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Fitzpatrick D, Laird E, Ward M, Hoey L, Hughes CF, Strain JJ, Cunningham C, Healy M, Molloy AM, McNulty H, Lannon R, McCarroll K. Secondary hyperparathyroidism: Predictors and relationship with vitamin D status, bone turnover markers and bone mineral density. Bone 2024; 184:117108. [PMID: 38642819 DOI: 10.1016/j.bone.2024.117108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Secondary hyperparathyroidism (SHPT) has adverse implications for bone health but is relatively understudied. In this study we examine the prevalence and determinants of SHPT and describe the relationship of SHPT with bone turnover markers and bone mineral density (BMD) in older Irish adults. METHOD Eligible participants (n = 4139) were identified from the Trinity-Ulster-Department of Agriculture (TUDA) study, a cohort of Irish adults aged ≥60 years. Exclusion criteria included an estimated glomerular filtration rate (eGFR) <30 ml/min and serum calcium >2.5 mmol/l to remove hyperparathyroidism due to advanced chronic kidney disease (CKD) and primary hyperparathyroidism respectively. The relationship between SHPT and bone turnover markers and BMD (measured by densitometry) was examined in a subsample (n = 1488). Vitamin D deficiency was defined as 25-hydroxyvitamin D [25 (OH)D] <30 nmol/l. RESULTS Participants had a mean age of 73.6 ± 7.9 years, 65.1 % were female and 19.4 % were found to be vitamin D deficient. The prevalence of SHPT decreased as vitamin D increased, from 30.6 % in those deficient to 9.8 % in those with 25(OH)D ≥ 50 nmol/l and increased with declining kidney function. In non‑calcium supplement users, principal determinants of SHPT were vitamin D deficiency (OR 4.18, CI 3.05-5.73, p < 0.001), eGFR 30-44 ml/min (OR 3.69, CI 2.44-5.57, p < 0.001), loop diuretic use (OR 3.52, CI 2.59-4.79, p < 0.001) and to a lesser extent body mass index (p = 0.001), eGFR 45-59 ml/min (p < 0.001) and 25(OH)D level 30-49 nmol/l (p = 0.002). Similar findings were observed in calcium supplement users, though proton pump inhibitors were also associated with SHPT (OR 1.55, CI 1.08-2.22, p = 0.018) while vitamin D 30-49 nmol/l was not. In participants with SHPT versus those without, bone turnover markers were higher: bone alkaline phosphatase (p = 0.017) and tartrate-resistant acid phosphatase (p = 0.033), whilst there was lower BMD at the neck of femur (0.880 vs. 0.903 g/cm2, p = 0.033) and total hip (0.968 vs. 0.995 g/cm2, P = 0.017). DISCUSSION The results show that up to one in six older Irish adults had SHPT and this was associated with lower BMD and higher concentrations of bone turnover markers. Both vitamin D deficiency and 25(OH)D level 30-49 nmol/l were important predictors of SHPT. Loop diuretics and PPIs may also increase the risk of SHPT, and their use may need to be carefully considered in this population. Further studies examining the potential impact of these factors on bone health in similar populations to our study sample are warranted.
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Affiliation(s)
- Donal Fitzpatrick
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland.
| | - Eamon Laird
- Department of Health & Nutritional Sciences, Atlantic Technological University Sligo, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - J J Strain
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Rosaleen Lannon
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland
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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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Fitzpatrick D, Lannon R, Laird E, Ward M, Hoey L, Hughes CF, Strain JJ, Cunningham C, McNulty H, Molloy AM, McCarroll K. The association between proton pump inhibitors and hyperparathyroidism: a potential mechanism for increased fracture-results of a large observational cohort study. Osteoporos Int 2023; 34:1917-1926. [PMID: 37530847 PMCID: PMC10579148 DOI: 10.1007/s00198-023-06867-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
Proton pump inhibitors (PPIs) are associated with increased risk of osteoporotic fracture; however, the mechanism is unclear. PPI users taking calcium supplements were more likely to have hyperparathyroidism compared to non-users (OR 1.56, CI 1.08-2.23, p = 0.018). This highlights the importance of monitoring PPI use, especially in older adults. PURPOSE Proton pump inhibitors (PPIs) are associated with increased risk of osteoporotic fracture. Hyperparathyroidism may be implicated, but few studies have considered this relationship. This study evaluated the relationship between PPI use and hyperparathyroidism in older adults. METHODS Participants were from the TUDA study, a large cross-sectional cohort of older Irish adults. Participants with an estimated glomerular filtration rate (eGFR) < 30 ml/min and serum calcium > 2.5 mmol/l were excluded to avoid hyperparathyroidism due to chronic renal disease and primary hyperparathyroidism. Hyperparathyroidism was defined as a parathyroid hormone (PTH) > 65 pg/ml. Multivariate regression models were used to analyse the relationship between PPI use and hyperparathyroidism. RESULTS A total of 4139 participants met the inclusion criteria, of whom 37.8% (n = 1563) were taking PPI medication. PPI use was identified in 41.4% of calcium supplement users and 35.4% of non-calcium supplement users. Overall, compared to non-users of PPIs, those taking PPIs were older (74.8 vs 72.9 years, p < 0.001) and had a higher prevalence of hyperparathyroidism (17.8 vs 11.0%, p < 0.001). In those taking calcium supplements (but not in non-users), PPI use was significantly associated with hyperparathyroidism (OR 1.56, CI 1.08-2.23, p = 0.018) after adjusting for age, sex, body mass index, serum vitamin D, eGFR, timed-up-and-go, dairy intake, medications, and comorbidities. DISCUSSION The results are consistent with the hypothesis of PPIs reducing calcium absorption, leading to a rise in PTH which could mediate increased fracture risk. No relationship of PPI use with hyperparathyroidism was observed in non-users of calcium supplements, possibly owing to lower dietary calcium intake. These results highlight the importance of monitoring PPI use, especially in older adults at risk of fracture.
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Affiliation(s)
- Donal Fitzpatrick
- The Mercers Institute for Research On Ageing, St James's Hospital, Dublin, Ireland.
| | - Rosaleen Lannon
- The Mercers Institute for Research On Ageing, St James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College, Dublin, Ireland
| | - Eamon Laird
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
| | - J J Strain
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
| | - Conal Cunningham
- The Mercers Institute for Research On Ageing, St James's Hospital, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, BT52 1SA, Northern Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College, Dublin, Ireland
| | - Kevin McCarroll
- The Mercers Institute for Research On Ageing, St James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College, Dublin, Ireland
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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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Caso G, Grønhøj A, Vecchio R, Videbaek PN, Lähteenmäki L. Senior citizens' vitamin D supplements intake: evidence from Denmark. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:6233-6242. [PMID: 37148153 DOI: 10.1002/jsfa.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Several public interventions have been designed in recent years to urge the intake of vitamin D supplements among the senior population to avoid the direct and indirect consequences associated with vitamin D deficiency. However, the effectiveness of these public campaigns remains quite limited. In an online survey, the current study investigates attitudes towards vitamin D supplements intake and associated behaviours in a representative sample of Danish senior citizens (N = 554) - that is, individuals aged 55 years and above. RESULTS Approximately half of the sample reported taking vitamin D supplements in the preceding year. Furthermore, being male and having a positive perception of individuals' own health status increased the probability of being a non-user. Increasing confidence in the information provided by health authorities (such as medical doctors and pharmacies) is particularly critical for enhancing the likelihood of non-users to purchase vitamin D supplements. However, also encouraging the uptake of vitamin D supplements in specialized supermarkets with stands and promotions seems an appealing and practical solution to increase seniors' uptake of vitamin D supplements. CONCLUSIONS The present study outlines the characteristics of senior Danish non-users of vitamin D supplements. Additionally, the research provides information on the strategies that could be applied by public organizations to foster vitamin D supplements intake among this target segment of the population. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- Gerarda Caso
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Alice Grønhøj
- Department of Management - MAPP - Research on Value Creation in the Food Sector, Aarhus University, Aarhus, Denmark
| | - Riccardo Vecchio
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Pernille Nørgaard Videbaek
- Department of Management - MAPP - Research on Value Creation in the Food Sector, Aarhus University, Aarhus, Denmark
| | - Liisa Lähteenmäki
- Department of Management - MAPP - Research on Value Creation in the Food Sector, Aarhus University, Aarhus, Denmark
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Clements M, Heffernan M, Ward M, Hoey L, Doherty LC, Hack Mendes R, Clarke MM, Hughes CF, Love I, Murphy S, McDermott E, Grehan J, McCann A, McAnena LB, Strain JJ, Brennan L, McNulty H. A 2-Year Randomized Controlled Trial With Low-Dose B-Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status. J Bone Miner Res 2022; 37:2443-2455. [PMID: 36128889 PMCID: PMC10092614 DOI: 10.1002/jbmr.4709] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 01/19/2023]
Abstract
Folate, vitamins B12, B6, and riboflavin are required for one-carbon metabolism and may affect bone health, but no previous randomized trial has investigated all four nutrients in this context. We investigated the effect of low-dose B-vitamins for 2 years on bone mineral density (BMD) in a dual-centered, 2-year randomized controlled trial (RCT) in adults aged ≥50 years. Eligible participants not consuming B-vitamin supplements or fortified foods >4 times weekly were randomized to receive daily either combined folic acid (200 μg), vitamin B12 (10 μg), vitamin B6 (10 mg), and riboflavin (5 mg), or "active" placebo, whereby both the intervention and placebo groups received vitamin D (10 μg). BMD was assessed before and after intervention using dual-energy X-ray absorptiometry (DXA) scanning of the total hip, femoral neck, and lumbar spine (L1 to L4). Of 205 eligible participants randomized, 167 completed the trial in full. B-vitamin intervention resulted in increases in serum folate (p < 0.001), serum B12 (p < 0.001), and plasma pyridoxal-5-phosphate (p < 0.001) and decreases in functional biomarkers of B-vitamin status, erythrocyte glutathione reductase activation coefficient (p < 0.001), serum methylmalonic acid (MMA; p < 0.001), and serum total homocysteine (p < 0.001). B-vitamin intervention had no overall effect on BMD, which declined in both treatment groups by approximately 1% (ranging from -0.7% to -1.4%). However, in participants with lower baseline B12 status (serum B12 <246 pmol/L or MMA ≥0.22 μmol/L), B-vitamin intervention reduced the 2-year BMD decline versus placebo: adjusted mean (95% confidence interval [CI]) change of -0.003 (-0.008, 0.002) versus -0.015 (-0.021, -0.010) g/cm2 at the total hip and -0.004 (-0.010, 0.001) versus -0.013 (-0.018, -0.007) g/cm2 at the femoral neck. In conclusion, the findings indicate that although low-dose B-vitamin intervention for 2 years had no overall effect on BMD, improving B-vitamin status appears to have specific benefits for bone health in adults with lower B12 status. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michelle M Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Ingrid Love
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Shauna Murphy
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eilish McDermott
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jennifer Grehan
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Liadhan B McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Ji F, Yang Y, Xu L, Cai J, Ni M, Wang Q, Zhao S, Ma A. Poor diet quality evaluated with the China Healthy Diet Index in Chinese tuberculosis patients. J Hum Nutr Diet 2022; 35:1192-1201. [PMID: 34962001 DOI: 10.1111/jhn.12985] [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: 10/15/2021] [Accepted: 12/16/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of this study was to compare and evaluate the diet quality of tuberculosis patients and healthy adults by using the China Healthy Diet Index (CHDI) and to provide guidance for the diet of tuberculosis patients in the future. METHODS A case-control study of 1241 patients and 1241 healthy individuals matchedfor sex and age. The CHDI was used to score the overall diet quality of patients in the casegroup and the control group. RESULTS The CHDI score of tuberculosis patients was 61.61 and that of healthy controls was 63.97. After adjustment for confounders, participants with >80 on CHDI were 73.5% less likely to develop tuberculosis than participants with <51 (OR: 0.265, 95% CI: 0.086, 0.813, p < 0.05). In the original model, the CHDI scores in the highest range were inversely associated with tuberculosis risk compared with the lowest range (OR: 0.687, 95% CI: 0.420,1.122, p < 0.001). After adjusting for confounders, the CHDI score was significantly associated with a reduced risk of tuberculosis (OR: 0.265, 95% CI: 0.086, 0.813, p < 0.001). After adjusting for confounders, a high-quality diet was positively correlated with anti-tuberculosis treatment outcomes (OR:0.957, 95% CI: 0.918,0.998, p = 0.039). CONCLUSION Compared with healthy adults, tuberculosis patients have poor diet quality with unreasonable diet structure. The insufficient intake of whole grains, vegetables, beans, aquatic products, meat and eggs and the excessive intake of pure energy food and solid fat suggests that the dietary structure of tuberculosis patients was unreasonable. This study provides an idea of the diet structure of tuberculosis patients.
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Affiliation(s)
- Fangfei Ji
- Department of Nutrition and Health, College of Public Health, Qingdao University, Qingdao, China
| | - Yuexin Yang
- Department of Nutrition and Health, College of Public Health, Qingdao University, Qingdao, China.,National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lei Xu
- Huai'an Center for Disease Control and Prevention, Huai'an, China
| | - Jing Cai
- Department of Nutrition and Health, College of Public Health, Qingdao University, Qingdao, China
| | - Mingde Ni
- Linyi People's Hospital East Branch, Linyi, China
| | - Qiuzhen Wang
- Department of Nutrition and Health, College of Public Health, Qingdao University, Qingdao, China
| | | | - Aiguo Ma
- Department of Nutrition and Health, College of Public Health, Qingdao University, Qingdao, China.,Institute of Nutrition and Health, Qingdao University, Qingdao, China
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da Silva TBP, Luiz MM, Delinocente MLB, Steptoe A, de Oliveira C, Alexandre TDS. Is Abdominal Obesity a Risk Factor for the Incidence of Vitamin D Insufficiency and Deficiency in Older Adults? Evidence from the ELSA Study. Nutrients 2022; 14:nu14194164. [PMID: 36235815 PMCID: PMC9572900 DOI: 10.3390/nu14194164] [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: 08/12/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Cross-sectional studies have demonstrated an association between abdominal obesity, determined by waist circumference (WC), and vitamin D (25(OH)D) deficiency in older adults. However, longitudinal evidence is based only on general obesity determined using body mass index (BMI). We investigated whether abdominal obesity is associated with the incidence of 25(OH)D insufficiency (>30 and ≤50 nmol/L) and deficiency (≤30 nmol/L), and whether vitamin D supplementation modifies these associations. We included 2459 participants aged ≥50 years from the English Longitudinal Study of Ageing (ELSA) with 25(OH)D sufficiency (>50 nmol/L) at baseline. Abdominal obesity was defined as >88 cm for women and >102 cm for men. After 4 years, 25(OH)D concentrations were reassessed. Multinomial logistic regression models controlled by covariates were performed. Abdominal obesity increased the risk of the incidence of 25(OH)D insufficiency (RRR = 1.36; 95% CI: 1.01−1.83) and deficiency (RRR = 1.64; 95% CI: 1.05−2.58). These risks were maintained when excluding individuals who took vitamin D supplementation (RRR = 1.38; 95% CI: 1.02−1.88) and (RRR = 1.62; 95% CI: 1.02−2.56). Abdominal obesity is associated with the risk of incidence of low 25(OH)D concentrations. WC seems to be an adequate tool for screening individuals with obesity and at potential risk of developing these conditions.
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Affiliation(s)
- Thaís Barros Pereira da Silva
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
| | - Mariane Marques Luiz
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
| | - Maicon Luís Bicigo Delinocente
- Postgraduate Program in Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Tiago da Silva Alexandre
- Department of Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
- Postgraduate Program in Gerontology, Federal University of São Carlos, Rodovia Washington Luís, Km 235, SP-310, São Carlos 13565-905, São Paulo, Brazil
- Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
- Correspondence: or ; Tel.: +55-16-3306-6671
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Low socioeconomic status predicts vitamin D status in a cross-section of Irish children. J Nutr Sci 2022; 11:e61. [PMID: 35912305 PMCID: PMC9334117 DOI: 10.1017/jns.2022.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1-17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (<30 nmol/l) was prevalent affecting 23 % and was more common in disadvantaged areas (34 %) and in those aged >12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue.
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10
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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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11
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Nutrition policy: developing scientific recommendations for food-based dietary guidelines for older adults living independently in Ireland. Proc Nutr Soc 2022; 81:49-61. [DOI: 10.1017/s0029665122001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the ‘over-65s’ to optimise health is critically important. Older adults represent a diverse population – some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate for older adults. Published international reports were used to update nutrient intake goals for older adults, and available Irish data on dietary intakes and nutritional status biomarkers were explored from a population-based study (the National Adult Nutrition Survey; NANS) and two longitudinal cohorts: the Trinity-Ulster and Department of Agriculture (TUDA) and the Irish Longitudinal Study on Ageing (TILDA) studies. Nutrients of public health concern were identified for further examination. While most nutrient intake goals were similar to those for the general adult population, other aspects were identified where nutritional concerns of ageing require more specific food-based dietary guidelines. These include, a more protein-dense diet using high-quality protein foods to preserve muscle mass; weight maintenance in overweight or obese older adults with no health issues and, where weight-loss is required, that lean tissue is preserved; the promotion of fortified foods, particularly as a bioavailable source of B vitamins and the need for vitamin D supplementation.
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12
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Li FR, Chen PL, Lv YB, Cheng X, Yang HL, Yin ZX, Zhao F, Zhang XR, Li ZH, Shen D, Mao C, Wu XB, Shi XM. Association Between Plasma 25-hydroxyvitamin D Concentrations and Incident Activities of Daily Living Disability: A Longitudinal Community-Based Cohort Study. J Am Med Dir Assoc 2021; 22:1946-1952.e3. [PMID: 33249058 DOI: 10.1016/j.jamda.2020.10.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/21/2020] [Accepted: 10/28/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES A few studies of Western populations have found inconsistent results regarding the associations between vitamin D status and physical function. We explored the association between circulating vitamin D status [plasma 25-hydroxyvitamin D, 25(OH)D] and incident activities of daily living (ADL) disability among Chinese older adults. DESIGN Community-based longitudinal cohort study. SETTING AND PARTICIPANTS A total of 2453 men and women (median age 84.0 years) in 7 Chinese longevity areas were included. MEASURES Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident ADL, with adjustments for potential sociodemographic, and lifestyle confounders and biomarkers. Because there was a statistically significant interaction between plasma 25(OH)D and sex in relation to incident ADL, men and women were analyzed separately. RESULTS The median concentrations of plasma 25(OH)D were 46.6 nmol/L and 36.4 nmol/L for men and women, respectively. Compared with the lowest quartile in the fully adjusted model, the HR for incident ADL disability for the highest quartile was 0.55 (95% CI 0.36-0.85) for women; for men, a null association was indicated (HRhighest vs lowest 0.61, 95% CI 0.37-1.00). However, when using the recommended circulating 25(OH)D thresholds by the US Institute of Medicine, those with vitamin D sufficiency (≥50 nmol/L) had better ADL disability prognoses than those with vitamin D deficiency (<30 nmol/L) in both sexes (men HR 0.45, 95% CI 0.28-0.72; women HR 0.58, 95% CI 0.37-0.90). CONCLUSIONS AND IMPLICATIONS The relationship between plasma 25(OH)D concentration and incident ADL disability was sex-specific among Chinese older adults. However, participants with recommended vitamin D sufficiency may have better disability prognoses in both sexes, suggesting that the recommended 25(OH)D concentration for bone health may extend to functional outcomes such as ADL disability in Chinese older adults.
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Affiliation(s)
- Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Zhao-Xue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Zhao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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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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Bonatto S, Vieira Paniz VM, de Freitas Dutra C, Dutra BV, Henn RL. Serum 25-hydroxyvitamin D concentration among users of a referral outpatient unit for vascular diseases and associated factors. Clin Nutr ESPEN 2021; 42:299-306. [PMID: 33745596 DOI: 10.1016/j.clnesp.2021.01.017] [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: 11/01/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Assess serum 25-hydroxyvitamin D (25OHD) concentration and associated factors among users of a referral outpatient unit for vascular diseases in Southern Brazil. DESIGN Cross-sectional study conducted for almost one year, from March 2016 to January 2017. The serum vitamin D level was determined biochemically and classified as: sufficient (>50 nmol/L), insufficient (30-50 nmol/L) and deficient (<30 nmol/L). Associations were tested through multiple linear regression. SETTING At a reference outpatient clinic specialized in vascular diseases located in a southern Brazilian medium-sized city (latitude 29°S). SUBJECTS Consecutive sample of 133 individuals of both sexes, aged at least 40 years. RESULTS The mean serum 25OHD concentration was 54.9 ± 25.9 nmol/L (57.7 ± 27.9 nmol/L for men; 52.2 ± 24.2 nmol/L for women, p = 0.267). A total of 12.8% of the participants had vitamin D deficiency and 32.3% had insufficiency. Regarding the total sample, variables associated to the serum 25OHD concentration were: age (β = -0.55; CI95% -0.95; -0.17), sun exposure (β = 1.22; CI95% 0.32; 2.10) and vitamin D intake (β = 7.29; CI95% 2.10; 12.48). Among men, a significant association was observed for age (β = -0.82; CI95% -1.47; -0.17, p = 0.015) and borderline for sun exposure (β = 1.22; CI95% 0.32; 2.10, p = 0.053). Among women, only vitamin D intake was significantly associated with serum concentration of this vitamin (β = 8.74; CI95% 1.32; 16.17, p = 0.022). CONCLUSION Although the mean 25OHD concentration was greater than 50 nmol/L, about 45% of this consecutive sample presented poor vitamin D nutritional status. Unadjusted for seasonality, factors associated with serum 25OHD concentration were age and sun exposure among men and vitamin D intake among women.
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Affiliation(s)
- Simone Bonatto
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil; Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil.
| | - Vera Maria Vieira Paniz
- Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil
| | - Clandio de Freitas Dutra
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil
| | - Bruna Valduga Dutra
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil
| | - Ruth Liane Henn
- Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil
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15
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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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16
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Vitamin D and Hospital Admission in Older Adults: A Prospective Association. Nutrients 2021; 13:nu13020616. [PMID: 33672800 PMCID: PMC7918803 DOI: 10.3390/nu13020616] [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: 01/28/2021] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022] Open
Abstract
The health effects of vitamin D are well documented, with increasing evidence of its roles beyond bone. There is, however, little evidence of the effects of vitamin D on hospitalisation among older adults. This study aimed to prospectively determine the relationship of vitamin D status in older adults with hospital admission and emergency department (ED) attendance. Trinity University of Ulster Department of Agriculture (TUDA) is a large cross-sectional study of older adults with a community population from three disease-defined cohorts (cognitive dysfunction, hypertension, and osteoporosis). Participants included in this analysis were recruited between 2008 and 2012. ED and hospital admission data were gathered from the date of TUDA participation until June 2013, with a mean follow up of 3.6 years. Of the 3093 participants, 1577 (50.9%) attended the ED during the period of follow-up. Attendees had lower mean serum 25(OH)D concentrations than non-attendees (59.1 vs. 70.6 nmol/L). Fully adjusted models showed an inverse association between vitamin D and ED attendance (Hazard Ratio (HR) 0.996; 95% Confidence Interval (CI) 0.995-0.998; p < 0.001). A total of 1269 participants (41%) were admitted to hospital during the follow-up. Those admitted had lower mean vitamin D concentrations (58.4 vs. 69.3 nmol/L, p < 0.001). In fully adjusted models, higher vitamin D was inversely associated with hospital admission (HR 0.996; 95% CI 0.994-0.998; p < 0.001) and length of stay (LOS) (β = -0.95, p = 0.006). This study showed independent prospective associations between vitamin D deficiency and increased hospitalisation by older adults. The need for further evaluation of current recommendations in relation to vitamin D supplementation, with consideration beyond bone health, is warranted and should focus on randomised controlled trials.
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17
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Nutritional Biomarkers and Associated Factors in Community-Dwelling Older Adults: Findings from the SHIELD Study. Nutrients 2020; 12:nu12113329. [PMID: 33138134 PMCID: PMC7693785 DOI: 10.3390/nu12113329] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
Aging is associated with intrinsic and extrinsic changes which affect the nutrient intake and nutritional status of an older individual. Suboptimal nutritional status is linked with adverse health outcomes. There are limited data in this area for community-dwelling older adults who are not at risk of malnutrition. The objective of this study was to describe the nutritional biomarkers in 400 community-dwelling older adults (aged ≥65 years) with normal nutritional status (Malnutrition Universal Screening Test score of 0) in Singapore and to identify factors associated with these biomarkers. The majority of the participants had normal levels of pre-albumin, albumin, total protein, creatinine, zinc, corrected calcium, vitamin B12, ferritin and hemoglobin. Females had significantly higher levels of corrected calcium and vitamin B12 than males, whereas males had significantly higher levels of pre-albumin, albumin, creatinine, serum ferritin, 25-hydroxyvitamin D (25(OH)D) and hemoglobin than females. About half of the participants (52%) had low level of 25(OH)D (<30 μg/L) and 10% had low zinc level (<724 μg/L). Among those with low level of 25(OH)D, 74% had 25(OH)D insufficiency (20–<30 μg/L) and 26% had 25(OH)D deficiency (<20 μg/L). Younger age, female gender, non-Chinese ethnicity and no intake of vitamin D supplement were associated with lower serum 25(OH)D level, whereas higher body mass index (BMI) was associated with low zinc level. These findings highlight the problem of hidden nutritional insufficiencies can be missed in seemingly normal nourished community-dwelling older adults.
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18
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Kowalówka M, Główka AK, Karaźniewicz-Łada M, Kosewski G. Clinical Significance of Analysis of Vitamin D Status in Various Diseases. Nutrients 2020; 12:E2788. [PMID: 32933052 PMCID: PMC7551674 DOI: 10.3390/nu12092788] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D plays a role not only in the proper functioning of the skeletal system and the calcium-phosphate equilibrium, but also in the immune system, the cardiovascular system and the growth and division of cells. Although numerous studies have reported on the analysis of vitamin D status in various groups of patients, the clinical significance of measurements of vitamin D forms and metabolites remains ambiguous. This article reviews the reports analyzing the status of vitamin D in various chronic states. Particular attention is given to factors affecting measurement of vitamin D forms and metabolites. Relevant papers published during recent years were identified by an extensive PubMed search using appropriate keywords. Measurement of vitamin D status proved to be a useful tool in diagnosis and progression of metabolic syndrome, neurological disorders and cancer. High performance liquid chromatography coupled with tandem mass spectrometry has become the preferred method for analyzing the various forms and metabolites of vitamin D in biological fluids. Factors influencing vitamin D concentration, including socio-demographic and biochemical factors as well as the genetic polymorphism of the vitamin D receptor, along with vitamin D transporters and enzymes participating in vitamin D metabolism should be considered as potential confounders of the interpretation of plasma total 25(OH)D concentrations.
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Affiliation(s)
- Magdalena Kowalówka
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
| | - Anna K. Główka
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781 Poznań, Poland
| | - Grzegorz Kosewski
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Street, 60-354 Poznań, Poland; (M.K.); (A.K.G.); (G.K.)
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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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Angelino D, Caffrey A, Moore K, Laird E, Moore AJ, Gill CIR, Mena P, Westley K, Pucci B, Boyd K, Mullen B, McCarroll K, Ward M, Strain JJ, Cunningham C, Molloy AM, McNulty H, Del Rio D. Phenyl‐γ‐valerolactones and healthy ageing: Linking dietary factors, nutrient biomarkers, metabolic status and inflammation with cognition in older adults (the VALID project). NUTR BULL 2020. [DOI: 10.1111/nbu.12444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- D. Angelino
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- Faculty of Bioscience and Technology for Food, Agriculture, and Environment University of Teramo Teramo Italy
| | - A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - K. Moore
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - E. Laird
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. J. Moore
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - C. I. R. Gill
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - P. Mena
- Human Nutrition Unit Department of Food and Drug University of Parma Parma Italy
| | - K. Westley
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - B. Pucci
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - K. Boyd
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - B. Mullen
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - K. McCarroll
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - J. J. Strain
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - C. Cunningham
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. M. Molloy
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - D. Del Rio
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- School of Advanced Studies on Food and Nutrition University of Parma Parma Italy
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Determinants of vitamin D supplementation among older adults and its effect on 25(OH)D levels according to bone mineral density status. NUTR HOSP 2020; 37:28-36. [PMID: 31960687 DOI: 10.20960/nh.02917] [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] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: although supplementation with vitamin D has been reported as a main determinant of 25-hydroxyvitamin D status [25(OH)D] levels, there are limited data in regard to the factors associated with vitamin D supplementation in older adults. Aims: to examine the characteristics of participants associated with vitamin D supplement use and its effect on 25(OH)D concentrations according to bone mineral density (BMD). Methods: the present analysis was based on data from participants aged 60 years and older in the National Health and Nutrition Examination Survey. Logistic regression models were created to examine the demographic, lifestyle, and health characteristics associated with vitamin D supplementation. Moreover, general linear models were assembled to assess the effect of vitamin D supplement doses on 25(OH)D concentrations according to BMD status. Results: of 5,204 participants, 45.3% reported taking vitamin D supplements, at least 400 IU per day. Overall, women, non-Hispanic whites, college education, former smokers, physical activity, and > 2 comorbidities were variables significantly associated with increased odds of taking vitamin D supplements. Notably, among subjects with osteoporosis, those taking vitamin D supplements between 400 and 800 IU per day had on average 20.7 nmol/L higher 25(OH)D concentrations compared with their non-user counterparts. Conclusions: demographic and healthy lifestyle characteristics are the main determinants of vitamin D supplement use among older adults. Moreover, even among subjects with low bone mass, vitamin D supplements between 400 and 800 IU per day are adequate to reach sufficient 25(OH)D concentrations.
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Orces C, Lorenzo C, Guarneros JE. The Prevalence and Determinants of Vitamin D Inadequacy among U.S. Older Adults: National Health and Nutrition Examination Survey 2007-2014. Cureus 2019; 11:e5300. [PMID: 31579639 PMCID: PMC6768617 DOI: 10.7759/cureus.5300] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Older adults (i.e., adults aged ≥ 60 years) are at higher risk of vitamin D deficiency compared to younger adults as a result of inadequate dietary vitamin D intake and limited exposure to sunlight. Thus, the present study aimed to describe the prevalence of vitamin deficiency and inadequacy among U.S. adults aged ≥ 60 years and the effect of vitamin D supplementation on 25, hydroxyvitamin D (25(OH)D) and its metabolites concentrations. Methods The present analysis was based on data from 6,261 participants in the National Health and Nutrition Examination Survey cycles 2007/2008 through 2013/2014. The prevalence of vitamin D deficiency and inadequacy was described according to demographic, behavioral, and health characteristics. Vitamin D deficiency was defined as 25(OH)D < 30 nmol/L; and vitamin D inadequacy was defined as < 50 nmol/L. Logistic regression models were assembled to examine the independent association of participants characteristics and the odds of having 25(OH)D inadequacy. Similarly, general linear models were used to assess the effect of vitamin D supplementation doses on 25(OH)D and its metabolites concentrations. Results The prevalence of 25(OH)D deficiency and inadequacy was 4.0% (standard error (SE), 0.4) and 17.4% (SE, 0.8), respectively. In general, the prevalence of 25(OH)D deficiency and inadequacy increased significantly among participants examined during the fall and winter months, women, non-Hispanic black patients, obese subjects, smokers, those physically inactive, and older adults with a daily vitamin D intake < 400 IU. After adjustment for potential confounders, subjects examined during the fall and winter months, females, non-Hispanic blacks, obesity, having a sedentary lifestyle, smokers, and a total vitamin D intake < 400 IU/day were variables significantly associated with increased odds of having vitamin D inadequacy. Notably, vitamin D supplement doses between 400 and 800 IU or > 800 IU/day were significantly correlated with higher 25(OH)D3 concentrations considered as sufficient. Conclusion 25(OH)D inadequacy remains prevalent among U.S. older adults. Notably, optimal 25(OH)D3 concentrations were consistently seen among vitamin D supplement users. Despite this finding, nearly half of the participants did not take vitamin D supplements. Thus, vitamin D supplementation should be considered an effective strategy to maintain adequate 25(OH)D status among older adults.
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Affiliation(s)
- Carlos Orces
- Rheumatology, Laredo Medical Center, Laredo, USA
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The Prevalence and Determinants of Vitamin D Status in Community-Dwelling Older Adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients 2019; 11:nu11061253. [PMID: 31159411 PMCID: PMC6627050 DOI: 10.3390/nu11061253] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 01/01/2023] Open
Abstract
Vitamin D deficiency is often associated with adverse health outcomes in older adults. The circulating 25-hydroxyvitamin D (25(OH)D) status predominately relies on UV exposure. However, the extent of which northerly latitude exasperates deficiency is less explored in ageing. We aimed to investigate vitamin D deficiency in community-dwelling, older adults, residing at latitudes 50–55° north. This study was comprised of 6004 adults, aged >50 years from wave 6 (2012–2013) of the English Longitudinal Study of Ageing (ELSA). Deficiency was categorised by two criteria: Institute of Medicine (IOM) (<30 nmol/L) and Endocrine Society (ES) (<50 nmol/L). The overall prevalence of Institute of Medicine (IOM) and Endocrine Society (ES) definitions of deficiency were 26.4% and 58.7%, respectively. Females (odds ratio (OR) 1.23; CI: 1.04–1.44), those aged 80+ (OR: 1.42; CI: 1.01–1.93), smoking (OR: 1.88; CI: 1.51–2.34); of non-white ethnicity (OR: 3.8; CI:2.39–6.05); being obese (OR: 1.32; CI:1.09–1.58), and of poor self-reported health (OR:1.99; CI:1.33, 2.96), were more likely to be vitamin D deficient (by IOM). Residents in the south of England had a reduced risk of deficiency (OR: 0.78; CI:0.64–0.95), even after adjustment for socioeconomic and traditional predictors (obesity, age, lifestyle, etc.) of vitamin D status. Other factors, such as being retired, having a normal BMI, engaging in regular vigorous physical activity, vitamin D supplement use, sun travel, and summer season were also significantly positive correlates of deficiency. Similar results were observed for the ES cut-off definition. Importantly, more than half of adults aged >50 years had 25(OH)D concentrations <50 nmol/L. These findings demonstrate that low vitamin D status is highly prevalent in older English adults and the crucial importance of public health strategies throughout midlife and older age to achieve optimal vitamin D status.
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O'Sullivan F, Raftery T, van Weele M, van Geffen J, McNamara D, O'Morain C, Mahmud N, Kelly D, Healy M, O'Sullivan M, Zgaga L. Sunshine is an Important Determinant of Vitamin D Status Even Among High-dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients. Photochem Photobiol 2019; 95:1060-1067. [PMID: 30649836 DOI: 10.1111/php.13086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Abstract
Sunshine is considered to be the most important source of vitamin D. Due to an increased risk of skin cancer, sun avoidance is advised, but this directly contributes to the high prevalence of vitamin D deficiency. The simple solution is to advise vitamin D supplementation. The aim of this study was to examine the absolute and relative contribution of sunshine and supplementation to vitamin status. This study was a secondary analysis of an RCT of 92 Crohn's disease patients in remission (49% female, median age = 44). Participants were randomized to 2000 IU day-1 of vitamin D3 or placebo for 1 year, with 25-hydroxyvitamin D (25(OH)D) being measured at baseline and every 4 months. Based on participant's place of residence, daily ambient UVB dose at wavelengths that can induce vitamin D synthesis (D-UVB) was obtained. Cumulative and weighted ambient D-UVB (cw-D-UVB) exposure prior to each blood draw was calculated for each participant. Linear regression analysis and multilevel modeling were used to examine the association between UVB exposure, supplementation and 25(OH)D concentration. There was considerable annual variation in D-UVB, cw-D-UVB and 25(OH)D. Both supplementation and cw-D-UVB were found to be strongly associated with 25(OH)D: in multilevel model, an increase of approximately 6 nmol L-1 for every 100 kJ m-2 in cw-D-UVB was found, among those receiving placebo and supplementation (P < 0.0001). Treatment was associated with increase of 23 nmol L-1 (P < 0.0001). Sunshine is an important determinant of 25(OH)D concentration, even in those who are taking high-dose vitamin D supplements and reside at a higher mid-latitude location.
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Affiliation(s)
- Fiona O'Sullivan
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
| | - Tara Raftery
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Michiel van Weele
- Royal Netherlands Meteorological Institute (KNMI), De Bilt, The Netherlands
| | - Jos van Geffen
- Royal Netherlands Meteorological Institute (KNMI), De Bilt, The Netherlands
| | - Deirdre McNamara
- Department of Gastroenterology, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Colm O'Morain
- Department of Gastroenterology, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Nasir Mahmud
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Dervla Kelly
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Trinity College Dublin, Dublin, Republic of Ireland
| | - Maria O'Sullivan
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Republic of Ireland
| | - Lina Zgaga
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Republic of Ireland
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Yao Y, Fu S, Li N, Hu F, Zhang H, Zhu Q, Luan F, Zhang F, Zhao Y, He Y. Sex, Residence and Fish Intake Predict Vitamin D Status in Chinese Centenarians. J Nutr Health Aging 2019; 23:165-171. [PMID: 30697626 DOI: 10.1007/s12603-018-1126-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This study aims to investigate the prevalence of vitamin D deficiency in Chinese centenarians and to identify the factors associated with vitamin D deficiency. DESIGN Cross-sectional population-based study. SETTING Hainan province in the south of China. PARTICIPANTS 943 subjects aged 100 years old and older. METHODS Details on sociodemographics and lifestyle characteristics were collected using a structured questionnaire. Anthropometrics and blood samples were obtained. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentration < 20ng/mL (50nmol/L). RESULTS The overall prevalence of vitamin D deficiency among these 943 centenarians was 39.9% (376 subjects) and the mean serum vitamin D concentrations were 22.7±9.5 (ng/mL). Female centenarians had higher prevalence of vitamin D deficiency than male (44.0% vs. 21.7%, P <0.001). Multivariate logistic regression analyses showed that being female, urban residency, lower body mass index, higher serum parathyroid hormone levels, no fish consumption, and less sun exposure time were all significant and independent determinants of vitamin D deficiency. No significant associations of vitamin D deficiency with ethnic, education, geographic location, tea drinking, alcohol use, or smoking were found in this study. CONCLUSION Vitamin D deficiency was common in Chinese centenarians, especially in women. Given that vitamin D deficiency is linked to numerous adverse health outcomes, dietary, outdoor activities and other intervention measures are needed to correct vitamin D deficiency in this population.
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Affiliation(s)
- Y Yao
- Yali Zhao, Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, China,
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Itkonen ST, Erkkola M, Lamberg-Allardt CJE. Vitamin D Fortification of Fluid Milk Products and Their Contribution to Vitamin D Intake and Vitamin D Status in Observational Studies-A Review. Nutrients 2018; 10:nu10081054. [PMID: 30096919 PMCID: PMC6116165 DOI: 10.3390/nu10081054] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
Fluid milk products are systematically, either mandatorily or voluntarily, fortified with vitamin D in some countries but their overall contribution to vitamin D intake and status worldwide is not fully understood. We searched the PubMed database to evaluate the contribution of vitamin D-fortified fluid milk products (regular milk and fermented products) to vitamin D intake and serum or plasma 25-hydroxyvitamin D (25(OH)D) status in observational studies during 1993–2017. Twenty studies provided data on 25(OH)D status (n = 19,744), and 22 provided data on vitamin D intake (n = 99,023). Studies showed positive associations between the consumption of vitamin D-fortified milk and 25(OH)D status in different population groups. In countries with a national vitamin D fortification policy covering various fluid milk products (Finland, Canada, United States), milk products contributed 28–63% to vitamin D intake, while in countries without a fortification policy, or when the fortification covered only some dairy products (Sweden, Norway), the contribution was much lower or negligible. To conclude, based on the reviewed observational studies, vitamin D-fortified fluid milk products contribute to vitamin D intake and 25(OH)D status. However, their impact on vitamin D intake at the population level depends on whether vitamin D fortification is systematic and policy-based.
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Affiliation(s)
- Suvi T Itkonen
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
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The relationship between adiposity and cognitive function in a large community-dwelling population: data from the Trinity Ulster Department of Agriculture (TUDA) ageing cohort study. Br J Nutr 2018; 120:517-527. [DOI: 10.1017/s0007114518001848] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPrevious reports investigating adiposity and cognitive function in the population allude to a negative association, although the relationship in older adults is unclear. The aim of this study was to investigate the association of adiposity (BMI and waist:hip ratio (WHR)) with cognitive function in community-dwelling older adults (≥60 years). Participants included 5186 adults from the Trinity Ulster Department of Agriculture ageing cohort study. Neuropsychological assessment measures included the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Multi-variable linear regression models were used to assess the association between adiposity and cognitive function adjusting for insulin resistance, inflammation and cerebrovascular disease. The mean ages were 80·3 (sd6·7), 71·0 (sd7·3) and 70·2 (sd6·3) years on the cognitive, bone and hypertensive cohorts, respectively. In the cognitive cohort, BMI was positively associated with immediate and delay memory, visuospatial/constructional ability, language and MMSE, and negatively with FAB (log-transformed), whereas WHR was negatively associated with attention. In the bone cohort, BMI was not associated with any cognitive domain, whereas WHR was negatively associated with visuospatial/constructional ability, attention and MMSE. In the hypertensive cohort, BMI was not associated with any cognitive domain, whereas WHR was negatively associated with immediate and delayed memory, visuospatial/constructional ability, language and MMSE and positively with FAB (log-transformed). In the cognitive and bone cohorts, the association of WHR and attention disappeared by further controlling for C-reactive protein and HbA1C. In this study of older adults, central adiposity was a stronger predictor of poor cognitive performance than BMI. Older adults could benefit from targeted public health strategies aimed at reducing obesity and obeseogenic risk factors to avoid/prevent/slow cognitive dysfunction.
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McCann A, McNulty H, Rigby J, Hughes CF, Hoey L, Molloy AM, Cunningham CJ, Casey MC, Tracey F, O’Kane MJ, McCarroll K, Ward M, Moore K, Strain J, Moore A. Effect of Area‐Level Socioeconomic Deprivation on Risk of Cognitive Dysfunction in Older Adults. J Am Geriatr Soc 2018; 66:1269-1275. [DOI: 10.1111/jgs.15258] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Adrian McCann
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Helene McNulty
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Jan Rigby
- National Centre for GeoComputationMaynooth UniversityMaynoothIreland
| | - Catherine F. Hughes
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Anne M. Molloy
- Institute of Molecular Medicine, School of Medicine, Trinity College DublinDublinIreland
| | | | - Miriam C. Casey
- Mercer's Institute for Research on Ageing, St James's HospitalDublinIreland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care TrustColeraineNorthern IrelandUnited Kingdom
| | - Maurice J. O’Kane
- Clinical Chemistry LaboratoryAltnagelvin Hospital, Western Health and Social Care TrustLondonderryNorthern IrelandUnited Kingdom
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's HospitalDublinIreland
| | - Mary Ward
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Katie Moore
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - J.J. Strain
- Nutrition Innovation Centre for Food and HealthUlster UniversityColeraineNorthern IrelandUnited Kingdom
| | - Adrian Moore
- School of Environmental SciencesUlster UniversityColeraineNorthern IrelandUnited Kingdom
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Socio-economic determinants of vitamin D deficiency in the older Polish population: results from the PolSenior study. Public Health Nutr 2018; 21:1995-2003. [PMID: 29352837 DOI: 10.1017/s1368980017003901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Numerous studies have reported an association between vitamin D (25-hydroxyvitamin D; 25(OH)D) deficiency and low economic status, lower educational level, drugs exposure, smoking and reduced physical activity. Our study analysed the association between sociodemographic factors and 25(OH)D status in Polish (Caucasian) seniors. DESIGN Cross-sectional study (part of the PolSenior study). Serum 25(OH)D concentration was measured by a solid-phase ELISA method; a standardized questionnaire evaluated educational level, economic status, alcohol consumption, current or past cigarette smoking, physical activity, activities of daily living (ADL) and instrumental activities of daily living. SETTING Community-dwelling randomly selected individuals aged 65 years or older, selected using three-stage stratified, proportional draw. SUBJECTS Seniors (n 3472; 1658 women and 1814 men). RESULTS Mean serum 25(OH)D concentration was 20·5 (sd 9·6) ng/ml. Values below the recommended level (30 ng/ml) were detected in 82·8 % of men and 90·4 % of women. Regression analysis revealed that the difference between sexes was associated with decreased walking activity in women, probably resulting in less sunlight exposure. There was a positive association between any disability in ADL and the presence of vitamin D deficiency/insufficiency. In the sex-adjusted analysis, older age, alcohol abstinence and lack of cycling and long-distance walking were explanatory variables for vitamin D deficiency. CONCLUSIONS Vitamin D deficiency/insufficiency is frequent in the older Polish population and associated with functional disability and impaired mobility of seniors.
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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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Vitamin D deficiency in older adults and its associated factors: a cross-sectional analysis of the Mexican Health and Aging Study. Arch Osteoporos 2017; 12:8. [PMID: 28028727 PMCID: PMC5497731 DOI: 10.1007/s11657-016-0297-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/06/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D deficiency was common in older adults from a country with adequate sun exposure. The variables associated with this deficiency provide insight into the next steps needed to characterize older adults with this deficiency and to treat it accordingly. PURPOSE The aim of this study was to describe the prevalence of and factors associated with vitamin D deficiency among Mexican older adults. METHODS This was a secondary analysis of the last wave of the Mexican Health and Aging Study. Vitamin D levels along with other biomarkers were obtained from a sub-sample of Mexican adults older than 60 years. Prevalence was described by sex and age group, and a multivariate analysis was performed to test the factors associated with this condition. RESULTS Data from 1088 adults over the age of 60 years were analyzed. The mean serum vitamin D level was 23.1 ± 8.1 ng/mL and was significantly higher among men than women (25.6 ± 0.6 and 22.8 ± 0.5 ng/mL, respectively; p < 0.001). In total, 37.3% (n = 406) presented with vitamin D deficiency, 65% of whom were women. Low 25-(OH)-vitamin D levels were associated with female sex (OR 1.74, 95% CI 1.59-2.42), current smoking (OR 2.21, 95% CI 1.47-3.39), education (OR 1.1, 95% CI 1.06-1.13), physical activity (OR 1.74, 95% CI 1.31-2.23), and high levels of glycated hemoglobin (OR 1.16, 95% CI 1.07-1.25). CONCLUSIONS Vitamin D deficiency was highly prevalent in Mexican older adults and was associated with a number of factors, indicating the multifactorial causality of this deficiency.
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Prevalence and Predictors of Subclinical Micronutrient Deficiency in German Older Adults: Results from the Population-Based KORA-Age Study. Nutrients 2017; 9:nu9121276. [PMID: 29168737 PMCID: PMC5748727 DOI: 10.3390/nu9121276] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study’s objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors, using multiple logistic regression. Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B12, and iron were analyzed. The prevalence of subclinical vitamin D and vitamin B12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD (<50 nmol/L) and low vitamin B12 concentrations (<221 pmol/L), respectively. Furthermore, 11.0% had low iron (men <11.6 µmol/L, women <9.0 µmol/L) and 8.7% had low folate levels (<13.6 nmol/L). Common predictors associated with subclinical micronutrient deficiency included very old age, physical inactivity, frailty and no/irregular use of supplements. Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B12. The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.
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Laird E, Molloy AM, McNulty H, Ward M, McCarroll K, Hoey L, Hughes CF, Cunningham C, Strain JJ, Casey MC. Greater yogurt consumption is associated with increased bone mineral density and physical function in older adults. Osteoporos Int 2017; 28:2409-2419. [PMID: 28462469 DOI: 10.1007/s00198-017-4049-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/10/2017] [Indexed: 12/29/2022]
Abstract
UNLABELLED In this cohort of community dwelling older adults (>60 years), we observed significant positive associations between the frequencies of yogurt intake with measures of bone density, bone biomarkers, and indicators of physical function. Improving yogurt intakes could be a valuable health strategy for maintaining bone health in older adults. INTRODUCTION The associations of yogurt intakes with bone health and frailty in older adults are not well documented. The aim was to investigate the association of yogurt intakes with bone mineral density (BMD), bone biomarkers, and physical function in 4310 Irish adults from the Trinity, Ulster, Department of Agriculture aging cohort study (TUDA). METHODS Bone measures included total hip, femoral neck, and vertebral BMD with bone biochemical markers. Physical function measures included Timed Up and Go (TUG), Instrumental Activities of Daily Living Scale, and Physical Self-Maintenance Scale. RESULTS Total hip and femoral neck BMD in females were 3.1-3.9% higher among those with the highest yogurt intakes (n = 970) compared to the lowest (n = 1109; P < 0.05) as were the TUG scores (-6.7%; P = 0.013). In males, tartrate-resistant acid phosphatase (TRAP 5b) concentrations were significantly lower in those with the highest yogurt intakes (-9.5%; P < 0.0001). In females, yogurt intake was a significant positive predictor of BMD at all regions. Each unit increase in yogurt intake in females was associated with a 31% lower risk of osteopenia (OR 0.69; 95% CI 0.49-0.96; P = 0.032) and a 39% lower risk of osteoporosis (OR 0.61; 95% CI 0.42-0.89; P = 0.012) and in males, a 52% lower risk of osteoporosis (OR 0.48; 95% CI 0.24-0.96; P = 0.038). CONCLUSION In this cohort, higher yogurt intake was associated with increased BMD and physical function scores. These results suggest that improving yogurt intakes could be a valuable public health strategy for maintaining bone health in older adults.
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Affiliation(s)
- E Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - A M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - H McNulty
- Northern Ireland Centre for Food and Health, Ulster University , Coleraine, UK
| | - M Ward
- Northern Ireland Centre for Food and Health, Ulster University , Coleraine, UK
| | - K McCarroll
- St James's Hospital, The Mercers Institute for Research on Ageing, Dublin, Ireland
| | - L Hoey
- Northern Ireland Centre for Food and Health, Ulster University , Coleraine, UK
| | - C F Hughes
- Northern Ireland Centre for Food and Health, Ulster University , Coleraine, UK
| | - C Cunningham
- St James's Hospital, The Mercers Institute for Research on Ageing, Dublin, Ireland
| | - J J Strain
- Northern Ireland Centre for Food and Health, Ulster University , Coleraine, UK
| | - M C Casey
- St James's Hospital, The Mercers Institute for Research on Ageing, Dublin, Ireland
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Wang Q, Liu Y, Ma Y, Han L, Dou M, Zou Y, Sun L, Tian H, Li T, Jiang G, Du B, Kou T, Song J, Kok FJ, Schouten EG. Severe hypovitaminosis D in active tuberculosis patients and its predictors. Clin Nutr 2017; 37:1034-1040. [PMID: 28514999 DOI: 10.1016/j.clnu.2017.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/18/2017] [Accepted: 04/21/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). METHODS A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. RESULTS The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1%) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1%) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95% CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. CONCLUSIONS Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.
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Affiliation(s)
- Qiuzhen Wang
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China.
| | - Yufeng Liu
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Yan Ma
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Lei Han
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mei Dou
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Yue Zou
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Limei Sun
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Hong Tian
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Tongxia Li
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Guofeng Jiang
- Qingdao Chest Hospital, Chongqing Middle Road, Qingdao, China
| | - Baoli Du
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Tingyan Kou
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Jiaqi Song
- Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, China
| | - Frans J Kok
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Evert G Schouten
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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Biomarkers of folate and related B-vitamins as predictors of cognitive decline in older Irish adults over a 5 year follow up period. Proc Nutr Soc 2017. [DOI: 10.1017/s0029665117000040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Laird E, Casey MC, Ward M, Hoey L, Hughes CF, McCarroll K, Cunningham C, Strain JJ, McNulty H, Molloy AM. Dairy Intakes in Older Irish Adults and Effects on Vitamin Micronutrient Status: Data from the TUDA Study. J Nutr Health Aging 2017; 21:954-961. [PMID: 29083435 DOI: 10.1007/s12603-016-0845-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Consumption of dairy products has been associated with positive health outcomes including a lower risk of hypertension, improved bone health and a reduction in the risk of type 2 diabetes. The suggested dairy intake for health in older adults is three servings per day but recent analysis of the NHANES data for older adults reported 98% were not meeting these recommendations. No studies have investigated the consequences of such declines in the dairy intakes of Irish older adults and the subsequent effects on vitamin micronutrient status. OBJECTIVES To study the daily dairy intakes of older Irish adults and to examine how the frequency of dairy food consumption affects vitamin micronutrient status. METHODS Participants (n 4,317) were from the Trinity Ulster Department of Agriculture (TUDA) Study, a large study of older Irish adults (aged >60 yrs) designed to investigate gene-nutrient interactions in the development of chronic diseases of aging. The daily intake portion for milk, cheese and yoghurt was calculated from food frequency questionnaire (FFQ) responses. Blood samples were analysed for vitamin biomarkers as follows: vitamin B12 (total serum cobalamin and holotranscobalamin (holoTC)), folate (red cell folate (RCF) and serum folate), vitamin B2 (erythrocyte glutathione reductase activation coefficient (EGRac)), vitamin B6 (serum pyridoxal phosphate) and vitamin D (serum 25(OH)D). RESULTS The mean total reported dairy intake was 1.16 (SD 0.79) portions per day with males consuming significantly fewer total dairy portions compared to females (1.07 vs 1.21 respectively) (P<0.05). There was no significant difference in total daily dairy serving intakes by age decade (60-69, 70-79, >80 yrs). Overall, only 3.5% of the total population (n 151) achieved the recommended daily dairy intake of three or more servings per day. A significantly higher proportion of females (4%) compared to males (2.4%) met these dairy requirements (P=0.011). Blood concentrations of vitamin B12 biomarkers, RCF, vitamin B2 and vitamin B6 were significantly worse in those with the lowest tertile of dairy intake (0-0.71 servings) compared to those in the highest tertile (1.50-4.50 servings) (P<0.05). CONCLUSION This study found that more than 96% of the older adults sampled did not meet current daily dairy intake recommendations. The study is the largest to-date examining dairy intakes in older Irish adults, and provides evidence that daily dairy intakes (in particular yogurt) contribute significantly to the B-vitamin and vitamin D biomarker status of older adults. These results suggest that older adults who are already vulnerable to micronutrient inadequacies, are forgoing the nutritional advantages of vitamin-rich dairy products.
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Affiliation(s)
- E Laird
- E. Laird, School of Biochemistry and Immunology, Trinity College Dublin, Ireland,
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Coen RF, McCarroll K, Casey M, McNulty H, Laird E, Molloy AM, Ward M, Strain JJ, Hoey L, Hughes C, Cunningham CJ. The Frontal Assessment Battery: Normative Performance in a Large Sample of Older Community-Dwelling Hospital Outpatient or General Practitioner Attenders. J Geriatr Psychiatry Neurol 2016; 29:338-343. [PMID: 27647791 DOI: 10.1177/0891988716666381] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Frontal Assessment Battery (FAB) is a short battery designed to assess frontal executive functioning, but data for interpretation of performance are limited. OBJECTIVES The Trinity, Ulster, Department of Agriculture (TUDA) study provided the opportunity to derive performance data from a large sample of community-dwelling hospital outpatient or general practitioner (GP) attenders. METHODS Normative analysis based on 2508 TUDA participants meeting these criteria: Mini-Mental State Examination (MMSE) >26/30, not depressed (Center for Epidemiologic Studies Depression <16) or anxious (Hospital Anxiety and Depression Scale <8), no history of stroke, or transient ischemic attack. Correlation and regression analyses were used to evaluate the effects of age, education, gender, and general cognition (MMSE). Norms for FAB were created stratified by age and education, using overlapping midpoint ranges of 10 years with a 3-year interval from age 60 to 97. RESULTS Age and education accounted for 9.6% of variance in FAB score ( r2 = .096) with no significant effect of gender. The FAB and MMSE were modestly correlated ( r = .29, P < .01) with MMSE increasing the model's total explained variance in FAB score from 9.6% to 14%. CONCLUSION This is the largest study to date to create normative data for the FAB. Age and education had the most significant impact on FAB performance, which was largely independent of global cognition (MMSE). These data may be of benefit in interpreting FAB performance in individuals with similar demographic/health status characteristics in hospital outpatient or GP settings.
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Affiliation(s)
- Robert F Coen
- 1 Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- 1 Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Miriam Casey
- 1 Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Helene McNulty
- 2 Northern Ireland Centre for Food and Health Centre, Ulster University, Coleraine, Northern Ireland
| | - Eamon Laird
- 3 Institute of Molecular Medicine, Trinity College, Dublin, Ireland
| | - Anne M Molloy
- 3 Institute of Molecular Medicine, Trinity College, Dublin, Ireland
| | - M Ward
- 2 Northern Ireland Centre for Food and Health Centre, Ulster University, Coleraine, Northern Ireland
| | - J J Strain
- 2 Northern Ireland Centre for Food and Health Centre, Ulster University, Coleraine, Northern Ireland
| | - Leane Hoey
- 2 Northern Ireland Centre for Food and Health Centre, Ulster University, Coleraine, Northern Ireland
| | - Catherine Hughes
- 2 Northern Ireland Centre for Food and Health Centre, Ulster University, Coleraine, Northern Ireland
| | - Conal J Cunningham
- 1 Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
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The benefits of utilising geo-mapping for visualising the vitamin D status of Dublin city and the surrounding urban districts. Ir J Med Sci 2016; 186:807-813. [PMID: 27770264 DOI: 10.1007/s11845-016-1517-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/07/2016] [Indexed: 01/03/2023]
Abstract
CONTEXT There have been few published reports of visualising vitamin D status at a micro level, i.e., within large individual urban centres of countries. OBJECTIVE To produce a visual map of the vitamin D status [25-hydroxy vitamin D-25(OH)D] of a large urban centre (n > 350,000) incorporating the regions of Dublin city that constitute the general practitioner catchment area of a large academic teaching adult hospital. DESIGN, SETTING AND PARTICIPANTS An observational investigation of 5287 free living Irish adults (>18 years). RESULTS Approximately, 15.2 % of those sampled in the winter period (October-February) were vitamin D deficient (<30 nmol/L) compared with 10.8 % of those sampled in the summer period (March-September). Vitamin D tests requested from the most social economically deprived urban locations (Dublin 8 and Lucan postal districts) had the highest rates of deficiency (23.5 and 20.4 %, respectively, both seasons). On average, females had a significantly higher 25(OH)D concentration compared with males (57.9 vs 52.3 nmol/L, respectively), while the younger participants (18-50 years) mean 25(OH)D concentration was 27 % lower in winter and 20.7 % lower in summer in comparison with the older participants (>50 years) (P < 0.0001). CONCLUSIONS For the first time in Ireland, a visual depiction of data can be used to aid in the rapid identification of vitamin D status trends within a major urban area. These findings provide useful data to help inform public health policy regarding endemic vitamin D insufficiency to help target the population groups and resident location areas most at risk.
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Vitamin D status and its predictors in New Zealand aged-care residents eligible for a government-funded universal vitamin D supplementation programme. Public Health Nutr 2016; 19:3349-3360. [PMID: 27453540 DOI: 10.1017/s1368980016001683] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The provision of prescribed vitamin D to all aged-care residents has been implemented in New Zealand as part of a government-led falls prevention programme. To our knowledge, there has been no evaluation of this universal programme on vitamin D status and functional and health outcomes. Thus, we aimed to determine 25-hydroxyvitamin D (25(OH)D) concentrations and their predictors in aged-care residents across the country and to investigate whether the government-funded programme was associated with adequate vitamin D status. DESIGN Cross-sectional survey of sociodemographic, biochemical, anthropometric, dietary and health characteristics. Blood samples were analysed for serum 25(OH)D and other biochemical measures. Multiple regression was used to examine predictors of vitamin D status. SETTING Sixteen residential aged-care facilities throughout New Zealand. SUBJECTS Residents aged ≥60 years with residency duration >12 weeks (n 309). RESULTS Mean serum 25(OH)D was 89·9 (95 % CI 85·2, 94·5) nmol/l and monthly supplements (1250 µg (50 000 IU)) were taken by 75 % of all residents. Of those not taking a funded supplement, 65·3 % had serum 25(OH)D 125 nmol/l. CONCLUSIONS Residents taking supplemental vitamin D had adequate vitamin D status; however monitoring of long-term supplementation should be considered, due to the high proportion of participants with high serum 25(OH)D levels.
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