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O'Sullivan M, Moran C, Griffin TP, Doheny H, McCartney DM, O'Shea PM. Impact of the COVID-19 lockdown on the vitamin D status of people in the West of Ireland. Ir J Med Sci 2024; 193:1061-1071. [PMID: 37864675 DOI: 10.1007/s11845-023-03543-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 09/29/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE Identify the impact of COVID-19 lockdown restrictions on the vitamin D status of individuals in the west of Ireland. DESIGN Cross-sectional study. SETTING Adults who had wintertime serum 25(OH)D analysis completed in Galway University Hospital. PARTICIPANTS A total of 16,725 participants (2015-2020 (n = 13,449) and 2020-2021 (n = 3276)). Baseline demographics; sex, age, origin of the sample and the date of sample collection. RESULTS Median serum vitamin D and serum vitamin D3 concentrations were higher in the 5-month period from October-February 2020-2021 (61 nmol/L (± 36-85 nmol/L) and 60 nmol/L (± 34-85 nmol/L)) respectively, than for the corresponding 5-month period (October-February) in 2015-2020 (53 nmol/L (± 32-78 nmol/L) and 51 nmol/L (± 30-77 nmol/L)) respectively. These changes coincided with a decline in the prevalence of deficiency. In the 5-month period October-February 2020-2021, 19.2% of the population were vitamin D deficient (< 30 nmol/L) compared to 22.5% in the corresponding 5-month period in 2015-2020, and 38.1% were vitamin D deficient (< 50 nmol/L) in the 5-month period October-February 2020-2021 compared to 46.6% in the corresponding 5-month period in 2015-2020. Males were more likely to be deficient at both thresholds (p < 0.001). For the total cohort, at the < 30 nmol/L threshold, inpatients (25.5%) and nursing home residents (34.1%) had higher prevalence of deficiency. CONCLUSIONS Vitamin D levels were higher in the 5-month period of October-February 2020-2021, and this precipitated a decline in deficiency at both thresholds, indicating that lockdown coincided with enhanced vitamin D status. We postulate that it may be attributable to changes in diet and/or supplementation, or increased sun exposure, but further confirmatory studies are required.
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Affiliation(s)
- Maria O'Sullivan
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland.
| | - Caoimhe Moran
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland
| | - Tomás P Griffin
- Centre for Endocrinology, Diabetes Mellitus and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Helen Doheny
- Department of Clinical Biochemistry, Saolta University Health Care Group (SUHCG), Galway University Hospital, Galway, Ireland
| | - Daniel Ma McCartney
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland
| | - Paula M O'Shea
- School of Medicine, University of Galway, Galway, Ireland
- Department of Clinical Biochemistry, Saolta University Health Care Group (SUHCG), Galway University Hospital, Galway, Ireland
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McCourt AF, Mulrooney SL, O’Neill GJ, O’Riordan ED, O’Sullivan AM. Serum 25-hydroxyvitamin D response to vitamin D supplementation using different lipid delivery systems in middle-aged and older adults: a randomised controlled trial. Br J Nutr 2023; 130:1548-1557. [PMID: 36912075 PMCID: PMC10551469 DOI: 10.1017/s0007114523000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Food fortification improves vitamin D intakes but is not yet mandated in many countries. Combining vitamin D with different dietary lipids altered vitamin D absorption in in vitro and postprandial studies. This randomised, placebo-controlled trial examined the effect of the lipid composition of a vitamin D-fortified dairy drink on change in 25-hydroxyvitamin D (25(OH)D) concentrations. Sixty-three healthy adults aged 50+ years were randomised to one of the following for 4 weeks: vitamin D-fortified olive oil dairy drink, vitamin D-fortified coconut oil dairy drink, vitamin D supplement or placebo control dairy drink. All vitamin D groups received 20 µg of vitamin D3 daily. Serum was collected at baseline and post-intervention to measure 25(OH)D concentrations and biomarkers of metabolic health. Repeated-measures general linear model ANCOVA (RM GLM ANCOVA) compared changes over time. There was a significant time × treatment interaction effect on 25(OH)D concentrations for those classified as vitamin D-insufficient (P < 0·001) and -sufficient at baseline (P = 0·004). 25(OH)D concentrations increased significantly for all insufficient participants receiving vitamin D3 in any form. However, for vitamin D-sufficient participants at baseline, 25(OH)D concentrations only increased significantly with the coconut oil dairy drink and supplement. There was no effect of vitamin D on biomarkers of metabolic health. Vitamin D fortification of lipid-containing foods may be used in lieu of supplementation when supplement adherence is low or for individuals with dysphagia. These results are important given the recent recommendation to increase vitamin D intakes to 15-20 µg for older adults in Ireland.
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Affiliation(s)
- Aislinn F. McCourt
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Steven L. Mulrooney
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Graham J. O’Neill
- TUD School of Food Science and Environmental Health, Technological University Dublin (TUD), Dublin, Republic of Ireland
| | - E. Dolores O’Riordan
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Aifric M. O’Sullivan
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
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3
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Scully H, Laird EJ, Healy M, Crowley V, Walsh JB, McCarroll K. Vitamin D: determinants of status, indications for testing and knowledge in a convenience sample of Irish adults. Br J Nutr 2023; 130:1144-1154. [PMID: 37675548 DOI: 10.1017/s0007114523000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Vitamin D deficiency is common in Irish adults, though there is limited research on its determinants, knowledge of vitamin D or indications for testing. We aimed to explore the determinants of vitamin D status in adults and examine knowledge and reasons for testing. The study population comprised adults who had serum 25-hydroxyvitamin D tested by general practitioners request at a Dublin Hospital in 2020. Questionnaires detailing dietary intake, sun exposure, ethnicity, biophysical factors and vitamin D knowledge were sent to a sample stratified by age, sex and vitamin D status. In total, there were 383 participants, mean age 56·0 (sd 16·6) years. Wintertime deficiency disproportionally affected non-white v. white (60 % v. 24 %, P < 0·001). The greatest predictors of deficiency were low vitamin D intake (< 10 μg/d) (P < 0·001) and non-white ethnicity (P = 0·006), followed by sun avoidance (P = 0·022). It was also more prevalent in those with lower body exposure when outdoors. The majority (86 %) identified vitamin D as important for bone health. However, 40 % were tested for non-clinical indications and half were not aware of the recommended daily allowance (RDA). Low vitamin D intake was the most important determinant of deficiency, but ethnicity and sun exposure habits were also significant predictors. The majority had no clear indication for testing and were not aware of the RDA. Public health policies to improve knowledge and vitamin D intake, especially for those of non-white ethnicity and with reduced sun exposure, should be considered.
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Affiliation(s)
- Helena Scully
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Eamon J Laird
- Department of Sport and Exercise, University of Limerick, Limerick, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Vivion Crowley
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
| | - James Bernard Walsh
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Kevin McCarroll
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
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4
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Khamees AM, Al Groosh DH. Effect of vitamin D deficiency on postorthodontic relapse: An animal study. Clin Exp Dent Res 2023; 9:701-710. [PMID: 37448180 PMCID: PMC10441610 DOI: 10.1002/cre2.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the effect of vitamin D deficiency (VDD) on orthodontic tooth movement (OTM), retention, and relapse and to assess the effect of systemic administration of vitamin D (VD) in a rat model. MATERIALS AND METHODS A total of 32 male Wistar rats were divided into two groups, a control group of 11 rats and an experimental group of 21 rats with VDD, after enhancement using a custom diet. Of the VDD group, 11 rats were supplemented with systemic vitamin D3 and categorized as vitamin (VD supplement [VDS]) groups. The VDS group received 40,000 IU/kg via intramuscular injection on Days 1 and 15 of the orthodontic treatment period. A modified orthodontic appliance was fitted to apply 0.5 N of force to move the maxillary right first molars mesially for 14 days, followed by retention and relapse periods for 7 days. Space created during OTM was measured and reassessed after the retention and relapse periods. The relapse ratio was estimated, and histomorphometric analysis was performed to assess the number of osteoblasts, osteoclast bone cells, and bone area. RESULTS A significant increase in the relapse ratio and a reduction in osteoblast cells and bone area were observed in the VDD group. By contrast, the amount of tooth movement was significantly higher together with osteoblast cells and bone marrow in VDS with a significant reduction in relapse ratio. CONCLUSION VDD was associated with a significant reduction in osteoblast cell count and total bone area in addition to a significant increase in relapse ratio. Routine screening of VD may be beneficial before commencing orthodontic treatment.
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Affiliation(s)
- Asmaa M. Khamees
- Department of Orthodontics, College of DentistryUniversity of BaghdadBaghdadIraq
| | - Dheaa H. Al Groosh
- Department of Orthodontics, College of DentistryUniversity of BaghdadBaghdadIraq
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Fresh Beef and Lamb Consumption in Relation to Nutrient Intakes and Markers of Nutrition and Health Status among the Population Aged 5-90 Years in Ireland. Nutrients 2023; 15:nu15020313. [PMID: 36678183 PMCID: PMC9863121 DOI: 10.3390/nu15020313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/10/2023] Open
Abstract
The dietary role of meat is under scrutiny for health and environmental reasons, yet a growing body of evidence proposes that advice to limit red meat consumption is unnecessarily restrictive. The aim of this study was to investigate the role of 'fresh beef and lamb' in the diet of the population (5-90 years) in Ireland and its association with markers of nutrition and health status. Analyses are based on data from three nationally representative dietary surveys in the Republic of Ireland. Dietary intake data were estimated using food records, and nutrient intakes were estimated based on UK and Irish food composition tables. Biochemical samples were collected and analysed using standard procedures. 'Fresh beef and lamb' (defined as beef/lamb that had not undergone any preserving process other than chilling/freezing/quick-freezing) was consumed by 68-84% of the population and intakes ranged from 19 to 43 g/d across age groups. It made important contributions to intakes of protein, monounsaturated fat, vitamins D, B12, niacin, iron and zinc while also contributing relatively small proportions of total fat, saturated fat and salt. Higher consumption of 'fresh beef and lamb' was associated with higher intakes of protein, niacin, vitamins B6, B12, zinc and potassium (but also total fat) and lower intakes of carbohydrate and total sugars (but also dietary fibre). In adults, older adults and WCBA, higher consumption of 'fresh beef and lamb' was not associated with increased risk factors of cardio-metabolic diseases nor was it associated with better or poorer nutritional status for vitamins D, B12 or iron. This study adds to the evidence base on the contribution of 'fresh beef and lamb' in the diet and may be useful to policymakers updating guidance for healthy diets from sustainable food systems.
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Selenium intakes in the Irish adult population. J Nutr Sci 2023; 12:e35. [PMID: 37008414 PMCID: PMC10052560 DOI: 10.1017/jns.2023.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
Abstract
Selenium (Se) is an essential trace element which has an important role as a constituent of seleno-proteins involved in various physiological processes. Previous research in Irish adults suggests that intakes of this important nutrient are suboptimal. The aim of the present study was to estimate the current intakes and major food sources of Se by Irish adults. Mean daily intakes (MDIs) of Se were calculated using data from the National Adult Nutrition Survey which involved 1500 Irish adults aged 18–90 years. The Se content of foods and drinks consumed over a 4-d period was determined using data from the Irish Total Diet Study (TDS). Adequacy of Se intakes was assessed by calculating the proportion of the population with intakes below the adequate intake (AI) of 70 μg/d and lower reference nutrient intake of 40 μg/d (LRNI). The MDI of Se in the total population was 71⋅7 μg/d, with significantly higher intakes reported in men (80⋅2 μg/d) compared with women (63⋅4 μg/d, P < 0⋅01). Meat and meat products were the major contributing food group to Se intakes for both men (37 %) and women (31 %). Overall, 47 % of the population were not meeting the recommended AI, while 4 % of the total population were not meeting the LRNI. Although the average intake of Se is above the AI, a significant proportion of the population is not meeting this recommendation and continued monitoring of Se intakes is necessary, particularly by at-risk groups and also in the context of sustainability.
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Barrett R, Youssef M, Shah I, Ioana J, Lawati AA, Bukhari A, Hegarty S, Cormican LJ, Judge E, Burke CM, Cody C, Feely J, Hutchinson K, Tormey W, Neill EO, Shea AO, Connolly M, McCartney DMA, Faul JL. Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults. Nutrients 2022; 14:nu14163252. [PMID: 36014757 PMCID: PMC9413855 DOI: 10.3390/nu14163252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022] Open
Abstract
COVID-19 and a low vitamin D state share common risk factors, which might explain why vitamin D deficiency has been linked with higher COVID-19 mortality. Moreover, measures of serum vitamin D may become lower during systemic inflammatory responses, further confounding the association via reverse causality. In this prospective study (recruited over 12 months), we examined whether the association between a low vitamin D state and in-hospital mortality due to SARS-CoV-2 pneumonia in unvaccinated subjects is explained by (i) the presence of shared risk factors (e.g., obesity, advanced age) or (ii) a reduction in serum 25(OH)D due to COVID-19 (i.e., reverse causality). In this cohort of 232 (mean age = 56 years) patients (all had SARS-CoV-2 diagnosed via PCR AND required supplemental oxygen therapy), we failed to find an association between serum vitamin D and levels of CRP, or other inflammatory markers. However, the hazard ratio for mortality for subjects over 70 years of age (13.2) and for subjects with a serum 25(OH)D level less than 30 nmol·L−1 (4.6) remained significantly elevated even after adjustment for gender, obesity and the presence of diabetes mellitus. Subjects <70 years and >70 years had significantly higher mortality with a serum 25(OH)D less than 30 nmol·L−1 (11.8% and 55%), than with a serum 25(OH)D greater than 30 nmol·L−1 (2.2% and 25%). Unvaccinated Caucasian adults with a low vitamin D state have higher mortality due to SARS CoV-2 pneumonia, which is not explained by confounders and is not closely linked with elevated serum CRP.
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Affiliation(s)
- Robert Barrett
- School of Biological and Health Sciences, Technological University Dublin, D08 NF82 Dublin, Ireland
| | - Modar Youssef
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Irfan Shah
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Julia Ioana
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Abdullah Al Lawati
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Abdullah Bukhari
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Suzanne Hegarty
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Liam J. Cormican
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Eoin Judge
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Conor M. Burke
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
- Department of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Catriona Cody
- Department of Intensive Care Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Joseph Feely
- Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | | | - William Tormey
- Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Eoghan O’ Neill
- Department of Microbiology, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
| | - Aoife O’ Shea
- School of Biological and Health Sciences, Technological University Dublin, D08 NF82 Dublin, Ireland
| | - Meabh Connolly
- School of Biological and Health Sciences, Technological University Dublin, D08 NF82 Dublin, Ireland
| | - Daniel M. A. McCartney
- School of Biological and Health Sciences, Technological University Dublin, D08 NF82 Dublin, Ireland
| | - John L. Faul
- Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
- Department of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, D02 YN 77 Dublin, Ireland
- Correspondence:
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8
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Jefferson A, Borges C. Evaluation of the safety, tolerability and plasma vitamin D response to long-term use of patented transdermal vitamin D patches in healthy adults: a randomised parallel pilot study. BMJ Nutr Prev Health 2022; 5:217-226. [PMID: 36619342 PMCID: PMC9813629 DOI: 10.1136/bmjnph-2022-000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/15/2022] [Indexed: 01/11/2023] Open
Abstract
Background Vitamin D delivered transdermally may suppress hyperactivity in nociceptor pain receptors and alter pain intensity, offering a useful addition to localised pain management in varying clinical settings. Currently, little is known about long-term usage of continuous-release vitamin D patches. Method We conducted a randomised parallel pilot trial to evaluate safety and tolerability of daily application of patented (US8821921B2) transdermal vitamin D patches over 8 weeks and assess time-level profile of serum vitamin D. Compliance, tolerance and sun exposure were monitored daily, serum 25(OH)D measured 2-weekly and dietary intake and safety markers 4-weekly. Results Thirty healthy adults were randomised to two treatment groups: big patch and small patch. mean age was 36 years (20-68 years) with a 63% female to 37% male split. Patches differed in size but contained identical ingredients including 30 000 IU cholecalciferol. Physical and blood safety markers remained stable, within normal clinical parameters, and with no clinically meaningful changes throughout. Five big patch participants experienced skin irritation, which was mild and occasional for three, but continuous for two leading to patch withdrawal. There were no skin reactions in small patch group. average, serum 25(OH)D levels increased by +14 nmol/L (SD 11.63, range, -4 to 40 nmol/L) between baseline and week 8, with no significant differences between patch sizes. There was a shift in overall vitamin D status between baseline and week 8 (23% deficient (<30 nmol/L) decreasing to 0%, and normal (>50 nmol/L) increasing from 37% to 70% at week 8). Conclusion Based on these results, long-term (8 weeks) application of patented transdermal vitamin D patches was found to be safe. There may be minor skin tolerance issues with big patches for some, which appears to relate to patch size. Larger trials are warranted to explore the increase in vitamin D levels beyond 8 weeks. Trial registration number NCT04851990.
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9
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Trojian T. COVID-19 and Vitamin D Supplementation. Curr Sports Med Rep 2022; 21:222-223. [PMID: 35801722 DOI: 10.1249/jsr.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Thomas Trojian
- Department of Family, Preventive and Community Medicine, Drexel College of Medicine, Philadelphia, PA
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10
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McCourt AF, Mulrooney SL, O'Neill GJ, O'Riordan ED, O'Sullivan AM. Postprandial 25-hydroxyvitamin D response varies according to the lipid composition of a vitamin D3 fortified dairy drink. Int J Food Sci Nutr 2021; 73:396-406. [PMID: 34615419 DOI: 10.1080/09637486.2021.1984400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In-vitro evidence suggests that the lipid component of foods alters vitamin D absorption. This single-blinded, cross-over postprandial study examined the effect of changing the lipid component of a 20 µg vitamin D3 fortified dairy drink on postprandial 25(OH)D concentrations. Participants consumed one dairy drink per visit: a non-lipid, a pre-formed oleic acid micelle, an olive oil and a fish oil dairy drink. There was a significant time*drink*baseline status effect on 25(OH)D concentrations (p = 0.039). There were no time*drink, time or drink effects on 25(OH)D in vitamin D sufficient participants (>50nmol/L). However, there was an effect of time on changes in 25(OH)D concentrations after the olive oil dairy drink (p = 0.034) in vitamin D insufficient participants (<50nmol/L). There were no effects after the other diary drinks. Olive oil may improve vitamin D absorption from fortified foods. Further research is needed to examine the practical implications of changing the lipid component of fortified foods.
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Affiliation(s)
- Aislinn F McCourt
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Steven L Mulrooney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Graham J O'Neill
- TUD School of Food Science and Environmental Health, Technological University Dublin (TUD), Dublin, Ireland
| | - E Dolores O'Riordan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Aifric M O'Sullivan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
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11
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McCartney DM, O'Shea PM, Faul JL, Healy MJ, Byrne G, Griffin TP, Walsh JB, Byrne DG, Kenny RA. Vitamin D and SARS-CoV-2 infection-evolution of evidence supporting clinical practice and policy development : A position statement from the Covit-D Consortium. Ir J Med Sci 2021; 190:1253-1265. [PMID: 33219912 PMCID: PMC7679797 DOI: 10.1007/s11845-020-02427-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Daniel M McCartney
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland.
| | - Paula M O'Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - John L Faul
- James Connolly Memorial Asthma Research Centre, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin 15, Ireland
| | - Martin J Healy
- Biochemistry Department, St. James's Hospital, Dublin 8, Ireland
| | - Greg Byrne
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland
| | - Tomás P Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
- Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals, Galway, Ireland
| | - James Bernard Walsh
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Declan G Byrne
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Medicine Directorate, St. James's Hospital, Dublin 8, Ireland
| | - Rose Anne Kenny
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
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12
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Scully H, Laird E, Healy M, Crowley V, Walsh JB, McCarroll K. Vitamin D retesting by general practitioners: a factor and cost analysis. Clin Chem Lab Med 2021; 59:1790-1799. [PMID: 34271597 DOI: 10.1515/cclm-2021-0607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Vitamin D testing by Primary Care doctors is increasing, placing greater workloads on healthcare systems. There is little data though on vitamin D retesting in Ireland. This study aims to investigate the factors associated with vitamin D retesting by Irish General Practitioners (GPs) and examine the resulting costs. METHODS This is a retrospective analysis over 5 years (2014-2018) of GP requested 25-hydroxyvitamin D (25(OH)D) results in 36,458 patients at a major city hospital in Dublin, Ireland. Those with one test were compared with individuals who were retested and samples categorised to determine changes in status between tests. RESULTS Nearly one in four patients (n=8,305) were retested. Positive predictors of retesting were female (p<0.001), age (60-69 years, p<0.001), location (Co. Kildare, p<0.001) and initial deficiency (<30 nmol/L, p<0.001) or insufficiency (30-49.9 nmol/L, p<0.001). Vitamin D status improved on retesting, with deficiency halving on first retest (9 vs. 18%, p<0.001) and dropping to 6% on further retests. About 12.2% of retests were done within 3 months and 29% had ≥2 retests within 1 year. 57% of retests were in those initially vitamin D replete (>50 nmol/L). The annual cost of inappropriate testing was €61,976. CONCLUSIONS One in four patients were retested and this varied by age, gender and patient location. Over 10% of retests were inappropriately early (<3 months), a third too frequent and over half were in replete individuals incurring significant costs. Clear guidance for GPs on minimum retesting intervals is needed, as well as laboratory ordering systems to limit requests using pre-defined criteria.
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Affiliation(s)
- Helena Scully
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - Vivion Crowley
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - James Bernard Walsh
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
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13
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Knapik JJ, Farina EK, Fulgoni VL, Lieberman HR. Clinically-diagnosed vitamin deficiencies and disorders in the entire United States military population, 1997-2015. Nutr J 2021; 20:55. [PMID: 34130698 PMCID: PMC8207601 DOI: 10.1186/s12937-021-00708-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study examined incidence rates, temporal trends, and demographic factors associated with vitamin deficiencies/disorders in all United States military personnel from 1997 to 2015 (mean N = 1,382,266/year). METHODS Employing an ecological study design, the Defense Medical Epidemiological Database and specific International Classification of Diseases codes were used to determine incidence rates for clinically-diagnosed vitamin deficiencies/disorders. Associations with demographic factors were examined. RESULTS The overall incidence rate of vitamin deficiencies/disorders was 92.7 cases/100,000 person-years (p-yr). Highest rates were for vitamin D (53.7 cases/100,000 p-yr), other B-complex vitamins (20.2 cases, 100,000 p-yr), vitamin B12 anemia (7.6 cases/100,000 p-yr), deficiencies of "other vitamins" (5.9 cases/100,000 p-yr), and vitamin A (2.5 cases/100,000 p-yr). Thiamin, riboflavin, niacin, pyridoxine, folate, vitamin C, and vitamin K deficiencies and hypervitaminoses A and D had < 1 case/100,000 p-yr. Rates for vitamin D, other B-complex, "other vitamin", and thiamin deficiencies increased over time, while vitamin A and C deficiencies decreased. Women had higher incidence rates for all examined deficiencies/ disorders except niacin and vitamin C. Incidence rates rose with age in 8 of 15 deficiency/disorder categories and blacks had higher incidence rates in 9 of 15 deficiency/disorder categories. CONCLUSIONS The overall rate of clinically-diagnosed vitamin deficiencies and disorders was low but higher in women and minority subgroups. As for most illnesses, the diagnosed incidence of such disorders may be an underestimate of the actual incidence. These findings can guide clinical decision making with regard to testing for nutritional deficiencies and delivering public health information to at risk populations. CLINICAL TRIAL REGISTRATION (No. ISRCTN58987177 ). Registration date 9 October 2019.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - Emily K Farina
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Victor L Fulgoni
- Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI, 49014, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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14
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Prendiville O, Walton J, Flynn A, Nugent AP, McNulty BA, Brennan L. Classifying Individuals Into a Dietary Pattern Based on Metabolomic Data. Mol Nutr Food Res 2021; 65:e2001183. [PMID: 33864732 DOI: 10.1002/mnfr.202001183] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/01/2021] [Indexed: 11/07/2022]
Abstract
SCOPE The objectives are to develop a metabolomic-based model capable of classifying individuals into dietary patterns and to investigate the reproducibility of the model. METHODS AND RESULTS K-means cluster analysis is employed to derive dietary patterns using metabolomic data. Differences across the dietary patterns are examined using nutrient biomarkers. The model is used to assign individuals to a dietary pattern in an independent cohort, A-DIET Confirm (n = 175) at four time points. The stability of participants to a dietary pattern is assessed. Four dietary patterns are derived: moderately unhealthy, convenience, moderately healthy, and prudent. The moderately unhealthy and convenience patterns has lower adherence to the alternative healthy eating index (AHEI) and the alternative mediterranean diet score (AMDS) compared to the moderately healthy and prudent patterns (AHEI = 24.5 and 22.9 vs 26.7 and 28.4, p < 0.001). The dietary patterns are replicated in A-DIET Confirm, with good reproducibility across four time points. The stability of participants' dietary pattern membership ranged from 25.0% to 61.5%. CONCLUSION The multivariate model classifies individuals into dietary patterns based on metabolomic data. In an independent cohort, the model classifies individuals into dietary patterns at multiple time points furthering the potential of such an approach for nutrition research.
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Affiliation(s)
- Orla Prendiville
- UCD School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Anne P Nugent
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Northern Ireland
| | - Breige A McNulty
- UCD School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
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15
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Abstract
BACKGROUND Vitamin D and its deficiency have recently been suspected to be involved in increased susceptibility and negative outcomes of COVID-19. This assumption was based on the well known immunomodulatory actions of vitamin D and on the consistent finding of low levels of 25 hydroxyvitamin D (25OHD) in hospitalized patients with COVID-19. Moreover, several studies reported a correlation between 25OHD levels and different clinical outcomes of the disease. AIM Aim of the current review was to approach the topic of vitamin D and COVID-19 from a different perspective summarizing the data which led to the evidence of the existence of an endocrine phenotype of COVID-19. CONCLUSIONS This review analyzed in the light of the current knowledge the possibility that several endocrine manifestations of COVID-19 could be holistically interpreted in the context of an inadequate vitamin D status.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy.
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16
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Griffin TP, Wall D, Blake L, Griffin DG, Robinson SM, Bell M, Mulkerrin EC, O'Shea PM. Vitamin D Status of Adults in the Community, in Outpatient Clinics, in Hospital, and in Nursing Homes in the West of Ireland. J Gerontol A Biol Sci Med Sci 2021; 75:2418-2425. [PMID: 31942614 DOI: 10.1093/gerona/glaa010] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Approximately 1 billion people worldwide have Vitamin D deficiency. The aim of this study was to compare Vitamin D status and serum 25-hydroxyvitamin D (25(OH)D) concentrations among adults sampled in the community, in outpatient clinics, as hospital inpatients and in nursing homes in the West of Ireland. The secondary aim was to determine the associations between length of hospital stay (inpatients) at the time of serum 25(OH)D sampling and Vitamin D status. METHODS A cross-sectional study was carried out. Patients who had serum 25(OH)D analysis carried out in Galway University Hospitals (January 2011-December 2015) were identified following interrogation of the electronic laboratory data system. Baseline demographics, location, and date of sample collection were recorded. Vitamin D deficiency was defined as a serum 25(OH)D concentration <25 nmol/L. RESULTS In total, 24,302 patient samples were eligible for inclusion: community 15,319; outpatient clinics 6,371; inpatients 2,339; and nursing home residents 273. Vitamin D deficiency was more common in nursing home residents than inpatients, or those sampled in outpatient clinics or in the community (42% vs 37% vs 17% vs 13%; p < .001). Inpatients sampled further into their hospital stay (≥3 days) had greater Vitamin D deficiency than inpatients sampled on 0-2 days (p = .007). Season (p < .001), sex (p < .001), and age (p < .001) were associated with 25(OH)D concentrations. Vitamin D deficiency was more common in Winter/Spring, in males, and in those aged ≥80 years. CONCLUSIONS Nursing home residents and inpatients are at the highest risk for Vitamin D deficiency. Season, sex, age, and day of hospital stay on which serum 25(OH)D concentrations were sampled were associated with Vitamin D status.
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Affiliation(s)
- Tomás Patrick Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway.,Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals
| | - Deirdre Wall
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway
| | - Liam Blake
- Department of Clinical Biochemistry, Galway University Hospitals
| | - Damian Gerard Griffin
- Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals.,Department of Clinical Biochemistry, Galway University Hospitals
| | | | - Marcia Bell
- Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals
| | - Eamon C Mulkerrin
- Department of Geriatric Medicine, Galway University Hospitals, Ireland
| | - Paula M O'Shea
- Department of Clinical Biochemistry, Galway University Hospitals
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17
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Food for thought: the importance of nutritional well-being during COVID-19. Ir J Psychol Med 2021:1-6. [PMID: 33455607 PMCID: PMC7900659 DOI: 10.1017/ipm.2021.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Individuals with mental illness have poorer physical health, nutritional status, and lowered life expectancy. Optimising their physical and nutritional status has become an increasingly important therapeutic goal. Current experience with COVID-19 has further emphasised the susceptibility to physical illness and poorer outcomes amongst individuals with mental illness and those who are nutritionally compromised. Although life as we knew it has been suspended until the widespread roll-out of a vaccine, individuals can take immediate action to improve physical and mental health by attending to and optimising their nutritional well-being. Clinicians within mental health services have a crucial role to play in assisting such change, and reminding their patients of the importance of pursuing a healthy and balanced diet.
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18
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McNamara AE, Walton J, Flynn A, Nugent AP, McNulty BA, Brennan L. The Potential of Multi-Biomarker Panels in Nutrition Research: Total Fruit Intake as an Example. Front Nutr 2021; 7:577720. [PMID: 33521031 PMCID: PMC7840580 DOI: 10.3389/fnut.2020.577720] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/17/2020] [Indexed: 12/26/2022] Open
Abstract
Dietary and food intake biomarkers offer the potential of improving the accuracy of dietary assessment. An extensive range of putative intake biomarkers of commonly consumed foods have been identified to date. As the field of food intake biomarkers progresses toward solving the complexities of dietary habits, combining biomarkers associated with single foods or food groups may be required. The objective of this work was to examine the ability of a multi-biomarker panel to classify individuals into categories of fruit intake. Biomarker data was measured using 1H NMR spectroscopy in two studies: (1) An intervention study where varying amounts of fruit was consumed and (2) the National Adult Nutrition Survey (NANS). Using data from an intervention study a biomarker panel (Proline betaine, Hippurate, and Xylose) was constructed from three urinary biomarker concentrations. Biomarker cut-off values for three categories of fruit intake were developed. The biomarker sum cut-offs were ≤ 4.766, 4.766–5.976, >5.976 μM/mOsm/kg for <100, 101–160, and >160 g fruit intake. The ability of the biomarker sum to classify individuals into categories of fruit intake was examined in the cross-sectional study (NANS) (N = 565). Examination of results in the cross-sectional study revealed excellent agreement with self-reported intake: a similar number of participants were ranked into each category of fruit intake. The work illustrates the potential of multi-biomarker panels and paves the way forward for further development in the field. The use of such panels may be key to distinguishing foods and adding specificity to the predictions of food intake.
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Affiliation(s)
- Aoife E McNamara
- School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.,UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Anne P Nugent
- School of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, United Kingdom
| | - Breige A McNulty
- School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Lorraine Brennan
- School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.,UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
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19
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McNicholas F, Furey-Burke L. Step zero: optimising nutrition for physical and mental health wellbeing during COVID-19. Ir J Med Sci 2021; 190:1633-1635. [PMID: 33409844 PMCID: PMC7787618 DOI: 10.1007/s11845-020-02448-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/21/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Fiona McNicholas
- Department of Child & Adolescent Psychiatry, SMMS, UCD, Dublin, Ireland. .,Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. .,Lucena Clinic Rathgar, Dublin 6, Ireland.
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20
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Weir RR, Johnston M, Lowis C, Fearon AM, Stewart S, Strain JJ, Pourshahidi LK. Vitamin D 3 content of cows' milk produced in Northern Ireland and its efficacy as a vehicle for vitamin D fortification: a UK model. Int J Food Sci Nutr 2020; 72:447-455. [PMID: 33100087 DOI: 10.1080/09637486.2020.1837743] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cows' milk is a relatively poor source of vitamin D but figures listed in UK food composition tables may be outdated. Samples of milk were collected for 1-year and vitamin D3 concentrations analysed using HPLC. Milk consumption data were obtained from the National Diet and Nutrition Survey (Years 1-4). A theoretical model applied vitamin D3 fortifications of 1 μg, 1.5 μg and 2 μg/100g to simulate improvements in vitamin D intakes. Mean ± SD vitamin D3 in whole milk was 0.06 ± 0.02 μg/100g. No seasonal differences were apparent. Fortification of cows' milks with 1 μg, 1.5 μg and 2.0 μg/100g, theoretically increased median vitamin D intakes from 2.0 μg/day to 4.2 μg, 5.1 μg and 5.9 μg/day, respectively. Higher vitamin D3 in milk from this study than that currently in food composition tables, suggests further analysis is warranted. This model suggests vitamin D fortification of cows' milk is an effective strategy to help more of the population achieve recently revised RNIs for vitamin D.
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Affiliation(s)
- Ruth R Weir
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, UK
| | - Mike Johnston
- Dairy Council for Northern Ireland (DCNI), Belfast, UK
| | - Carole Lowis
- Dairy Council for Northern Ireland (DCNI), Belfast, UK
| | - Ann M Fearon
- Food Science Branch, Agri-Food and Biosciences Institute (AFBI), Belfast, UK
| | - Sharon Stewart
- Food Science Branch, Agri-Food and Biosciences Institute (AFBI), Belfast, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, UK
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, UK
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21
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Vitamin D status in children and adults in Sweden: dietary intake and 25-hydroxyvitamin D concentrations in children aged 10-12 years and adults aged 18-80 years. J Nutr Sci 2020; 9:e47. [PMID: 33101664 PMCID: PMC7550965 DOI: 10.1017/jns.2020.40] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 08/13/2020] [Accepted: 09/04/2020] [Indexed: 01/26/2023] Open
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.
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22
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Lenighan YM, Nugent AP, Moloney AP, Monahan FJ, Walton J, Flynn A, Roche HM, McNulty BA. A modelling approach to investigate the impact of consumption of three different beef compositions on human dietary fat intakes. Public Health Nutr 2020; 23:2373-2383. [PMID: 31829294 PMCID: PMC11374570 DOI: 10.1017/s1368980019003471] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To apply a dietary modelling approach to investigate the impact of substituting beef intakes with three types of alternative fatty acid (FA) composition of beef on population dietary fat intakes. DESIGN Cross-sectional, national food consumption survey - the National Adult Nutrition Survey (NANS). The fat content of the beef-containing food codes (n 52) and recipes (n 99) were updated with FA composition data from beef from animals receiving one of three ruminant dietary interventions: grass-fed (GRASS), grass finished on grass silage and concentrates (GSC) or concentrate-fed (CONC). Mean daily fat intakes, adherence to dietary guidelines and the impact of altering beef FA composition on dietary fat sources were characterised. SETTING Ireland. PARTICIPANTS Beef consumers (n 1044) aged 18-90 years. RESULTS Grass-based feeding practices improved dietary intakes of a number of individual FA, wherein myristic acid (C14 : 0) and palmitic acid (C16 : 0) were decreased, with an increase in conjugated linoleic acid (C18 : 2c9,t11) and trans-vaccenic acid (C18 : 1t11; P < 0·05). Improved adherence with dietary recommendations for total fat (98·5 %), SFA (57·4 %) and PUFA (98·8 %) was observed in the grass-fed beef scenario (P < 0·001). Trans-fat intakes were increased significantly in the grass-fed beef scenario (P < 0·001). CONCLUSIONS To the best of our knowledge, the present study is the first to characterise the impact of grass-fed beef consumption at population level. The study suggests that habitual consumption of grass-fed beef may have potential as a public health strategy to improve dietary fat quality.
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Affiliation(s)
- Yvonne M Lenighan
- Nutrigenomics Research Group, UCD Conway Institute, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Aidan P Moloney
- Teagasc, Animal & Grassland Research and Innovation Centre, Grange, Dunsany, Co. Meath, Republic of Ireland
| | - Frank J Monahan
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- Department of Biological Sciences, Cork Institute of Technology, Cork, Republic of Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | - Helen M Roche
- Nutrigenomics Research Group, UCD Conway Institute, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Breige A McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Republic of Ireland
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23
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Scully H, Laird E, Healy M, Walsh JB, Crowley V, McCarroll K. Geomapping Vitamin D Status in a Large City and Surrounding Population-Exploring the Impact of Location and Demographics. Nutrients 2020; 12:E2663. [PMID: 32878330 PMCID: PMC7551618 DOI: 10.3390/nu12092663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D status was assessed in a large urban area to compare differences in deficiency and to geomap the results. In total, 36,466 participants from 28 geographical areas were identified in this cross-sectional, retrospective analysis of general practitioner (GP)-requested 25(OH)D tests at St James's Hospital, Dublin between 2014 and 2018. The population were community-dwelling adults, median age 50.7 (18-109 years) with 15% of participants deficient (<30 nmol/L), rising to 23% in the winter. Deficiency was greatest in younger (18-39 years) and oldest (80+ years) adults, and in males versus females (18% vs. 11%, p < 0.001). Season was the biggest predictor of deficiency (OR 4.44, winter versus summer, p < 0.001), followed by location (west Dublin OR 2.17, north Dublin 1.54, south Dublin 1.42 versus rest of Ireland, p < 0.001) where several urban areas with an increased prevalence of deficiency were identified. There was no improvement in 25(OH)D over the 5-year period despite increased levels of testing. One in four adults were vitamin D deficient in the winter, with significant variations across locations and demographics. Overall this study identifies key groups at risk of 25(OH)D deficiency and insufficiency, thus providing important public health information for the targeting of interventions to optimise 25(OH)D. Mandatory fortification may be necessary to address this widespread inadequacy.
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Affiliation(s)
- Helena Scully
- Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin 8, Ireland; (J.B.W.); (K.M.)
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland;
| | - Martin Healy
- Department of Biochemistry, St James’s Hospital, Dublin 8, Ireland; (M.H.); (V.C.)
| | - James Bernard Walsh
- Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin 8, Ireland; (J.B.W.); (K.M.)
| | - Vivion Crowley
- Department of Biochemistry, St James’s Hospital, Dublin 8, Ireland; (M.H.); (V.C.)
| | - Kevin McCarroll
- Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin 8, Ireland; (J.B.W.); (K.M.)
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24
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McNamara AE, Collins C, Harsha PSCS, González-Peña D, Gibbons H, McNulty BA, Nugent AP, Walton J, Flynn A, Brennan L. Metabolomic-Based Approach to Identify Biomarkers of Apple Intake. Mol Nutr Food Res 2020; 64:e1901158. [PMID: 32243719 DOI: 10.1002/mnfr.201901158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/16/2020] [Indexed: 01/18/2023]
Abstract
SCOPE There is an increased interest in developing biomarkers of food intake to address some of the limitations associated with self-reported data. The objective is to identify biomarkers of apple intake, examine dose-response relationships, and agreement with self-reported data. METHODS AND RESULTS Metabolomic data from three studies are examined: an acute intervention, a short-term intervention, and a free-living cohort study. Fasting and postprandial urine samples are collected for analysis by 1 H-NMR and liquid chromatography-mass spectrometry (LC-MS). Calibration curves are developed to determine apple intake and classify individuals into categories of intake. Multivariate analysis of data reveals that levels of multiple metabolites increase significantly post-apple consumption, compared to the control food-broccoli. In the dose-response study, urinary xylose, epicatechin sulfate, and 2,6-dimethyl-2-(2-hydroxyethyl)-3,4-dihydro-2H-1-benzopyran increase as apple intake increases. Urinary xylose concentrations in a free-living cohort perform poorly at an individual level but are capable of ranking individuals in categories of intake. CONCLUSION Urinary xylose exhibits a dose-response relationship with apple intake and performs well as a ranking biomarker in the population study. Other potential biomarkers are identified and future work will combine these with xylose in a biomarker panel which may allow for a more objective determination of individual intake.
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Affiliation(s)
- Aoife E McNamara
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Cassandra Collins
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Pedapati S C Sri Harsha
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Diana González-Peña
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Helena Gibbons
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Breige A McNulty
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Anne P Nugent
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Belfast, Northern Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
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25
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McCourt A, McNulty BA, Walton J, O'Sullivan A. Efficacy and safety of food fortification to improve vitamin D intakes of older adults. Nutrition 2020; 75-76:110767. [PMID: 32248053 DOI: 10.1016/j.nut.2020.110767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the best foods for potential vitamin D food fortification and to model the efficacy and safety of different food fortification scenarios in adults ≥50 y of age in Ireland. METHODS National Adult Nutrition Survey vitamin D data for participants ≥50 y of age were updated. Vitamin D from foods with natural and added vitamin D was estimated and daily vitamin D intake patterns were examined. Data modeling was used to estimate the effects of target food fortification scenarios. RESULTS Almost two-thirds of the mean daily vitamin D intake of adults ≥50 y of age (7 ± 7 µg) comes from foods with added vitamin D. Milk and bread are the most frequently consumed foods across all meals and were subsequently targeted for the data modeling exercise. Results from the data modeling show that vitamin D intake increased between 9 and 17 µg/d, depending on the fortification scenario. Fortifying milk or bread resulted in ∼30% or ∼55% of individuals meeting the Recommended Daily Allowance (RDA); however, fortifying both simultaneously resulted in ∼70% meeting the RDA. CONCLUSIONS Currently, the majority of Irish adults ≥50 y of age are not meeting dietary recommendations for vitamin D. Fortification of commonly consumed foods such as milk and bread could improve daily intakes such that ∼70% of the cohort would meet the minimum recommendation. Future research should examine the efficacy of different food fortification scenarios to improve vitamin D intakes for older adults.
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Affiliation(s)
- Aislinn McCourt
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Janette Walton
- School of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland.
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Morrissey E, Giltinan M, Kehoe L, Nugent AP, McNulty BA, Flynn A, Walton J. Sodium and Potassium Intakes and Their Ratio in Adults (18-90 y): Findings from the Irish National Adult Nutrition Survey. Nutrients 2020; 12:E938. [PMID: 32231006 PMCID: PMC7231049 DOI: 10.3390/nu12040938] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 01/26/2023] Open
Abstract
An individual's sodium to potassium intake ratio (Na:K) has been shown to be an important predictor of hypertension. The aim of this study was to estimate the mean 24 h urinary Na, K and Na:K of Irish adults and to identify the foods that determine Na:K in a nationally representative sample of Irish adults. This study was based on data from the Irish National Adult Nutrition Survey (2008-2010) (NANS), which collected spot urine samples and dietary data in a nationally representative sample of Irish adults aged 18+ years. The mean urinary molar Na:K of Irish men and women was 1.90 and 2.15, respectively, which exceed target molar ratios of ≤1.0 and ≤2.0. The mean estimated 24-h urinary excretion of Na was 4631 mg for men and 3525 mg for women, which exceed target maximum population intakes for all gender and age groups. The mean estimated 24-h urinary excretion of K was 3894 mg for men and 2686 mg for women, with intakes in women of all ages and older men (65+ years) below current recommendations. The key foods positively associated with a lower Na:K were fruits, vegetables, potatoes, breakfast cereals, milk, yogurt and fresh meat, while the foods negatively associated with a lower Na:K were breads, cured and processed meats and butters and fat spreads. Strategies to reduce sodium and increase potassium intakes are necessary to lower population Na:K, which may help to reduce the burden of hypertension-related diseases in the Irish population.
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Affiliation(s)
- Eoin Morrissey
- Department of Biological Sciences, Cork Institute of Technology, T12928 Cork, Ireland
| | - Miriam Giltinan
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland
| | - Anne P. Nugent
- UCD Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Belfast BT7 1NN, Northern Ireland, UK
| | - Breige A. McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland
| | - Janette Walton
- Department of Biological Sciences, Cork Institute of Technology, T12928 Cork, Ireland
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland
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27
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Griffin TP, Wall D, Blake L, G Griffin D, Robinson S, Bell M, Mulkerrin EC, O'Shea PM. Higher risk of vitamin D insufficiency/deficiency for rural than urban dwellers. J Steroid Biochem Mol Biol 2020; 197:105547. [PMID: 31756419 DOI: 10.1016/j.jsbmb.2019.105547] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/14/2019] [Accepted: 11/17/2019] [Indexed: 12/11/2022]
Abstract
There are many risk factors for Vitamin D deficiency. This study aimed to compare the Vitamin D status and serum 25(OH)D concentrations of adults living in an urban area to adults living in a rural area in the West of Ireland (latitude 53.27° North). A cross-sectional retrospective analysis of clinical records was performed. Following interrogation of the electronic laboratory information system, individuals who had serum 25(OH)D concentrations measured at Galway University Hospitals between January 2011 and December 2015 were identified. Clinical demographics, setting and date of sampling were recorded. In total, 17,590 patients (urban n = 4,824; rural n = 12,766) were eligible for inclusion. Serum 25(OH)D concentrations were lower among rural compared to urban dwellers irrespective of season (spring p < 0.001, summer p = 0.009, autumn p = 0.002, winter p < 0.001). There was a significant difference in Vitamin D status between urban and rural dwellers in three of the four seasons: spring- deficiency: 16%-v-23%, insufficiency: 39%-v-43%, sufficiency: 45%-v-35% (p < 0.001); autumn- deficiency: 11%-v-10%, insufficiency: 30%-v-35%, sufficiency: 59%-v-56% (p = 0.01); winter- deficiency: 23%-v-25%, insufficiency: 35%-v-42%, sufficiency: 41%-v-33% (p < 0.001). Serum 25(OH)D concentrations were higher and the prevalence of deficiency lower in urban/rural females compared to urban/rural males (p < 0.001). Serum 25(OH)D concentrations increased sequentially from the 18-39 year age group to the 60-69 year age group in both urban (p < 0.001) and rural (p < 0.001) dwellers and then decreased progressively as age increased to ≥90 years. The odds of Vitamin D deficiency increased with age, lower daily sunshine hours, male gender, rural address and season.
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Affiliation(s)
- Tomás P Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland; Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals, Galway, Ireland
| | - Deirdre Wall
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
| | - Liam Blake
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
| | - Damian G Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland; Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
| | - Stephanie Robinson
- Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | - Marcia Bell
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Eamon C Mulkerrin
- Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | - Paula M O'Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland.
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Giustina A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Dawson-Hughes B, Ebeling PR, Feldman D, Formenti AM, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Consensus statement from 2 nd International Conference on Controversies in Vitamin D. Rev Endocr Metab Disord 2020; 21:89-116. [PMID: 32180081 PMCID: PMC7113202 DOI: 10.1007/s11154-019-09532-w] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The 2nd International Conference on Controversies in Vitamin D was held in Monteriggioni (Siena), Italy, September 11-14, 2018. The aim of this meeting was to address ongoing controversies and timely topics in vitamin D research, to review available data related to these topics and controversies, to promote discussion to help resolve lingering issues and ultimately to suggest a research agenda to clarify areas of uncertainty. Several issues from the first conference, held in 2017, were revisited, such as assays used to determine serum 25-hydroxyvitamin D [25(OH)D] concentration, which remains a critical and controversial issue for defining vitamin D status. Definitions of vitamin D nutritional status (i.e. sufficiency, insufficiency and deficiency) were also revisited. New areas were reviewed, including vitamin D threshold values and how they should be defined in the context of specific diseases, sources of vitamin D and risk factors associated with vitamin D deficiency. Non-skeletal aspects related to vitamin D were also discussed, including the reproductive system, neurology, chronic kidney disease and falls. The therapeutic role of vitamin D and findings from recent clinical trials were also addressed. The topics were considered by 3 focus groups and divided into three main areas: 1) "Laboratory": assays and threshold values to define vitamin D status; 2) "Clinical": sources of vitamin D and risk factors and role of vitamin D in non-skeletal disease and 3) "Therapeutics": controversial issues on observational studies and recent randomized controlled trials. In this report, we present a summary of our findings.
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Affiliation(s)
- A Giustina
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - R A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - N Binkley
- Osteoporosis Clinical Research Program and Institute on Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - J Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Leuven, KU, Belgium
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - D Feldman
- Department of Medicine, Endocrinology Division, Stanford University School of Medicine, Stanford, CA, USA
| | - A M Formenti
- Chair of Endocrinology, School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Endocrinology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - C Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Rizzoli
- Divison of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C T Sempos
- Vitamin D Standardization Program LLC, Havre de Grace, MD, USA
| | - J P Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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29
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Hone M, Nugent AP, Walton J, McNulty BA, Egan B. Habitual protein intake, protein distribution patterns and dietary sources in Irish adults with stratification by sex and age. J Hum Nutr Diet 2020; 33:465-476. [PMID: 31997529 DOI: 10.1111/jhn.12736] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/21/2019] [Accepted: 12/24/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Given the importance of habitual dietary protein intake, distribution patterns and dietary sources in the aetiology of age-related declines of muscle mass and function, the present study examined these factors as a function of sex and age in Irish adults aged 18-90 years comprising The National Adult Nutrition Survey (NANS). METHODS In total, 1051 (males, n = 523; females, n = 528) undertook a 4-day semi-weighed food diary. Total, body mass relative intake and percentage contribution to total energy intake of dietary protein were determined in addition to protein distribution scores (PDS), as well as the contribution of food groups, animal- and plant-based foods to total protein intake. RESULTS Total and relative protein intake [mean (SD)] were highest in those aged 18-35 years [96 (3) g day-1 , 1.32 (0.40) g kg-1 day-1 ], with lower protein intakes with increasing age (i.e. in adults aged ≥65 years [82 (22) g, 1.15 (0.34) g kg-1 day-1 , P < 0.001 for both]. Differences in protein intake between age groups were more pronounced in males compared to females. Protein distribution followed a skewed pattern for all age groups [breakfast, 15 (10) g; lunch, 30 (15) g; dinner, 44 (17) g]. Animal-based foods were the dominant protein source within the diet [63% (11%) versus 37% (11%) plant protein, P < 0.001]. CONCLUSIONS Protein intake and the number of meals reaching the purported threshold for maximising post-prandial anabolism were highest in young adults, and lower with increasing age. For main meals, breakfast provided the lowest quantity of protein across all age categories and may represent an opportunity for improving protein distribution, whereas, in older adults, increasing the number of meals reaching the anabolic threshold regardless of distribution pattern may be more appropriate.
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Affiliation(s)
- M Hone
- School of Health and Human Performance, Dublin City University, Glasnevin, Ireland
| | - A P Nugent
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Ireland.,School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - J Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - B A McNulty
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Ireland
| | - B Egan
- School of Health and Human Performance, Dublin City University, Glasnevin, Ireland.,National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Ireland
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30
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Kehoe L, Walton J, Hopkins SM, McNulty BA, Nugent AP, Flynn A. Modelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B 12 deficiency in older adults. Eur J Nutr 2019; 59:2631-2639. [PMID: 31646387 DOI: 10.1007/s00394-019-02111-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/04/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The rate of neural tube defects (NTDs) in Europe has remained similar since the 1990s despite folic acid supplement recommendations (400 µg/day) for women of childbearing age. Mandatory folic acid fortification of staple foods has proved effective for reducing the prevalence of NTDs in over 80 countries. This study estimated the impact of addition of folic acid to bread or flour in the Republic of Ireland on reducing the risk of occurrence of NTD-affected pregnancies and the possible risk of masking (undiagnosed) vitamin B12 deficiency in older adults. METHODS Analyses were based on the Irish National Adult Nutrition Survey (2008-2010). Folic acid fortification was modelled using DaDiet© software. Estimates were made of the increase in average daily folic acid intake in women (18-50 years) and the risk of exceeding the tolerable upper intake level (UL) of 1000 µg for folic acid in adults over 50 years of age. RESULTS The fortification scenarios examined would reduce the risk of NTD-affected pregnancies by 8-32%, corresponding to an increase of 39-152 μg in the mean daily folic acid intake of WCBA. The risk of masking anaemia associated with vitamin B12 deficiency in older adults would be negligible as the probability of exceeding the UL for folic acid, even by a small amount, is very low (≤ 0.2%). CONCLUSIONS These levels of addition of folic acid to bread or flour would effectively reduce the risk of NTDs while allowing safe consumption of folic acid at current levels from other fortified foods and supplements.
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Affiliation(s)
- Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland.
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
- Department of Biological Sciences, Cork Institute of Technology, Cork, Republic of Ireland
| | - Sinead M Hopkins
- UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- Institute for Global Food Security, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
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31
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Mullaney L, Cawley S, Kennedy R, O'Higgins AC, McCartney D, Turner MJ. Maternal nutrient intakes from food and drinks consumed in early pregnancy in Ireland. J Public Health (Oxf) 2019; 39:754-762. [PMID: 27679659 DOI: 10.1093/pubmed/fdw106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/15/2016] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this observational study was to measure food, macronutrient and micronutrient intakes of women presenting for antenatal care and assess compliance with current nutritional recommendations. Methods Women were recruited in the first trimester of pregnancy. Maternal weight and height were measured and body mass index (BMI) calculated. Body composition was measured using bioelectrical impedance analysis. Maternal energy and nutrient intakes were estimated using a validated Willett Food Frequency Questionnaire and misreporting of energy intakes (EI) determined. Results Plausible EIs were reported in 402 women. Mean age, weight and BMI were 30.8 years, 67.1 kg and 24.6 kg/m2 respectively. Median EIs were 2111 kcal, and median protein, carbohydrate and fat intakes were 17.3, 48.1 and 36.2 g/MJ/day, respectively. More than 90% of women exceeded the recommended daily allowance for saturated fat. Nearly all of the women (99%) did not meet estimated average requirements (EAR) for vitamin D. One in three women failed to achieve a dietary folate intake of 400 µg/day. Over one in five women failed to meet the EAR for iron, and 14% failed to achieve the EAR for calcium. Conclusions Our findings highlight concerning deficits in nutrient intakes among women and will help guide professional dietary advice to women attending for future obstetric care in Ireland.
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Affiliation(s)
- Laura Mullaney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Shona Cawley
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Rachel Kennedy
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Amy C O'Higgins
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Republic of Ireland
| | - Daniel McCartney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Michael J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Republic of Ireland
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32
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Vitamin D and foot and ankle trauma: An individual or societal problem. Foot (Edinb) 2019; 39:100-105. [PMID: 31026676 DOI: 10.1016/j.foot.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/04/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Vitamin D deficiency is a worldwide health concern. Hypovitaminosis D may adversely affect recovery from bone injury. The authors aimed to perform an audit of the Vitamin D status of patients in three centres in the United Kingdom presenting with foot and ankle osseous damage. METHODS Serum 25-hydroxyvitamin-D (vitamin D) levels were obtained in patients presenting with imaging confirmed foot and ankle osseous trauma. Variables including age, gender, ethnicity, location, season, month, anatomical location and type of bone injury were recorded. RESULTS 308 patients were included from three different centres. 66.6% were female. The average age was 47.7 (range; 10-85). The mean hydroxyvitamin-D levels were 52.0 nmol/L (SD 28.5). 18.8% were grossly deficient, 23.7% deficient, 34.7% insufficient and 22.7% within normal range. 351 separate bone injuries were identified of which 104 were categorised as stress reactions, 134 as stress fractures, 105 as fractures and 8 non-unions. Age, gender, anatomical location and fracture type did not statistically affect vitamin D levels. Ethnicity did affect Vitamin D levels: non-Caucasians mean levels were 32.4 nmols/L compared to Caucasian levels of 53.2 nmol/L (p=0.0026). CONCLUSION Only 18.8% of our trauma patients had a normal Vitamin D level and 22.7% were grossly deficient. Patient age, gender, anatomical location and injury type did not statistically affect vitamin D levels. No difference between trauma and elective patients were found. Hypovitaminosis D is a problem of society in general rather than specific to certain foot and ankle injury patterns or particular patient groups sustaining trauma. LEVEL OF EVIDENCE 2b.
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Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon R. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol 2019; 180:P23-P54. [PMID: 30721133 DOI: 10.1530/eje-18-0736] [Citation(s) in RCA: 369] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D <30 nmol/L or 12 ng/mL) is found in >10% of Europeans. The European Calcified Tissue Society (ECTS) advises that the measurement of serum 25(OH)D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defects and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non-Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficiency, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer.
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Affiliation(s)
- Paul Lips
- Endocrine Section, Department of Internal Medicine, Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, University College Cork, Cork, Ireland
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutritional Sciences, University of Helsinki, Helsinki, Finland
| | | | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | - Jan Stepan
- Institute of Rheumatology, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Roger Bouillon
- Clinic and Laboratory of Endocrinology, Gasthuisberg, KU Leuven, Leuven, Belgium
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Laird E, O'Halloran AM, Carey D, Healy M, O'Connor D, Moore P, Shannon T, Molloy AM, Kenny RA. The Prevalence of Vitamin D Deficiency and the Determinants of 25(OH)D Concentration in Older Irish Adults: Data From The Irish Longitudinal Study on Ageing (TILDA). J Gerontol A Biol Sci Med Sci 2019; 73:519-525. [PMID: 28958047 DOI: 10.1093/gerona/glx168] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/31/2017] [Indexed: 12/28/2022] Open
Abstract
Background Few data are available examining the determinants of vitamin D status exclusively in older adults. We aimed to investigate the prevalence and determinants of vitamin D deficiency in a representative sample of the older Irish population (aged 50-98 years). Methods The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 5,356 community-dwelling older Irish adults from The Irish Longitudinal Study on Ageing (TILDA). Detailed demographic, geographic, lifestyle, and socioeconomic factors were assessed by questionnaire. Proportions of deficiency prevalence were generated by season sampled. Linear regression was used to investigate the association between 25(OH)D concentration and reported risk factors. Results The prevalence of deficiency (25(OH)D < 30 nmol/L) was 13.1% (95% CI: 12.1-14.2). Deficiency status was more prevalent in nonsupplement users, in winter, in smokers, in obese adults, the physically inactive, those living alone, and in the oldest old (>80 years). The main predictors (p < .05) of 25(OH)D concentration were supplement use (coefficient nmol/L: 27.2 [95% CI: 15.3-39.2]), smoking (-8.9 [-12.6--5.2]), summer season (5.9 [2.7-9.1]), and obesity (-4.0 [-6.3--1.7]). Conclusion Vitamin D deficiency is common among older Irish adults. These data indicate the need for targeted strategies within sections of the older population to improve vitamin D status.
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Affiliation(s)
- Eamon Laird
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | | | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Martin Healy
- The Department of Biochemistry & Clinical Pathology, St James's Hospital, Dublin, Ireland
| | - Deirdre O'Connor
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Patrick Moore
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Tom Shannon
- The Department of Biochemistry & Clinical Pathology, St James's Hospital, Dublin, Ireland
| | | | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,School of Medicine, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
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Abstract
Population ageing is rapidly progressing and it is estimated that by 2050 one in every five people globally will be aged 60 years or over. Research has shown that adequate nutritional status can positively impact the ageing process, resulting in improved quality of life and the prevention of chronic disease and mortality. However, due to physiological and social changes associated with ageing, older adults may be at increased risk of nutrient deficiencies. This review aims to investigate the nutrient intake and status of older adults in Europe and to explore the potential role of fortified foods and nutritional supplements in addressing some of the nutritional challenges identified in this population group. The available literature has highlighted unfavourable intakes of total and saturated fat, sugar, salt and dietary fibre together with low intakes and suboptimal status of key micronutrients such as vitamins D, B2, B12, folate and calcium. Evidence has shown that the consumption of fortified foods and use of nutritional supplements make significant contributions to intakes and status of these micronutrients in older adults. Continued monitoring of nutrient intake and status is important in light of changing fortification practices and food consumption patterns. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt), food fortification or supplementation to support successful ageing of our populations.
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Lyons J, Walton J, Flynn A. Larger Food Portion Sizes Are Associated with Both Positive and Negative Markers of Dietary Quality in Irish Adults. Nutrients 2018; 10:nu10121929. [PMID: 30563172 PMCID: PMC6316121 DOI: 10.3390/nu10121929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 11/24/2022] Open
Abstract
Reduction in portion size, particularly for energy-dense foods, is increasingly addressed in healthy eating guidelines in a bid to tackle the obesity epidemic. The effect of portion size on other aspects of dietary quality, such as nutrient intakes, is less studied. The aim of the current work was to investigate associations between food portion sizes and key indicators of dietary quality, namely energy-adjusted intakes of saturated fat, dietary fibre, sodium, calcium, iron, folate and vitamin D, and dietary energy density (DED), in Irish adults on the days the foods were consumed. Data from the Irish National Adult Nutrition Survey (2008–2010) (n = 1274, 18–64 years, 4-day semi-weighed record) were used for the analysis. DED was lower on the days larger portions of boiled potatoes, fruit, vegetables and baked beans were consumed, and higher on the days larger portions of white bread, ready-to-eat breakfast cereals (RTEBCs), frying meats, cheese, butter, biscuits, chocolate and sugar-sweetened beverages were consumed. Micronutrient intakes were higher on the days larger portions of brown bread, RTEBCs, vegetables and low-fat spreads were consumed, and lower on the days larger portions of white bread, butter, biscuits, chocolate, sugar-sweetened beverages and beer/cider were consumed, with the exception of folate. The study identifies foods for which larger portion sizes may be associated with positive dietary attributes, as well as the opposite. It provides an important evidence base from which more specific dietary guidance on food portion sizes might be developed for Irish adults.
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Affiliation(s)
- Jacqueline Lyons
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland.
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland.
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland.
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Li K, Brennan L, Bloomfield JF, Duff DJ, McNulty BA, Flynn A, Walton J, Gibney MJ, Nugent AP. Adiposity Associated Plasma Linoleic Acid is Related to Demographic, Metabolic Health and Haplotypes of FADS1/2 Genes in Irish Adults. Mol Nutr Food Res 2018; 62:e1700785. [DOI: 10.1002/mnfr.201700785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/04/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Kaifeng Li
- Institute of Food and Health; School of Agriculture and Food Science; University College Dublin (UCD); Belfield Republic of Ireland
| | - Lorraine Brennan
- Institute of Food and Health; School of Agriculture and Food Science; University College Dublin (UCD); Belfield Republic of Ireland
| | | | - Dan J. Duff
- Chemical Analysis Laboratories; Sandycove Republic of Ireland
| | - Breige A. McNulty
- Institute of Food and Health; School of Agriculture and Food Science; University College Dublin (UCD); Belfield Republic of Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences; University College Cork; Cork Republic of Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences; University College Cork; Cork Republic of Ireland
- School of Biological Sciences; Cork Institute of Technology; Cork Republic of Ireland
| | - Michael J. Gibney
- Institute of Food and Health; School of Agriculture and Food Science; University College Dublin (UCD); Belfield Republic of Ireland
| | - Anne P. Nugent
- Institute of Food and Health; School of Agriculture and Food Science; University College Dublin (UCD); Belfield Republic of Ireland
- School of Biological Sciences; Institute for Global Food Security; Queens University; Belfast Northern Ireland
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McKenna MJ, Murray B, Lonergan R, Segurado R, Tubridy N, Kilbane MT. Analysing the effect of multiple sclerosis on vitamin D related biochemical markers of bone remodelling. J Steroid Biochem Mol Biol 2018; 177:91-95. [PMID: 28887146 DOI: 10.1016/j.jsbmb.2017.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/27/2017] [Accepted: 09/05/2017] [Indexed: 01/27/2023]
Abstract
The Irish population is at risk of vitamin D deficiency during the winter months, but the secular trend over the past 40 years is for marked improvement. Multiple sclerosis (MS) is common in Ireland with a latitudinal pattern favouring highest incidence in northern regions; MS is linked strongly with vitamin D status as a causal factor. We sought firstly to study the relationship between vitamin D status and vitamin D-related bone biochemistry, and secondly to evaluate if MS had an independent effect on vitamin D related markers of bone remodelling. Using a case-control design of 165 pairs (MS patient and matched control) residing in three different geographic regions during winter months, we measured serum 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), C-terminal telopeptide of type I collagen (CTX) and total procollagen type I amino-terminal propeptide (PINP). Given the paired case-control design, associations were explored using mixed-effects linear regression analysis with the patient-control pair as a random effect and after log transformation of 25OHD. A two-way interaction effect was tested for vitamin D status (25OHD <30nmol/L) and the presence of MS on PTH, CTX, and PINP. In the total group, just over one-third (34.5%) had 25OHD <30nmol/L. PTH was elevated in 7.6%. CTX was not elevated in any case, and PINP was elevated in 4.5%. On mixed-effects linear regression analysis after adjusting for confounders (age, sex, renal function, and serum albumin), we demonstrated the principal determinant of 25OHD was geographical location (p<0.001), of PTH was 25OHD (p<0.001), of CTX was PTH (p<0.001), and of PINP was PTH (p<0.001). MS did not have an independent effect on PTH (p=0.921), CTX (p=0.912), or PINP (p=0.495). As regards an interaction effect, the presence of MS and 25OHD <30nmol/L was not significant but tended towards having lower PTH (p=0.207). In conclusion, in Ireland in winter only a minority had any abnormality in the secondary indices of vitamin D deficiency, and MS had no independent effect on parathyroid status or bone remodelling activity.
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Affiliation(s)
- Malachi J McKenna
- Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland; UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
| | - Barbara Murray
- Department of Clinical Chemistry, St Vincent's University Hospital, Dublin, Ireland
| | - Roisin Lonergan
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research (CSTAR), School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Niall Tubridy
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland; UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Mark T Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, Dublin, Ireland
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O'Donovan CB, Devlin NF, Buffini M, Walton J, Flynn A, Gibney MJ, Nugent AP, McNulty BA. Whole grain intakes in Irish adults: findings from the National Adults Nutrition Survey (NANS). Eur J Nutr 2018; 58:541-550. [PMID: 29353315 DOI: 10.1007/s00394-018-1615-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/08/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE Observational studies link high whole grain intakes to reduced risk of many chronic diseases. This study quantified whole grain intakes in the Irish adult population and examined the major contributing sources. It also investigated potential dietary strategies to improve whole grain intakes. METHODS Whole grain intakes were calculated in a nationally representative sample of 1500 Irish adults using data from the most recent national food survey, the National Adult Nutrition Survey (NANS). Food consumption was assessed, at brand level where possible, using a 4-day semi-weighed food diary with whole grain content estimated from labels on a dry matter basis. RESULTS Mean daily whole grain intakes were 27.8 ± 29.4 g/day, with only 19% of the population meeting the quantity-specific recommendation of 48 g per day. Wheat was the highest contributor to whole grain intake at 66%, followed by oats at 26%. High whole grain intakes were associated with higher dietary intakes of fibre, magnesium, potassium, phosphorus, and a higher alternative Mediterranean Diet Score. Whole grain foods were most frequently eaten at breakfast time. Regression analysis revealed that consumption of an additional 10 g of whole grain containing 'ready-to-eat breakfast cereals', 'rice or pastas', or 'breads' each day would increase intake of whole grains by an extra 5, 3.5, and 2.7 g, respectively. CONCLUSIONS This study reveals low intakes of whole grains in Irish adults. Recommending cereals, breads, and grains with higher whole grain content as part of public health campaigns could improve whole grain intakes.
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Affiliation(s)
- Clare B O'Donovan
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Niamh F Devlin
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Maria Buffini
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Michael J Gibney
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland. .,Department of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, Ireland.
| | - Breige A McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
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Bettencourt A, Boleixa D, Reis J, Oliveira JC, Mendonça D, Costa PP, Silva BMD, Marinho A, Silva AMD. Serum 25-hydroxyvitamin D levels in a healthy population from the North of Portugal. J Steroid Biochem Mol Biol 2018; 175:97-101. [PMID: 27825978 DOI: 10.1016/j.jsbmb.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/26/2016] [Accepted: 11/03/2016] [Indexed: 12/11/2022]
Abstract
Vitamin D status in human populations has become a matter of great concern, in the wake of a multitude of published works that document widespread vitamin D deficiency across Europe, even in countries with abundant sunlight. In Portugal there are no measures of 25-hydroxyvitamin D - 25(OH)D - levels in the general adult population. The purpose of this study was to measure 25(OH)D levels in a healthy population cohort and investigate the possible association with season and selected demographic and laboratory measurements. A cohort of 198 participants (18-67 years) living in the north of Portugal, Porto, conducted in July and August 2015 (summer time) and April 2016 (winter time) was studied to evaluate serum 25(OH)D levels. Sociodemographic characteristics (age, sex and body mass index) and season of the year were taken into account as possible 25(OH)D levels codeterminants. In the whole group, the mean level of serum 25(OH)D was 55.4±23.4 nmol/L, with 48% of the population presenting levels compatible with vitamin D deficiency (below 50 nmol/L). In the winter period, this value reaches 74%. No statistically significant differences were observed between genders (57.4±23.9 vs. 53.3±22.8 nmol/L, p=0.219) as well as no statistically significant correlation was found between age and 25(OH)D levels (p=0.349). As expected higher levels of 25(OH)D were observed in summer than in winter (68.2±21.5 vs. 42.2±16.9 nmol/L; p<0.0001). Serum 25(OH)D levels were significantly lower in obese compared to non-obese subjects (46.6±17.6 vs. 57.7±24.2 nmol/L, p=0.012). Vitamin D deficiency is prevalent in this area, affecting almost half of the population. Body mass index and season are predictors for lower 25-hydroxyvitamin D levels and vitamin D status. An effective strategy to prevent vitamin D deficiency and insufficiency should be envisaged and implemented in our population.
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Affiliation(s)
- Andreia Bettencourt
- Immunogenetics Laboratory, Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Daniela Boleixa
- Immunogenetics Laboratory, Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Júlia Reis
- Clinical Chemistry Department, Centro Hospitalar do Porto-Hospital de Santo António (CHP-HSA), Porto, Portugal
| | - José Carlos Oliveira
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Clinical Chemistry Department, Centro Hospitalar do Porto-Hospital de Santo António (CHP-HSA), Porto, Portugal
| | - Denisa Mendonça
- Population Study Department, Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Paulo Pinho Costa
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Department of Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Porto, Portugal
| | - Berta Martins da Silva
- Immunogenetics Laboratory, Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - António Marinho
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Unidade de Imunologia Clínica (UIC), Centro Hospitalar do Porto-Hospital de Santo António (CHP-HSA), Porto, Portugal.
| | - Ana Martins da Silva
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal; Unidade de Imunologia Clínica (UIC), Centro Hospitalar do Porto-Hospital de Santo António (CHP-HSA), Porto, Portugal; Department of Neurology, Centro Hospitalar do Porto-Hospital de Santo António (CHP-HSA), Porto, Portugal
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Abstract
Globally, an estimated 46 million people are currently living with dementia and this figure is projected to increase 3-fold by 2050, highlighting this major public health concern and its substantial associated healthcare costs. With pharmacological treatment yet to reach fruition, the emphasis on evidence-based preventative lifestyle strategies is becoming increasingly important and several modifiable lifestyle factors have been identified that may preserve cognitive health. These include good cardiovascular health, physical activity, low alcohol intake, smoking and a healthy diet, with growing interest in vitamin D. The aim of the present paper is to review the evidence supporting the potential roles of vitamin D in ageing and cognitive health in community-dwelling older adults. Furthermore, to describe the utility and challenges of cognitive assessments and outcomes when investigating vitamin D in this context. Evidence indicates that serum 25-hydroxyvitamin D (25(OH)D) may impact brain health. There is a biological plausibility from animal models that vitamin D may influence neurodegenerative disorders, through several mechanisms. Epidemiological evidence supports associations between low serum 25(OH)D concentrations and poorer cognitive performance in community-dwelling older populations, although an optimal 25(OH)D level for cognitive health could not be determined. The effect of raising 25(OH)D concentrations on cognitive function remains unclear, as there is a paucity of interventional evidence. At a minimum, it seems prudent to aim to prevent vitamin D deficiency in older adults, with other known common protective lifestyle factors, as a viable component of brain health strategies.
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Yin X, Gibbons H, Rundle M, Frost G, McNulty BA, Nugent AP, Walton J, Flynn A, Gibney MJ, Brennan L. Estimation of Chicken Intake by Adults Using Metabolomics-Derived Markers. J Nutr 2017; 147:1850-1857. [PMID: 28794208 DOI: 10.3945/jn.117.252197] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/10/2017] [Accepted: 07/10/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Improved assessment of meat intake with the use of metabolomics-derived markers can provide objective data and could be helpful in clarifying proposed associations between meat intake and health. OBJECTIVE The objective of this study was to identify novel markers of chicken intake using a metabolomics approach and use markers to determine intake in an independent cohort. METHODS Ten participants [age: 62 y; body mass index (in kg/m2): 28.25] in the NutriTech food intake study consumed increasing amounts of chicken, from 88 to 290 g/d, in a 3-wk span. Urine and blood samples were analyzed by nuclear magnetic resonance and mass spectrometry, respectively. A multivariate data analysis was performed to identify markers associated with chicken intake. A calibration curve was built based on dose-response association using NutriTech data. A Bland-Altman analysis evaluated the agreement between reported and calculated chicken intake in a National Adult Nutrition Survey cohort. RESULTS Multivariate data analysis of postprandial and fasting urine samples collected in participants in the NutriTech study revealed good discrimination between high (290 g/d) and low (88 g/d) chicken intakes. Urinary metabolite profiles showed differences in metabolite levels between low and high chicken intakes. Examining metabolite profiles revealed that guanidoacetate increased from 1.47 to 3.66 mmol/L following increasing chicken intakes from 88 to 290 g/d (P < 0.01). Using a calibration curve developed from the NutriTech study, chicken intake was calculated through the use of data from the National Adult Nutrition Survey, in which consumers of chicken had a higher guanidoacetate excretion (0.70 mmol/L) than did nonconsumers (0.47 mmol/L; P < 0.01). A Bland-Altman analysis revealed good agreement between reported and calculated intakes, with a bias of -30.2 g/d. Plasma metabolite analysis demonstrated that 3-methylhistidine was a more suitable indicator of chicken intake than 1-methylhistidine. CONCLUSIONS Guanidoacetate was successfully identified and confirmed as a marker of chicken intake, and its measurement in fasting urine samples could be used to determine chicken intake in a free-living population. This trial was registered at clinicaltrials.gov as NCT01684917.
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Affiliation(s)
- Xiaofei Yin
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Helena Gibbons
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Milena Rundle
- Faculty of Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Gary Frost
- Faculty of Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Breige A McNulty
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Anne P Nugent
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Michael J Gibney
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Lorraine Brennan
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Dublin, Ireland
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Gibbons H, Carr E, McNulty BA, Nugent AP, Walton J, Flynn A, Gibney MJ, Brennan L. Metabolomic-based identification of clusters that reflect dietary patterns. Mol Nutr Food Res 2017; 61. [DOI: 10.1002/mnfr.201601050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Helena Gibbons
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
| | - Eibhlin Carr
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
| | - Breige A. McNulty
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
| | - Anne P. Nugent
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences; University College Cork; Cork Republic of Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences; University College Cork; Cork Republic of Ireland
| | - Michael J. Gibney
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
| | - Lorraine Brennan
- Institute of Food and Health, UCD School of Agriculture and Food Science; University College Dublin; Dublin Republic of Ireland
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Horan MK, Donnelly JM, McKenna MJ, Crosbie B, Kilbane MT, McAuliffe FM. An examination of whether associations exist between maternal and neonatal 25OHD and infant size and adiposity at birth, 6-9 months and 2-2.5 years of age - a longitudinal observational study from the ROLO study. BMC Nutr 2017; 3:62. [PMID: 32153842 PMCID: PMC7050699 DOI: 10.1186/s40795-017-0184-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/09/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Vitamin D status in pregnancy and offspring bone health effects are well established, yet limited knowledge exists on the effect of maternal vitamin D status on offspring size/adiposity. This study examines the association of early (13 weeks), late (28 weeks) pregnancy and neonatal (umbilical) 25-hydroxyvitamin D (25OHD) on offspring size/adiposity. METHODS This analysis included mother-infant pairs from the ROLO study at birth (n = 292), 6-9 months (n = 160) and 2-2.5 years (n = 287) postpartum. RESULTS Using Institute of Medicine 2011 Report criteria, 30% of women in early pregnancy and 38% in late pregnancy were at risk of vitamin D deficiency (25OHD < 30 nmol/L). Birthweight was negatively associated with early-pregnancy 25OHD (p = 0.004) and neonatal 25OHD (p < 0.001). Birth length was not associated with 25OHD. Neonatal measures of overall adiposity were negatively associated with neonatal 25OHD (p = 0.001, and p = <0.001 respectively). At 2-2.5 years there was a negative association between weight-for-age z-score and early-pregnancy 25OHD (p < 0.041). CONCLUSIONS Maternal and neonatal 25OHD were negatively associated with offspring size/adiposity at birth and offspring weight-for-age at 2-2.5 years. Results may not reflect a general population replete in vitamin D, due to high prevalence of macrosomia and high risk of deficiency in this cohort. Improvement of pregnancy vitamin D status remains a public health concern. TRIAL REGISTRATION Current Controlled Trials ISRCTN54392969. 22/04/2009 retrospectively registered.
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Affiliation(s)
- Mary K. Horan
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Jean M. Donnelly
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Malachi J. McKenna
- Department of Endocrinology, St. Vincent’s University Hospital, Dublin 4, Ireland
| | - Brenda Crosbie
- Metabolism Laboratory, St Vincent’s University Hospital, Dublin 4, Ireland
| | - Mark T. Kilbane
- Metabolism Laboratory, St Vincent’s University Hospital, Dublin 4, Ireland
| | - Fionnuala M. McAuliffe
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
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High Vitamin D Levels May Downregulate Inflammation in Patients with Behçet's Disease. Int J Inflam 2017; 2017:8608716. [PMID: 28660088 PMCID: PMC5474237 DOI: 10.1155/2017/8608716] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/01/2017] [Accepted: 05/09/2017] [Indexed: 01/23/2023] Open
Abstract
Vitamin D plays a significant role in the immune system modulation and may confer a protective role in autoimmune diseases. We conducted a case-control study to compare 25(OH)D levels in patients with BD who were managed at a regional rheumatology programme in the midwest region of Ireland compared to matched controls. Healthy controls were selected from the Irish health system and matched in 1 : 5 ratio for age, sex, and the month of the year. 25(OH)D levels <20 nmol/L were classified as deficient while levels between 20 and 40 nmol/L were classified as insufficient. Differences between groups were assessed using Mann-Whitney test and associations between cases and controls were expressed as odds ratios and 95% confidence intervals. Nineteen patients with BD were compared with 95 controls matched by age, sex, and month of blood draw. 25(OH)D levels were significantly higher in patients in BD than in matched controls (median values: 45 nmol/L versus 22 nmol/L, p < 0.005) and tended to be lower in patients with active disease than in those without (median values: 35 nmol/L (IQR: 22.75-47.25 nm/L) versus 50 nmol/L (IQR: 35-67 nmol/L), p = 0.11). Compared to controls, patients with BD were significantly less likely to have 25(OH)D deficiency or insufficiency (OR: 0.09, 95% CI: 0.03-0.28, p < 0.001). Our findings suggest a possible role for 25(OH)D in modifying the inflammatory response in BD and uncover a potential opportunity to assess whether correction of Vit D deficiency confers protective benefits.
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Jakab E, Kalina E, Petho Z, Pap Z, Balogh A, Grant WB, Bhattoa HP. Standardizing 25-hydroxyvitamin D data from the HunMen cohort. Osteoporos Int 2017; 28:1653-1657. [PMID: 28321506 DOI: 10.1007/s00198-017-3924-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/11/2017] [Indexed: 12/31/2022]
Abstract
UNLABELLED Standardization of 25-hydroxyvitamin D (25OHD) values is still a challenge. We propose standardization by correction of the measured 25OHD values using the linear regression bias from the National Institute of Standards and Technology (NIST) 'total' target values reported by Vitamin D External Quality Assessment Scheme (DEQAS). Our approach could perhaps be a practical solution to the anomaly surrounding non-standardized 25OHD values. INTRODUCTION Standardization of 25OHD values is still a challenge. We propose standardization by correction of the measured 25OHD values using the linear regression equation derived from the analysis of relationship between total 25OHD values measured by the methodology used by the laboratory and the NIST total target values (TV) reported by the DEQAS for all 5 of the DEQAS samples in a given survey. METHODS We applied our approach to standardize total 25OHD values of the HunMen cohort. RESULTS All 206 samples for the HunMen cohort were evaluated using the automated Liaison DiaSorin total 25OHD chemiluminescence immunoassay (CLIA). The timing of these measurements coincided with that of the October 2015 DEQAS survey using samples 481 to 485. Following standardization, the mean total 25OHD changed from 53 to 62 nmol/L and the prevalence of hypovitaminosis D (<75 nmol/L) decreased significantly from 84 to 72%. CONCLUSION A simple approach readily applicable at the routine diagnostic laboratory could perhaps be a practical solution to the anomaly surrounding non-standardized 25OHD values.
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Affiliation(s)
- E Jakab
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary
| | - E Kalina
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary
| | - Z Petho
- Department of Rheumatology, University of Debrecen, Debrecen, H-4032, Hungary
| | - Z Pap
- Department of Traumatology, University of Debrecen, Debrecen, H-4032, Hungary
| | - A Balogh
- Department of Obstetrics and Gynecology, University of Debrecen, Debrecen, H-4032, Hungary
| | - W B Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, 94164-1603, USA
| | - H P Bhattoa
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary.
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O'Brien EC, Kilbane MT, McKenna MJ, Segurado R, Geraghty AA, McAuliffe FM. Calcium intake in winter pregnancy attenuates impact of vitamin D inadequacy on urine NTX, a marker of bone resorption. Eur J Nutr 2017; 57:1015-1023. [PMID: 28224220 DOI: 10.1007/s00394-017-1385-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/25/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE Pregnancy is characterised by increased bone turnover, but high bone turnover with resorption exceeding formation may lead to negative maternal bone remodelling. Recent studies are conflicting regarding the effect of calcium on skeletal health in pregnancy. The aim of this study was to examine the seasonal effect of serum 25-hydroxyvitamin D (25OHD) and dietary calcium on a marker of bone resorption. METHODS This was prospective study of 205 pregnant women [two cohorts; early pregnancy at 13 weeks (n = 96), and late pregnancy at 28 weeks (n = 109)]. Serum 25OHD and urine cross-linked N-telopeptides of type I collagen (uNTX) were measured at both time points. Intakes of vitamin D and calcium were recorded using 3-day food diaries at each trimester. RESULTS Compared to summer pregnancies, winter pregnancies had significantly lower 25OHD and significantly higher uNTX. Higher calcium intakes were negatively correlated with uNTX in winter, but not summer. In late pregnancy, compared to those reporting calcium intakes ≥1000 mg/day, intakes of <1000 mg/day were associated with a greater increase in uNTX in winter pregnancies than in summer (41.8 vs. 0.9%). Increasing calcium intake in winter by 200 mg/day predicted a 13.3% reduction in late pregnancy uNTX. CONCLUSIONS In late pregnancy, during winter months when 25OHD is inadequate, intakes of dietary calcium <1000 mg/day were associated with significantly increased bone resorption (uNTX). Additional dietary calcium is associated with reduced bone resorption in late pregnancy, with greater effect observed in winter. Further research regarding optimal dietary calcium and 25OHD in pregnancy is required, particularly for women gestating through winter.
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Affiliation(s)
- Eileen C O'Brien
- UCD Perinatal Research Centre, UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Mark T Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, Dublin, Ireland
| | - Malachi J McKenna
- UCD Perinatal Research Centre, UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.,Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland.,UCD School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research (CSTAR), School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Aisling A Geraghty
- UCD Perinatal Research Centre, UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, UCD Obstetrics and Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.
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49
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Szabó B, Tabák ÁG, Toldy E, Szekeres L, Szili B, Bakos B, Balla B, Kósa JP, Lakatos P, Takács I. The role of serum total and free 25-hydroxyvitamin D and PTH values in defining vitamin D status at the end of winter: a representative survey. J Bone Miner Metab 2017; 35:83-90. [PMID: 26661476 DOI: 10.1007/s00774-015-0729-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/18/2015] [Indexed: 12/12/2022]
Abstract
We sought the lowest serum total 25-hydroxyvitamin D (t-25OHD) values in geographic areas with four seasons and investigated whether the calculation of serum free 25-hydroxyvitamin D (f-25OHD) could provide additional information on vitamin D status. This is a representative, cross-sectional study restricted to a sampling period at the end of winter, using a non-probability, stratified sample of the adult community-dwelling Hungarian population (n = 882). We measured t-25OHD, vitamin D binding protein (DBP), parathyroid hormone (PTH), and albumin levels. f-25OHD concentrations were calculated. We assessed environmental factors that could affect vitamin D levels and diseases possibly related to vitamin D deficiency. Mean t-25OHD values of the total population were 41.3 ± 20.6 nmol/L. t-25OHD levels were below 75, 50, and 30 nmol/L in 97, 77, and 34 % of participants not receiving vitamin D supplementation, respectively. t-25OHD values weakly positively correlated with DBP (r = 0.174; p = 0.000), strongly with f-25OHD (r = 0.70; p = 0.000). The association between t-25OHD and f-25OHD and between t-25OHD and PTH were non-linear (p squared term = 0.0004 and 0.004, respectively). t-25OHD levels were not affected by gender, age, place of residence; however, they were related to body mass index, sunbed sessions, and tropical travel. In contrast, f-25OHD levels were different in males and females but were not related to obesity. t- and f-25OHD were lower among people with cardiovascular diseases (p = 0.012). Nearly the entire Hungarian population is vitamin D insufficient at the end of winter. The use of t-25OHD could show a spurious association with obesity; however, it does not reflect the obvious sex difference.
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Affiliation(s)
- Boglárka Szabó
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Ádám G Tabák
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Erzsébet Toldy
- Faculty of Health Science, Institute of Diagnostics, University of Pécs, Pécs, Hungary
- Central Laboratory, Markusovszky Teaching Hospital, Szombathely, Hungary
| | - László Szekeres
- National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Balázs Szili
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Bence Bakos
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Bernadett Balla
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - János Pál Kósa
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Péter Lakatos
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - István Takács
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary.
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50
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Delos Reyes J, Smyth A, Griffin D, O'Shea P, O'Keeffe S, Mulkerrin EC. Vitamin D Deficiency and Insufficiency Prevalence in the West of Ireland - A Retrospective Study. J Nutr Health Aging 2017; 21:1107-1110. [PMID: 29188868 DOI: 10.1007/s12603-017-0889-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Vitamin D plays an important role in calcium homeostasis and is essential for normal bone growth and remodeling. Previous studies of acutely ill and institutionalized older women in Galway revealed that vitamin D insufficiency is extremely common. We aimed to evaluate age and gender-related rates of vitamin D insufficiency and deficiency in adult patients attending their General Practitioners in the same region. DESIGN A retrospective cohort study. SETTING General practices in Galway, a city located on the west coast of Ireland, latitude 53.17 North. PARTICIPANTS A total of 15,708 consecutive blood samples from adults attending their General Practitioners between January 2013 and December 2014 were sent to the Clinical Biochemistry Laboratory in the University Hospital Galway for vitamin D level testing. 73% were from women. INTERVENTION Data were collected and grouped according to age, sex and season. Vitamin D levels (25OHD) were categorised into deficiency (<25nmol/L), insufficiency (25-50nmol/L) and sufficiency ( >50nmol/L). MEASUREMENTS Median and interquartile range were reported as vitamin D levels were not normally distributed. Descriptive statistics were performed using STATA/MP 13.1 for Mac. RESULTS While vitamin D levels were sufficient in 56.4% (n=8,496), they were insufficient in 32.4% (n=4,891) and deficient in 11.2% (n=1,691). Of the deficient group, 19%( 325) had levels <15nmol/L consistent with profound deficiency. Men were more likely than women to be deficient (12% (n=489) vs. 10.9% (n=1,202)) and insufficient (38.0% (n=1,550) vs. 30.4% (n=3,341)) (p<0.01). Highest rates of deficiency were seen in those 81-97 years (19.4% (n=136)) and 18-40 years (13.8% (n=543)), the former group showing less seasonal variation. CONCLUSION Overall prevalence of insufficiency is similar to those in national and European studies published recently. However, there is a high possibility that those most vulnerable to vitamin D deficiency were underrepresented in this cohort, when results from previous studies in the same region are considered. Further prospective studies are needed to guide treatment with supplementation of vitamin D for appropriate subgroups.
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Affiliation(s)
- J Delos Reyes
- Professor E.C. Mulkerrin, Department of Geriatric Medicine, University Hospital Galway, Ireland,
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