitamin D in Black and White infants randomized to three different vitamin D doses soon after birth.DesignAncillary study of a masked randomized clinical trial.Participants/settingSeventy-three infants born extremely preterm between 2012 and 2015 at a southern US academic neonatal unit (33’ latitude) who had >90% compliance with the assigned intervention were included.InterventionInfants were randomized to receive placebo (placebo group), 200 IU/day vitamin D (200 IU group), or 800 IU/day vitamin D (800 IU group) during the first 28 days after birth.Main outcome measuresSafety outcomes included serum 25-hydroxy vitamin D (25[OH]D) and calcium concentrations. Efficacy outcomes included the predictive risk of bronchopulmonary dysplasia.Statistical analysisPer-protocol analysis using unadjusted, repeated-measures mixed models.ResultsMean birth weight was 815 ± 199 g. Half were male and 56% were Black. Of 58 infants with 25(OH)D measurements at birth, 40 (69%) had vitamin D deficiency (<20 ng/mL). The mean difference in 25(OH)D in nanograms per milliliter between Postnatal Day 28 and Postnatal Day 1 was +9 in the placebo group, +23 in the 200 IU group, and +62 in the 800 IU group (P < 0.0001). The increase observed in 25(OH)D was more significant among Black infants. The predictive risk of severe bronchopulmonary dysplasia in the 200 IU and 800 IU groups was lower, but this difference did not reach statistical significance. No vitamin D or calcium toxicity was observed.ConclusionsA vitamin D dose of 800 IU/day safely corrected vitamin D deficiency by Postnatal Day 14.     

Bone mineral density,vitamin D,and nutritional status of children submitted to hematopoietic stem cell transplantation

ObjectiveThe aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y.MethodsWe conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods.ResultsWe observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average −9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (−5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS.ConclusionHSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.     

Vitamin D,cardio-inflammation,and endothelial dysfunction in older adults after orthopedic surgery: Results from an open-label trial to ameliorate cardiac function

ObjectivesAfter orthopedic surgery, clinical outcomes are affected by comorbid cardiovascular diseases (CVDs) and low 25-hydroxy-vitamin D (25-(OH)D). Myocardial function was suggested to be influenced by both the pro-inflammatory cytokine tumour necrosis factor alpha (TNFα) and the marker of endothelial dysfunction asymmetric dimethylarginine (ADMA).Material and methodsWe investigated TNFα and ADMA changes in association with serum levels of vitamin D and cardiac function in 47 older adults after major orthopedic surgery. Subjects were characterized for biochemical profiles and transthoracic echocardiographic measures. Assessments were done before and after the correction of hypovitaminosis D through a 6-month supplementation with calcifediol started at post-operative rehabilitation.ResultsThe means serum levels of both TNFα and ADMA reduced from 1.39 ± 0.47 pg/mL to 1.30 ± 0.37 pg/mL (P < 0.05) and from 0.69 ± 0.05 μmol/L to 0.68 ± 0.04 μmol/L (P < 0.05), respectively. Significant treatment effects were observed for systolic blood pressure (P < 0.05), left ventricular ejection function (P < 0.01), global longitudinal strain (P < 0.0001), 25-(OH)D (P < 0.001), and calcemia (P < 0.001).ConclusionAfter the normalization of low levels of vitamin D, we were able to observe a reduction of circulating TNFα and ADMA together with the amelioration of cardiac function. Even if our results suggest that vitamin D might exert cardiac effects indirectly through the decrease in cardio-inflammation and endothelial dysfunction, a better understanding of the precise molecular regulations should be better investigated.     

Multinutrient-Fortified Juices Improve Vitamin D and Vitamin E Status in Children: A Randomized Controlled Trial

BackgroundProvision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins.ObjectiveTo determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels.DesignA 12-week randomized, double-blind, controlled trial.Participants/settingOne hundred eighty participants (aged 8.04±1.42 years) were recruited at Tufts (n=70) and Boston University (n=110) during 2005-2006. Of those recruited, 176 children were randomized into three groups: CaD (700 mg calcium+200 IU vitamin D), CaDEA (700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene), or Ca (700 mg calcium). Children consumed two 240-mL glasses of CaD, CaDEA, or Ca fortified orange juice daily for 12 weeks.Main outcome measuresSerum 25(OH)D, α-tocopherol, and retinol concentrations.Statistical analysesChanges in 25(OH)D, α-tocopherol, retinol, and parathyroid hormone concentrations were examined. Covariates included sex, age, race/ethnicity, body mass index, and baseline 25(OH)D, α-tocopherol, retinol, or parathyroid hormone levels. Multivariate models and repeated measures analysis of variance tested for group differences with pre–post measures (n=141).ResultsBaseline 25(OH)D was 68.4±27.7 nmol/L (27.4±11.10 ng/mL) ), with 21.7% of participants having inadequate 25(OH)D (<50 nmol/L [20.03 ng/mL]). The CaD group's 25(OH)D increase was greater than that of the Ca group (12.7 nmol/L [5.09 ng/mL], 95% CI 1.3 to 24.1; P=0.029). The CaDEA group's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups (3.79 μmol/L [0.16 μg/mL], 95% CI 2.5 to 5.1 and 3.09 μmol/L [0.13 μg/mL], 95% CI −1.8 to 4.3), respectively (P<0.0001). Retinol levels did not change, and body weight remained as expected for growth.ConclusionsDaily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks.     

Effects of a healthy Nordic diet on plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome: a randomized,placebo-controlled trial (SYSDIET)

Purpose

At northern latitudes, vitamin D is not synthesized endogenously during winter, causing low plasma 25-hydroxyvitamin D (25(OH)D) concentrations. Therefore, we evaluated the effects of a healthy Nordic diet based on Nordic nutrition recommendations (NNR) on plasma 25(OH)D and explored its dietary predictors.

Methods

In a Nordic multi-centre trial, subjects (n = 213) with metabolic syndrome were randomized to a control or a healthy Nordic diet favouring fish (≥300 g/week, including ≥200 g/week fatty fish), whole-grain products, berries, fruits, vegetables, rapeseed oil and low-fat dairy products. Plasma 25(OH)D and parathyroid hormone were analysed before and after 18- to 24-week intervention.

Results

At baseline, 45 % had vitamin D inadequacy (<50 nmol/l), whereas 8 % had deficiency (<25 nmol/l). Dietary vitamin D intake was increased by the healthy Nordic diet (P < 0.001). The healthy Nordic and the control diet reduced the prevalence of vitamin D inadequacy by 42 % (P < 0.001) and 19 % (P = 0.002), respectively, without between-group difference (P = 0.142). Compared with control, plasma 25(OH)D (P = 0.208) and parathyroid hormone (P = 0.207) were not altered by the healthy Nordic diet. Predictors for 25(OH)D were intake of vitamin D, eicosapentaenoic acids (EPA), docosahexaenoic acids (DHA), vitamin D supplement, plasma EPA and plasma DHA. Nevertheless, only vitamin D intake and season predicted the 25(OH)D changes.

Conclusion

Consuming a healthy Nordic diet based on NNR increased vitamin D intake but not plasma 25(OH)D concentration. The reason why fish consumption did not improve vitamin D status might be that many fish are farmed and might contain little vitamin D or that frying fish may result in vitamin D extraction. Additional ways to improve vitamin D status in Nordic countries may be needed.     

Increased vitamin D-binding protein and decreased free 25(OH)D in obese women of reproductive age

Purpose

Obese subjects have lower circulating 25-hydroxyvitamin D (25(OH)D) than normal-weight subjects. Knowledge is scarce regarding differences in vitamin D-binding protein (DBP), free 25(OH)D, and intake of vitamin D between normal-weight and obese subjects. The purpose of this study was to examine intake and vitamin D status in obese compared with normal-weight women.

Methods

Between September 2009 and October 2011, 43 obese and 43 normal-weight women, 22–45 years of age, mean BMI of 39.1 ± 4.6 and 21.6 ± 1.8 kg/m², respectively, were recruited in the western Sweden region (latitude 57°N). Blood samples, data regarding diet, and sun exposure were collected.

Results

DBP concentrations were 320 ± 121 and 266 ± 104 μg/mL (P = 0.02) in obese and normal-weight women, respectively. Calculated free 25(OH)D was 13.3 ± 5.5 (obese) and 23.7 ± 10.7 (normal-weight) (P < 0.001). The obese women had a 20.1 nmol/L lower mean 25(HO)D concentration compared to normal-weight women (P < 0.001). 56 % of obese women and 12 % of normal-weight women had 25(OH)D concentrations ≤50 nmol/L. There was no statistically significant difference in total vitamin D intake between the groups. 39 % of the women had a total vitamin D intake <7.5 μg/day, the current national recommendation for vitamin D in Sweden.

Conclusions

Obese women had higher DBP concentrations compared with normal-weight women and lower free 25(OH)D. The obese women were more likely to have 25(OH)D concentrations that could be considered suboptimal. Vitamin D intake was generally low in normal-weight and obese women of childbearing age.     

Serum 25(OH)D response to vitamin D3 supplementation: A meta-regression analysis

ObjectiveThe aim of this study was to review factors that influence serum 25(OH)D when patients are given vitamin D supplements.MethodsFrom a comprehensive search of all randomized controlled clinical trials with vitamin D₃ supplementation available on PubMed up to November 2011, we selected 33 with 43 treatment arms that included at least 30 adult participants. The achieved pooled mean difference (PMD) and 95% confidence intervals (CIs) were calculated using the random-effects models. Meta-regression and subgroup analyses were performed for prespecified factors, including dose, duration, baseline serum 25(OH)D, and age.ResultsWith a mean baseline serum 25(OH)D of 50.4 nmol/L, PMD was 37 nmol/L (95% CI, 33–41) with significant heterogeneity among studies. Dose (slope: 0.006; P < 0.001), trial duration (slope: 0.21; P < 0.001), baseline serum 25(OH)D (slope: −0.19; P < 0.001), and age (slope: 0.42; P < 0.001) independently influenced vitamin D response. Similar results were found in studies with a mean baseline serum 25(OH)D <50 nmol/L. In subgroup analyses, the PMD was higher with doses ≥800 IU/d (39.3 nmol/L) after 6 to 12 mo (41.7 nmol/L), with baseline 25(OH)D <50 nmol/L (39.6 nmol/L), and in adults aged >80 y (40.5 nmol/L).ConclusionThis meta regression indicates that a higher increase in serum levels of 25(OH)D in adults is found with a dose of ≥800 IU/d, after at least 6 to 12 mo, and even when baseline 25(OH)D is low and in adults >80 y.     

Risk factors for vitamin D deficiency in women aged 20–50 years consulting in general practice: a cross-sectional study

Abstract

Objective: Vitamin D deficiency is often unidentified, although treatment is simple and inexpensive. Our objective was to estimate the influence of concealing clothes and other risk factors for vitamin D deficiency in women aged 20 to 50 years consulting general practitioners. Methods: 13 GPs in the Rhone Alps area planned to recruit 300 women (100 veiled and 200 non-veiled) from January to March 2008. Serum 25(OH)D and PTH were measured in one single laboratory (Biomnis^®) by a radio-immunoassay method. A survey was administered about dietary habits, sun exposure, and quality of life. Results: Among 247 women enrolled, 196 were analysed: 61 wearing concealing clothes (31.2%) and 135 without (68.8%). As expected, 25(OH)D serum level was significantly lower in covered women (20.1 versus 38.9 nmol/l P < 0.001). Of women who did not wear concealing clothing, 39.3% had severe hypovitaminosis D (25(OH)D concentration < 30 nmol/l). Women wearing concealing clothes had more often other known risk factors such as dark skin (P < 0.001), less sunlight exposure, or a higher Body Mass Index (P = 0.009). Besides concealing clothing (OR 6.37, 95% CI: 1.35–30.09), multivariate analyses revealed two independent risk factors for vitamin D deficiency: no full-body sun exposure (OR: 3.06, 95% CI: 1.18–7.94) and no outdoor sports (OR: 2.81, 95% CI: 1.11–7.12) for threshold 52 nmol/l.

Conclusion: Young women consulting their GP had hypovitaminosis D more often than expected. Besides concealing clothing, absence of full body sun exposure during summer and of outdoor sports practice could suggest a possible vitamin D deficiency.     

A high-fat diet in the presence of vitamin D deficiency status is associated with a negative influence on calcaneal quantitative ultrasound parameters in young adults: a cross-sectional study

Vitamin D deficiency and a high-fat diet are considered health problems worldwide. The aims of this study were to examine the prevalence of vitamin D deficiency/insufficiency in young adults, factors related to the vitamin D status, and the influence of vitamin D deficiency and/or a high-fat diet on bone parameters. Here, we investigated the hypothesis that a high-fat diet in the presence of a vitamin D-deficient status would have a more negative influence on bone parameters than a normal-fat diet with such a status. In the present study, we targeted young Japanese adults aged 21-23 (n = 175). We conducted a diet survey based on 3-day food records, biochemical examination of serum, and quantitative ultrasound measurements at the calcaneus. As a result, the rates of vitamin D deficiency {serum 25-hydroxyvitamin D₃ [25(OH)D] concentration less than 20 ng/mL} and insufficiency [serum 25(OH)D concentration less than 30 ng/mL but not less than 20 ng/mL] were 60.6 and 30.9%, respectively. A positive correlation was observed between the serum 25(OH)D level and serum bone-specific alkaline phosphatase level, which is a serum marker of bone formation (r = 0.253, P< .01) or the speed of sound (SOS) as an index of bone density (r = 0.259, P< .01). A negative correlation was observed between the ratio of fat intake to total energy intake (%E) and serum 25(OH)D levels (r = −0.206, P< .01). Furthermore, we revealed that a high-fat diet in the presence of a vitamin D deficient status reduced the SOS parameter compared with a normal-fat diet with a vitamin D-deficient status (P< .05).     

A Randomized Clinical Trial of Vitamin D Supplementation in Healthy Adolescents

PurposeThe most safe and effective dose of vitamin D supplementation for healthy adolescents is currently unknown. The aim of this study was to compare the efficacy of 200 IU versus 1,000 IU of daily vitamin D₃ for supplementation in healthy adolescents with baseline vitamin D sufficiency.MethodsWe conducted a double-blind, randomized clinical trial. Fifty-six subjects, ages 11–19 years, with baseline vitamin D sufficiency received 1,000 IU or 200 IU of daily vitamin D₃ for 11 weeks. Compliance was assessed using MEMS6 Trackcaps and pill counts.ResultsFifty-three subjects completed the clinical trial. Subjects in the two treatment arms were similar in terms of age, race, gender, body mass index, and dietary calcium and vitamin D intake. Serum 25(OH)D level in the 200 IU treatment arm was 28.1 ± 6.2 ng/mL at baseline (mean ± SD) and 28.9 ± 7.0 ng/mL at follow-up. In the 1,000 IU treatment arm, 25(OH)D levels were 29.0 ± 7.3 and 30.1 ± 6.6 at baseline and follow-up, respectively. Mean change in 25(OH)D level did not differ significantly between treatment arms (p = .87), nor did mean change in parathyroid hormone, calcium, phosphate, bone turnover markers, fasting glucose, or fasting insulin.ConclusionsIn healthy adolescents with baseline vitamin D sufficiency, supplementation with vitamin D₃ doses of 200 and 1,000 IU for 11 weeks did not increase serum 25(OH)D levels, with no significant difference observed between treatment arms.     

Season,dietary factors,and physical activity modify 25-hydroxyvitamin D concentration during pregnancy

Purpose

The objectives of this cross-sectional study were to define maternal and umbilical cord blood (UCB) 25-hydroxyvitamin D (25(OH)D) to characterize maternal factors modifying 25(OH)D during pregnancy and predict UCB 25(OH)D in two subgroups with Declined [Δ25(OH)D?<0 nmol/l] and Increased [Δ25(OH)D?>0 nmol/l] 25(OH)D concentration.

Methods

A complete dataset was available from 584 women. 25(OH)D was determined at gestational weeks 6–13 and in UCB. Baseline characteristics were collected retrospectively using questionnaires. Δ25(OH)D was calculated as UCB 25(OH)D?early pregnancy 25(OH)D. Dietary patterns were generated with principal component analysis. Multivariate regression models were applied.

Results

Vitamin D deficiency was scarce, since only 1% had 25(OH)D concentration?<50 nmol/l both in early pregnancy and in UCB. Shared positive predictors of UCB 25(OH)D in the subgroups of Declined and Increased, were early pregnancy 25(OH)D (P?<?0.001) and supplemental vitamin D intake (P?<?0.04). For the Increased subgroup summer season at delivery (P?=?0.001) and “sandwich and dairy” dietary pattern characterized with frequent consumption of vitamin D fortified margarine and milk products (P?=?0.009) were positive predictors of UCB 25(OH)D. Physical activity (P?=?0.041) and maternal education (P?=?0.004) were additional positive predictors in the Declined group

Conclusions

Maternal and newborn vitamin D status was sufficient, thus public health policies in Finland have been successful. The key modifiable maternal determinants for 25(OH)D during pregnancy, and of the newborn, were supplemental vitamin D intake, frequent consumption of vitamin D fortified foods, and physical activity.

     

Breakfast Skipping Is Associated with Vitamin D Deficiency among Young Adults entering Initial Military Training

BackgroundVitamin D deficiency (VDD), defined as serum 25-hydroxyvitamin D (25[OH]D) levels < 20 ng/mL [to convert 25[OH]D ng/mL to nmol/L, multiply by 2.5]) is prevalent in young adults and has been associated with adverse health outcomes, including stress fracture during periods of increased physical activity such as military training. Foods commonly consumed at breakfast provide an important source of vitamin D, yet breakfast skipping is common among young adults. However, whether breakfast skipping is associated with VDD in young adults is unclear.ObjectivesThis study aimed to determine whether breakfast skipping is associated with odds of VDD among recruits entering initial military training (IMT), and with changes in serum 25(OH)D during IMT. In addition, whether diet quality and vitamin D intake mediated these associations was determined.DesignSecondary analysis of individual participant data collected during five IMT studies. Breakfast skipping (≥ 3 times/week) was self-reported. Dietary intake was determined using food frequency questionnaires, and vitamin D status was assessed using circulating 25(OH)D concentrations pre- and post-IMT.Participants and settingParticipants were healthy US Army, US Air Force, and US Marine recruits (N = 1,569, 55% male, mean ± standard deviation age 21 ± 4 years) entering military service between 2010 and 2015 at Fort Jackson, SC; Fort Sill, OK; Lakeland Air Force Base, TX; or the Marine Corps Recruit Depot, Parris Island, SC.Main outcome measuresPrimary outcomes were VDD pre-IMT and change in 25(OH)D from pre- to post-IMT.Statistical analysis performedAssociations were determined using multivariate-adjusted logistic and linear regression and mediation models.ResultsForty-six percent of military recruits were classified as breakfast skippers pre-IMT, and 30% were VDD. Breakfast skipping was associated with a higher odds of pre-IMT VDD (odds ratio 1.5, 95% CI 1.1 to 1.9), and lower vitamin D intake and diet quality were partial mediators of the association. Serum 25(OH)D concentrations improved (P = 0.01) among habitual breakfast skippers versus nonskippers during IMT; however, regression to the mean could not be ruled out. Neither change in diet quality nor vitamin D intake were associated with change in 25(OH)D concentrations during IMT.ConclusionsBreakfast skipping is prevalent among incoming military recruits and is associated with VDD. This relationship may be mediated by lower diet quality and vitamin D intake.     

Vitamin D status and body fat measured by dual-energy X-ray absorptiometry in a general population of Japanese children

ObjectiveFor a general population of children, data on the relationship between vitamin D status and adiposity are limited. The aim of this study was to assess the relationships between the serum concentration of 25-hydroxyvitamin D (25-OH-D) and body fat variables measured by dual-energy X-ray absorptiometry (DXA) in a general population of Japanese children, including underweight, normal, and overweight children.MethodsThe source population comprised 521 fifth-grade children who attended either of the two public schools in Hamamatsu, Japan. Total and regional body fat mass (FM) measured by DXA were evaluated along with the serum concentration of 25-OH-D.ResultsWe were able to analyze the FM and 25-OH-D data of 400 of the 521 children. Among boys, significant inverse relationships were observed between serum vitamin D levels and body fat variables (total FM, r = ?0.201; trunk FM, r = ?0.216; appendicular FM, r = ?0.187; P < 0.05 for all values). Mean values of total FM and trunk FM in the vitamin D-deficient group (25-OH-D <50 nmol/L) were larger than those in the vitamin D-sufficient group (25-OH-D ≥75 nmol/L) after adjusting for confounding factors, such as sedentary behavior (P < 0.05). No relationship was observed between vitamin D status and FM among girls.ConclusionsVitamin D deficiency was associated with higher total and trunk adiposities in a general population of Japanese children, particularly boys.     

Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy

Purpose

Anorexia nervosa (AN) is associated with reduced bone mass and an increased fracture risk. The aim was to evaluate the vitamin D status and the association with body mass index (BMI), fat mass and bone mineral density (BMD) in patients with severe AN during a prospective intervention study of intensive nutrition therapy.

Methods

This study comprised 25 Swedish female AN patients (20.1 ± 2.3 years), who were treated as inpatients for 12 weeks with a high-energy diet. Serum 25-hydroxyvitamin D (25(OH)D), calcium, phosphate and parathyroid hormone (PTH) were measured. BMD and body composition were assessed by dual-energy X-ray absorptiometry at study start and after 12 weeks.

Results

Twenty-two patients completed the study. The mean weight gain was 9.9 kg and BMI (mean ± SD) increased from 15.5 ± 0.9 to 19.0 ± 0.9 kg/m², P < 0.0001. Fat mass increased from median 12 to 27 %. The median serum 25(OH)D level was 84 nmol/L at baseline, which decreased to 76 nmol/L, P < 0.05. PTH increased from median 21.9 to 30.0 ng/L, P < 0.0001. BMC increased during the study period, P < 0.001.

Conclusions

Serum 25(OH)D levels were adequate both at study start and completion, however, nominally decreased after the 12-week nutritional intervention. PTH increased subsequently, which coincide with the decreased 25(OH)D levels. The reduction in 25(OH)D could be due to an increased storage of vitamin D related to the increase in fat mass since vitamin D is sequestered in adipose tissue.

     

Prevalence and Predictors of Low Serum 25-Hydroxyvitamin D among Female African-American Breast Cancer Survivors

Background

African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors.