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Am J Clin Nutr. 2016 Apr;103(4):1033-44. doi: 10.3945/ajcn.115.120873. Epub 2016 Feb 10.

Vitamin D deficiency in Europe: pandemic?

Author information

1
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, and k.cashman@ucc.ie.
2
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.
3
ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain; CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III, Madrid, Spain;
4
ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain;
5
Department of Public Health, Ghent University, Ghent, Belgium;
6
Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain;
7
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark;
8
Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway;
9
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;
10
Department of Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany;
11
Medical Research Council Human Nutrition Research Unit, Elsie Widdowson Laboratory, Cambridge, United Kingdom;
12
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research.
13
Department of General Practice & Elderly Care Medicine, and.
14
Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
15
Department of Internal Medicine, Section of Endocrinology, Vrije Universiteit University Medical Center, Amsterdam, Netherlands;
16
Icelandic Heart Association, Kopavogur, Iceland;
17
Icelandic Heart Association, Kopavogur, Iceland; University of Iceland, Reykjavik, Iceland;
18
Division of Epidemiology and Clinical Applications, National Eye Institute and.
19
Department of Health, Functional Capacity and Welfare and Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland;
20
Department of Food and Environmental Sciences, Helsinki University, Helsinki, Finland; and.
21
Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL.
22
Office of Dietary Supplements, NIH, Bethesda, MD;
23
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland;

Abstract

BACKGROUND:

Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys.

OBJECTIVE:

This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe.

DESIGN:

The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data.

RESULTS:

An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations.

CONCLUSIONS:

Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.

KEYWORDS:

25(OH)D; Europe; prevalence; standardized; vitamin D deficiency

PMID:
26864360
PMCID:
PMC5527850
DOI:
10.3945/ajcn.115.120873
[Indexed for MEDLINE]
Free PMC Article

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