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Seasonal variations in vitamin D do not change the musculoskeletal health of physically active ambulatory men with cerebral palsy: a longitudinal cross-sectional comparison study. Nutr Res 2023; 111:24-33. [PMID: 36812881 DOI: 10.1016/j.nutres.2022.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/03/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
Increased levels of vitamin D in the summer months from natural seasonal variations in sun exposure have been linked to improvements in musculoskeletal health and function in UK populations; however, studies have shown that differences in lifestyles because of disability can inhibit the natural vitamin D increase in these populations. We hypothesized that men with cerebral palsy (CP) will experience smaller increases in 25-hydroxyvitamin D (25(OH)D) from winter to summer and men with CP will not experience any improvements in musculoskeletal health and function during the summer. A longitudinal observational study in 16 ambulant men with CP aged 21.0 ± 1.3 years and 16 healthy, physical activity matched, typically developed controls aged 25.4 ± 2.6 years, completed assessments of serum 25(OH)D and parathyroid hormone during winter and summer. Neuromuscular outcomes included vastus lateralis size, knee extensor strength, 10-m sprint, vertical jumps, and grip strength. Bone ultrasounds were performed to obtain radius and tibia T and Z scores. Men with CP and typically developed controls showed a 70.5% and 85.7% increase in serum 25(OH)D from winter to summer months, respectively. Neither group showed seasonal effect on neuromuscular outcomes muscle strength, size, vertical jump, or tibia and radius T and Z scores. A seasonal interaction effect was seen in the tibia T and Z scores (P < .05). In conclusion, there were similar seasonal increases in 25(OH)D observed in men with CP and typically developed controls, but serum 25(OH)D levels were still considered insufficient to improve bone or neuromuscular outcomes.
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Horikawa A, Kasukawa Y, Hongo M, Kodama H, Sano A, Miyakoshi N. A prospective analysis of concentration of 25-OHD between northern and southern district in Japan in year-round study. Medicine (Baltimore) 2022; 101:e31340. [PMID: 36316947 PMCID: PMC9622566 DOI: 10.1097/md.0000000000031340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Although osteoporotic patients have already been recognized as having a low-volume vitamin D status, the concentration of active vitamin D precursor has not been studied in detail. This trial aimed to clarify the concentration of 25-hydroxyvitamin D (25-OHD), which is a natural type of vitamin D and compare between 2 separate areas in Japan. To compare and clarify the concentration of 25-OHD between 2 separate areas, Japanese patients who were diagnosed as having osteoporosis based on bone mineral density were studied. We analyzed 2 different hospitals' patients whose residence is separated into a northern district (Akita city: north latitude 39" 43') and a southern district (Shizuoka city: north latitude 34" 58'). Both of them have completely different daylight hours. Three-hundred sixty eight patients (174 in Akita, 194 in Shizuoka) were enrolled in this trial to compare the differences of concentration of 25-OHD by Welch's t t-test. There were significant differences in the concentration of 25-OHD and age between them. Akita patients were significantly higher than that of Shizuoka patients despite Shizuoka having much daylight hours of Akita. In conclusion, there might be no relationship between the concentration of 25 OHD and exposure to sunlight.
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Affiliation(s)
| | - Yuji Kasukawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Michio Hongo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | | | | | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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Chee WF, Aji AS, Lipoeto NI, Siew CY. Maternal Vitamin D Status and Its Associated Environmental Factors: A Cross-Sectional Study. Ethiop J Health Sci 2022; 32:885-894. [PMID: 36262702 PMCID: PMC9554773 DOI: 10.4314/ejhs.v32i5.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is common among women during pregnancy. This study aims to determine the prevalence of vitamin D deficiency and their shared modifiable environmental factors among pregnant women in Indonesia and Malaysia. METHODS Blood samples of 844 third-trimester pregnant women (Indonesians: 311; Malaysians: 533) were collected to determine their serum 25(OH) D levels. Information on sun exposure and sun protection behaviours were obtained through face-to-face interviews. Dietary vitamin D intake was assessed by using a semiquantitative food frequency questionnaire. RESULTS The prevalence of vitamin D deficiency (<30 nmol/L) among Indonesian and Malaysian pregnant women were 42.4% and 72.0%, respectively. Percentage of exposed body surface area was inversely associated with vitamin D deficiency among Indonesian pregnant women (OR = 0.21, 95% CI = 0.09-0.48). Among Malaysian pregnant women, higher intakes of dietary vitamin D were associated with lower risk of vitamin D deficiency (OR = 0.48, 95% CI = 0.29-0.81). Analysis of the combined cohorts revealed a lower risk of vitamin D deficiency among pregnant women who had a daily intake of at least 15 mcg vitamin D (OR = 0.58, 95% CI = 0.38-0.88) and exposure of more than 27% body surface area to the sunlight (OR = 0.30, 95% CI = 0.16-0.60). CONCLUSIONS Despite abundant sunshine, vitamin D deficiency is prevalent among pregnant women in tropical countries. The present study suggests that nutrition education on vitamin D intake and sun exposure during pregnancy is necessary for primary prevention of vitamin D deficiency in pregnant women living in the tropical countries.
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Affiliation(s)
- Woon Fui Chee
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Arif Sabta Aji
- Graduate School of Public Health, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia, Department of Nutrition, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
| | - Nur Indrawaty Lipoeto
- Department of Nutrition, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia
| | - Chin Yit Siew
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia, Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Kilmister EJ, Tan ST. Insights Into Vascular Anomalies, Cancer, and Fibroproliferative Conditions: The Role of Stem Cells and the Renin-Angiotensin System. Front Surg 2022; 9:868187. [PMID: 35574555 PMCID: PMC9091963 DOI: 10.3389/fsurg.2022.868187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/22/2022] [Indexed: 12/15/2022] Open
Abstract
Cells exhibiting embryonic stem cell (ESC) characteristics have been demonstrated in vascular anomalies (VAs), cancer, and fibroproliferative conditions, which are commonly managed by plastic surgeons and remain largely unsolved. The efficacy of the mTOR inhibitor sirolimus, and targeted therapies that block the Ras/BRAF/MEK/ERK1/2 and PI3KCA/AKT/mTOR pathways in many types of cancer and VAs, further supports the critical role of ESC-like cells in the pathogenesis of these conditions. ESC-like cells in VAs, cancer, and fibroproliferative conditions express components of the renin-angiotensin system (RAS) – a homeostatic endocrine signaling cascade that regulates cells with ESC characteristics. ESC-like cells are influenced by the Ras/BRAF/MEK/ERK1/2 and PI3KCA/AKT/mTOR pathways, which directly regulate cellular proliferation and stemness, and interact with the RAS at multiple points. Gain-of-function mutations affecting these pathways have been identified in many types of cancer and VAs, that have been treated with targeted therapies with some success. In cancer, the RAS promotes tumor progression, treatment resistance, recurrence, and metastasis. The RAS modulates cellular invasion, migration, proliferation, and angiogenesis. It also indirectly regulates ESC-like cells via its direct influence on the tissue microenvironment and by its interaction with the immune system. In vitro studies show that RAS inhibition suppresses the hallmarks of cancer in different experimental models. Numerous epidemiological studies show a reduced incidence of cancer and improved survival outcomes in patients taking RAS inhibitors, although some studies have shown no such effect. The discovery of ESC-like cells that express RAS components in infantile hemangioma (IH) underscores the paradigm shift in the understanding of its programmed biologic behavior and accelerated involution induced by β-blockers and angiotensin-converting enzyme inhibitors. The findings of SOX18 inhibition by R-propranolol suggests the possibility of targeting ESC-like cells in IH without β-adrenergic blockade, and its associated side effects. This article provides an overview of the current knowledge of ESC-like cells and the RAS in VAs, cancer, and fibroproliferative conditions. It also highlights new lines of research and potential novel therapeutic approaches for these unsolved problems in plastic surgery, by targeting the ESC-like cells through manipulation of the RAS, its bypass loops and converging signaling pathways using existing low-cost, commonly available, and safe oral medications.
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Affiliation(s)
| | - Swee T. Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand
- Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Lower Hutt, New Zealand
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- *Correspondence: Swee T. Tan
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Wu SE, Chen WL. Moderate Sun Exposure Is the Complementor in Insufficient Vitamin D Consumers. Front Nutr 2022; 9:832659. [PMID: 35350415 PMCID: PMC8957913 DOI: 10.3389/fnut.2022.832659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/10/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Aims Vitamin (Vit) D plays a vital role in human health, and the prevalence of Vit D deficiency worldwide has been a rising concern. This study investigates the serum 25-hydroxy-Vit D [25(OH)D] status in healthy US civilians and identifies how the two main sources, sun exposure and dietary Vit D intake, determine the final 25(OH)D levels in individuals. Methods A total of 2,360 of participants from The National Health and Nutrition Examination Survey (NHANES) 2009–2014 were analyzed. We divided the levels of sun exposure and dietary Vit D intake of all subjects into 10 strata and gave a score ranging from 1 to 10 points, respectively. Scores 1–5 in sun exposure and dietary intake were considered as relatively low exposure groups, whereas scores 6–10 were considered as relatively high exposure groups. Serum Vit D inadequacy was defined as <50 nmol/L. Linear and logistic regression analyses were used to examine the associations between sources of Vit D and serum 25(OH)D levels. Results In relatively low Vit D intake groups (Vit D intake score 1–5), relatively high sun exposure (sun exposure score >5) resulted in higher serum 25(OH)D levels (average 57 nmol/L) compared with relatively low sun exposure (sun exposure score <5) (average 50 nmol/L), whereas this difference became negligible in high intake groups (Vit D intake score 6–10). Moreover, the greatest slope occurred in the low Vit D intake curve (decile 3 of Vit D intake), which shows increased sun exposure time causing the greatest degree of change in serum 25(OH)D level in this group. Conclusion Sun exposure can significantly make up for deficiencies in subjects who consume insufficient dietary Vit D. Compared with the extra cost and time for building habits of Vit D supplementation, moderate sun exposure appears to be a simple and costless means for the public to start in daily practice.
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Affiliation(s)
- Shou-En Wu
- Department of Dermatology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Department of Biochemistry, National Defense Medical Center, Taipei City, Taiwan
- *Correspondence: Wei-Liang Chen,
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Oshiro CE, Hillier TA, Edmonds G, Peterson M, Hill PL, Hampson S. Vitamin D deficiency and insufficiency in Hawaii: Levels and sources of serum vitamin D in older adults. Am J Hum Biol 2022; 34:e23636. [PMID: 34213035 PMCID: PMC8720322 DOI: 10.1002/ajhb.23636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To examine the major sources of vitamin D [25-hydroxyvitamin D (25(OH)D)] and evaluate their collective role on rates of vitamin D deficiency/insufficiency among older adults. METHODS Cross-sectional analysis of the relationship between serum 25(OH)D levels and sources of vitamin D (self-reported and objectively validated sun exposure, supplementation, food including fortified sources). Study subjects were part of the Hawaii Longitudinal Study of Personality and Health who completed a clinic visit between 55 and 65 years (M = 59.6) and food frequency questionnaire, and provided serum to assay 25(OH)D (n = 223). RESULTS Although mean serum 25(OH)D levels were overall sufficient (34.3 ng/ml, [SD = 10.9]), over one-third of participants (38%) had vitamin D deficiency/insufficiency (<30 ng/ml). Asians were the most likely to be insufficient and Filipinos were the least likely (43% vs. 11%, respectively). Overall, supplement use and sun exposure were both associated with higher 25(OH)D levels and lower risk of vitamin D deficiency/insufficiency. Moreover, Vitamin D sources varied by race/ethnic groups. In multivariate models, higher body mass index, being Asian or Native Hawaiian/Pacific Islander, low supplement use, and low sun exposure were associated with higher risk for vitamin D deficiency/insufficiency (<30 ng/ml). CONCLUSIONS Over 1/3 of the older adult sample was vitamin D deficient/insufficient, despite most of the participants living in a tropical climate with year-round access to sun as a vitamin D source. Sun exposure and supplement use, but not food intake, explained differences in vitamin D deficiency/insufficiency in this population.
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Affiliation(s)
- Caryn E. Oshiro
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research, 501 Alakawa St. Suite 201, Honolulu, HI 96817
| | - Teresa A. Hillier
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research, 501 Alakawa St. Suite 201, Honolulu, HI 96817,Kaiser Permanente Northwest, Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227-1098
| | - Grant Edmonds
- Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403
| | - Missy Peterson
- Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403
| | - Patrick L. Hill
- Washington University, 1 Brookings Drive, Campus Box 1125, St. Louis, MO 63130
| | - Sarah Hampson
- Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403
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Nichols S, Dalrymple N, Prout P, Ramcharitar-Bourne A. Dietary intake patterns, nutrient adequacy and associated factors in a multi-ethnic Caribbean population. Nutr Health 2022; 29:297-307. [PMID: 35014896 DOI: 10.1177/02601060211070907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Diet is a significant contributor to health and wellbeing of individuals. Aim: In this study we investigated patterns of dietary intakes, levels of nutrient inadequacies and associated sociodemographic, anthropometric and lifestyle factors among adults in Trinidad and Tobago. Method: The study was cross-sectional in nature. A convenience sample of 11783 persons from districts throughout Trinidad and Tobago completed a self-administered questionnaire comprising socio-demographic and lifestyle items. Anthropometry was self-reported with 15% of participants having measurements done according to recommended procedures. Dietary patterns were determined by principal component analysis (PCA) while nutrient intakes and adequacy were assessed using the NutriGenie 7.0 software and nutrient adequacy ratio (MAR) respectively. Foods were categorised as unprocessed/minimally processed and processed/ultra-processed. The University of The West Indies Ethics Committee approved the study. Results: Approximately 72.5% of participants met the Goldberg criteria for plausible reporting. The three predominant dietary patterns 'Typical', 'Fruits and Vegetables', and 'High Fat' explained 45% of the total variance in foods consumed. Processed/ultra-processed foods accounted for most of the energy (80%) and nutrients consumed. Nutrient inadequacies were observed for potassium, vitamins B12, D, E, K, fibre, magnesium; and iron among females. The mean adequacy ratio (MAR) for participants was 67%. MAR was positively associated with predominant dietary patterns independent of socioe demographic and lifestyle factors (p < 0.001). Conclusion: Irrespective of their nature, the predominant dietary pattern was associated with nutrient adequacy among participants. Reducing the risk of inadequate nutrient intakes may be addressed by increasing availability, access and consumption of appropriate sources of these micronutrients.
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Affiliation(s)
- Selby Nichols
- Department of Agricultural Economics and Extension (DAEE), 37612The University of The West Indies, St. Augustine, Trinidad and Tobago
| | - Nequesha Dalrymple
- Department of Agricultural Economics and Extension (DAEE), 37612The University of The West Indies, St. Augustine, Trinidad and Tobago.,Department of Curriculum and Instruction, Faculty of Education and Humanities, University of Guyana
| | - Patrice Prout
- Department of Agricultural Economics and Extension (DAEE), 37612The University of The West Indies, St. Augustine, Trinidad and Tobago
| | - Anisa Ramcharitar-Bourne
- Department of Agricultural Economics and Extension (DAEE), 37612The University of The West Indies, St. Augustine, Trinidad and Tobago
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Nenseth HZ, Sahu A, Saatcioglu F, Osguthorpe S. A Nutraceutical Formula Is Effective in Raising the Circulating Vitamin and Mineral Levels in Healthy Subjects: A Randomized Trial. Front Nutr 2021; 8:703394. [PMID: 34540877 PMCID: PMC8440802 DOI: 10.3389/fnut.2021.703394] [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: 04/30/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Low levels of nutrient intake are common in industrialized countries. This has negative implications on health and is associated with chronic diseases. Supplementation of vitamins, minerals, and key nutrients to optimal levels may, therefore, be beneficial for individual health and for the health economy. Although the use of supplements has become very common, due to a lack of monitoring, there is very limited data on the efficacy of supplementation with different formulas. In this study, we present the results of a randomized controlled study on the efficacy of a novel formulated nutraceutical, N247, in 250 healthy volunteers aged 26-75 years and a placebo control group (n = 35). The broad-spectrum formulation of N247 includes essential vitamins, minerals, and trace elements that are adequately balanced in regard to synergies and related metabolic functions. Moreover, tolerance, safety, and nutrient availability is an important aspect of daily, long-term use of N247. After 3 months of regular N247 use, levels of vitamins and minerals in serum were significantly increased in the N247 group compared with the control group and a placebo group, with excellent compliance rates. Coupled with additional natural ingredients that aim to increase the potency of the nutrients, N247 may represent a novel and beneficial supplement for individuals with nutritional deficiencies. Clinical Trial Registration:https://clinicaltrials.gov/, identifier: NCT04054505.
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Affiliation(s)
| | - Aparna Sahu
- Turiyan Psyneuronics Pvt. Ltd, Bangalore, India
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Garand M, Toufiq M, Singh P, Huang SSY, Tomei S, Mathew R, Mattei V, Al Wakeel M, Sharif E, Al Khodor S. Immunomodulatory Effects of Vitamin D Supplementation in a Deficient Population. Int J Mol Sci 2021; 22:5041. [PMID: 34068701 PMCID: PMC8126205 DOI: 10.3390/ijms22095041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/31/2022] Open
Abstract
In addition to its canonical functions, vitamin D has been proposed to be an important mediator of the immune system. Despite ample sunshine, vitamin D deficiency is prevalent (>80%) in the Middle East, resulting in a high rate of supplementation. However, the underlying molecular mechanisms of the specific regimen prescribed and the potential factors affecting an individual's response to vitamin D supplementation are not well characterized. Our objective is to describe the changes in the blood transcriptome and explore the potential mechanisms associated with vitamin D3 supplementation in one hundred vitamin D-deficient women who were given a weekly oral dose (50,000 IU) of vitamin D3 for three months. A high-throughput targeted PCR, composed of 264 genes representing the important blood transcriptomic fingerprints of health and disease states, was performed on pre and post-supplementation blood samples to profile the molecular response to vitamin D3. We identified 54 differentially expressed genes that were strongly modulated by vitamin D3 supplementation. Network analyses showed significant changes in the immune-related pathways such as TLR4/CD14 and IFN receptors, and catabolic processes related to NF-kB, which were subsequently confirmed by gene ontology enrichment analyses. We proposed a model for vitamin D3 response based on the expression changes of molecules involved in the receptor-mediated intra-cellular signaling pathways and the ensuing predicted effects on cytokine production. Overall, vitamin D3 has a strong effect on the immune system, G-coupled protein receptor signaling, and the ubiquitin system. We highlighted the major molecular changes and biological processes induced by vitamin D3, which will help to further investigate the effectiveness of vitamin D3 supplementation among individuals in the Middle East as well as other regions.
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Affiliation(s)
- Mathieu Garand
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Mohammed Toufiq
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Parul Singh
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Susie Shih Yin Huang
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Sara Tomei
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Rebecca Mathew
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Valentina Mattei
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Mariam Al Wakeel
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha 26999, Qatar;
| | - Elham Sharif
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha 26999, Qatar;
| | - Souhaila Al Khodor
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
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Kusumastuty I, Handayani D, Tjahjono HA, Sari EP, Rahayuningtyas SK, Saputra AB. Hubungan Paparan Sinar Matahari, Status Gizi, dan Asupan Makan terhadap Kadar Vitamin D Anak dan Remaja Penderita Diabetes Mellitus Tipe 1. AMERTA NUTRITION 2021. [DOI: 10.20473/amnt.v5i1.2021.41-51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Previous research state the correlation between vitamin D deficiency and Type 1 diabetes. The deficiency of Vitamin D is caused by vitamin D intake, sunlight exposure, or nutritional status. Indonesia, as a tropical country, is close to the equator and receives sunlight all year long. Little research has been done on vitamin D levels in children and adolescents with Type 1 Diabetes in Indonesia.Objective: The study aims to determine the relationship among sunlight exposure, nutritional status, food intake, and vitamin D levels in children and adolescents with Type 1 Diabetes.Methods: The study design was cross-sectional with a sample size of 31 children and adolescents aged 5-19 years. Sunlight exposure data were collected using the Sun Exposure Questionnaire form, nutritional status o BMI/age data were using the WHO Anthro, food intake data were using the Semi-Quantitative Food Frequency Questioner, and vitamin D level data were using the ELISA method. Statistical analysis was conducted by using SPSS Version 21 with Pearson and Spearman correlation test.Results: All respondents showed vitamin D deficiency. Most respondents had low sunlight exposure and nutritional status in the normoweight category. The majority of respondents had good energy and protein intake, excess fat, low carbohydrates, and low vitamin D and calcium.Conclusion:There is a positive relationship between sunlight exposure and vitamin D level (p = 0.001, r = 0.627). However, there is no relationship among nutritional status, protein intake, fat, carbohydrates, vitamin D and calcium on the level of vitamin D (p = 0.409; p = 0.240; p = 0.311; p = 0.822; p = 0.231; 0.382).
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Akinlawon OJ, Lai CQ, Noel SE, Flanagan KD, Tucker KL. Risk Factors Associated with Vitamin D Status among Older Puerto Rican Adults. J Nutr 2021; 151:999-1007. [PMID: 33693857 PMCID: PMC8030721 DOI: 10.1093/jn/nxaa426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/20/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been associated with health problems globally, but there is limited information on vitamin D status and associated risk factors among adults in underserved populations. OBJECTIVE This study aimed to identify risk factors for vitamin D deficiency/insufficiency among Puerto Rican adults from the Boston Puerto Rican Health Study (BPRHS). METHODS A total of 822 adults (45-75 y, at baseline) were included in these analyses. Deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] <30 and insufficiency as 30 to <50 nmol/L. Dietary intake was assessed with a validated FFQ. Associations between risk factors, including dietary vitamin D, supplement use, ancestry, skin pigmentation, months in the past year spent in a southern climate, and serum 25(OH)D were assessed with multivariable general linear models. RESULTS Approximately 13% of participants were deficient in 25(OH)D and another 43% insufficient. Skin pigment was associated with 25(OH)D using 3 measures, greater African ancestry (β ± SE) (-7.74 ± 2.91, P = 0.01); interviewer assessed dark or medium, compared with white, skin tone, (-5.09 ± 2.19, P = 0.02 and -5.89 ± 1.58, P < 0.001, respectively); and melanin index of the upper inner right arm, assessed using a spectrophotometer (-2.04 ± 0.84, P = 0.02). After adjusting for ancestry, factors associated with lower serum 25(OH)D included smoking (-4.49 ± 1.58, P = 0.01); BMI (-0.21 ± 0.10, P = 0.04); and spring compared with autumn blood draw (-4.66 ± 1.68, P = 0.004). Factors associated with higher serum 25(OH)D included female sex compared with male (4.03 ± 1.58, P = 0.01); dietary vitamin D intake μg/d (0.71 ± 0.25, P < 0.004); vitamin D supplement use (4.50 ± 1.87, P = 0.02); income to poverty ratio (0.01 ± 0.01, P = 0.06), and months in a southern climate during the past year (0.96 ± 0.56, P = 0.09). CONCLUSIONS Vitamin D deficiency/insufficiency was prevalent in this Puerto Rican population living in the northeastern USA. Several factors were associated with this, which may assist in identifying those at risk. Interventions are needed to improve serum 25(OH)D concentration, particularly among those with limited exposure to sunlight.
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Affiliation(s)
- Oladimeji J Akinlawon
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Chao-Qiang Lai
- Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Kaylea D Flanagan
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Lee SS, Ling KH, Tusimin M, Subramaniam R, Rahim KF, Loh SP. Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women. BMC Pregnancy Childbirth 2020; 20:714. [PMID: 33228578 PMCID: PMC7684735 DOI: 10.1186/s12884-020-03397-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. METHOD Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using a questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using an Ultra-High-Performance Liquid Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. RESULTS Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD < 30 nmol/L). VDD (25OHD < 30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, a significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD < 30 nmol/L). CONCLUSIONS The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state.
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Affiliation(s)
- Siew-Siew Lee
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - King-Hwa Ling
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.,Department of Genetics, Harvard Medical School, Boston, MA, 02115, USA
| | - Maiza Tusimin
- Prince Court Medical Centre, 50450, Kuala Lumpur, Malaysia
| | - Raman Subramaniam
- Fetal Medicine and Gynaecology Centre (FMGC), 46200, Petaling Jaya, Selangor, Malaysia
| | | | - Su-Peng Loh
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia. .,Research Centre of Excellence for Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43300 UPM, Serdang, Selangor, Malaysia.
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13
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Agarwal P, Morris MC, Barnes LL. Racial Differences in Dietary Relations to Cognitive Decline and Alzheimer's Disease Risk: Do We Know Enough? Front Hum Neurosci 2020; 14:359. [PMID: 33100990 PMCID: PMC7497764 DOI: 10.3389/fnhum.2020.00359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023] Open
Abstract
The elderly population in the US is increasing and projected to be 44% minority by 2060. African Americans and Hispanics are at increased risk of cognitive impairment and Alzheimer’s disease compared to non-Hispanic whites. These conditions are associated with many other adverse health outcomes, lower quality of life, and substantial economic burden. In the past few decades, diet has been identified as an important modifiable risk factor for cognitive decline and Alzheimer’s disease. Some studies report poor diet quality among African American and Hispanic older adult populations compared to their white counterparts. We have a limited understanding of how diet affects brain health in different racial-ethnic groups. One primary reason for our lack of knowledge is that most cohort studies are of majority non-Hispanic white participants. Moreover, those that do include minority participants do not publish their findings stratified by racial-ethnic groups, and likely have a less accurate measurement of dietary intake among minority groups. In this review, we summarize the current, albeit limited, literature on racial/ethnic differences in dietary relations to dementia outcomes. We will also discuss methodological issues in conducting nutrition studies in diverse cultures, and suggestions for future research directions. Overcoming the gaps will make it possible to make dietary recommendations for Alzheimer’s prevention that are more relevant for different racial/ethnic groups and set us on a faster track to reduce health disparities.
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Affiliation(s)
- Puja Agarwal
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States
| | - Martha C Morris
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
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14
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Kuang Y, Xiao Y, Fang Z, Zhang Y, Shen M, Chen X, Chen M, Lv C, Zhu W. Association of Serum Vitamin D With Psoriasis and Effect Modification by Central Obesity. Front Med (Lausanne) 2020; 7:236. [PMID: 32626717 PMCID: PMC7315806 DOI: 10.3389/fmed.2020.00236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Psoriasis is a chronic recurrent inflammatory disease involving many common mechanisms associated with obesity, such as systemic inflammation and vitamin D deficiency. This study aimed to examine the association of the serum concentration of 25-hydroxyvitamin D with psoriasis and the effect modification by obesity among the affected patients. Methods: A mixed cross-section study was conducted. We consecutively included untreated psoriasis patients from the outpatients who visited the Department of Dermatology of Xiangya Hospital and recruited 205 gender-matched healthy controls from the Hunan Civil Servant Cohort. In both groups, we measured the serum 25-hydroxyvitamin D level, body mass index (BMI), waist-hip-ratio (WHR) and other psoriasis-related clinical indicators. Results: A total of 203 psoriasis outpatients and 205 gender-matched cohort participants with complete data of serum vitamin D concentration were included in the analysis. The serum vitamin D levels of the two groups were close to each other, while the mean WHR of the psoriasis outpatients was significantly higher. Compared with the controls, the risk of psoriasis increased significantly when the vitamin D level decreased from 20 to 10 nmol/L. A significant interaction between the serum vitamin D level and the obesity category (BMI × WHR) was identified. After stratification by WHR, vitamin D was not associated with psoriasis in subjects with normal WHR. In contrast, the association between vitamin D deficiency and psoriasis retained and the effect size augmented in patients with central obesity. Conclusions: WHR may modify the association between serum vitamin D and psoriasis. Treatment advocating Vitamin D supplements may tailor to psoriasis patients with metabolic disorders.
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Affiliation(s)
- Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Zhiqin Fang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Yichi Zhang
- The First High School of Changsha, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | | | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
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15
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Leiu KH, Chin YS, Mohd Shariff Z, Arumugam M, Chan YM. High body fat percentage and low consumption of dairy products were associated with vitamin D inadequacy among older women in Malaysia. PLoS One 2020; 15:e0228803. [PMID: 32053636 PMCID: PMC7018013 DOI: 10.1371/journal.pone.0228803] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/23/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Serum vitamin D insufficiency is a public health issue, especially among older women. Sun exposure is fundamental in the production of vitamin D, but older women have less optimal sun exposure. Therefore, factors such as body composition and diet become more essential in sustaining sufficient serum levels of vitamin D. The objective of the current study is to determine factors contributing towards serum vitamin D insufficiency among 214 older women. METHODS The respondents had their body weight, height, waist circumference and body fat percentage measured, as well as interviewed for their socio-demographic characteristics, sun exposure and dietary intake. Fasting blood samples were obtained from the respondents to measure their serum 25-hydroxyvitamin D [25(OH)D] concentration. RESULTS There were 82.7% (95% CI: 77.6%, 87.8%) of the respondents that had serum vitamin D insufficiency (< 50 nmol/L) with an average of 37.4 ± 14.3nmol/L. In stepwise multiple linear regression, high percentage of body fat (ß = -0.211, p <0.01) and low consumption of milk and dairy products (ß = 0.135, p <0.05) were the main contributors towards insufficient serum vitamin D levels, but not socio-demographic characteristics, other anthropometric indices, sun exposure and diet quality. CONCLUSION Older women with high body fat percentage and low dairy product consumption were more likely to have serum vitamin D insufficiency. Older women should ensure their body fat percentage is within a healthy range and consume more milk and dairy products in preventing serum vitamin D insufficiency.
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Affiliation(s)
- Kok Hong Leiu
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Manohar Arumugam
- Department of Orthopedics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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16
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Palacios C, Trak‐Fellermeier MA, Martinez RX, Lopez‐Perez L, Lips P, Salisi JA, John JC, Peña‐Rosas JP. Regimens of vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2019; 10:CD013446. [PMID: 31581312 PMCID: PMC6776191 DOI: 10.1002/14651858.cd013446] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D deficiency during pregnancy increases the risk of pre-eclampsia, gestational diabetes, preterm birth, and low birthweight. In a previous Cochrane Review we found that supplementing pregnant women with vitamin D alone compared to no vitamin D supplementation may reduce the risk of pre-eclampsia, gestational diabetes, and low birthweight and may increase the risk of preterm births if it is combined with calcium. However the effects of different vitamin D regimens are not yet clear. OBJECTIVES To assess the effects and safety of different regimens of vitamin D supplementation alone or in combination with calcium or other vitamins, minerals or nutrients during pregnancy, specifically doses of 601 international units per day (IU/d) or more versus 600 IU/d or less; and 4000 IU/d or more versus 3999 IU/d or less. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (12 July 2018), and the reference lists of retrieved studies. SELECTION CRITERIA Randomised trials evaluating the effect of different vitamin D regimens (dose, frequency, duration, and time of commencement of supplementation during pregnancy), alone or in combination with other nutrients on pregnancy and neonatal health outcomes. We only included trials that compared 601 IU/d or more versus 600 IU/d or less and 4000 IU/d or more versus 3999 IU/d or less. We did not include in the analysis groups that received no vitamin D, as that comparison is assessed in another Cochrane Review. DATA COLLECTION AND ANALYSIS Two review authors independently: i) assessed the eligibility of studies against the inclusion criteria; ii) extracted data from included studies, and iii) assessed the risk of bias of the included studies. Our primary maternal outcomes were: pre-eclampsia, gestational diabetes, and any adverse effects; our primary infant outcomes were preterm birth and low birthweight. Data were checked for accuracy. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS In this review, we included data from 30 trials involving 7289 women. We excluded 11 trials, identified 16 ongoing/unpublished trials and two trials are awaiting classification. Overall risk of bias for the trials was mixed.Comparison 1. 601 IU/d or more versus 600 IU/d or less of vitamin D alone or with any other nutrient (19 trials; 5214 participants)Supplementation with 601 IU/d or more of vitamin D during pregnancy may make little or no difference to the risk of pre-eclampsia (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.65 to 1.42); 5 trials; 1553 participants,low-certainty evidence), may reduce the risk of gestational diabetes (RR 0.54, 95% CI 0.34 to 0.86; 5 trials; 1846 participants; moderate-certainty evidence), may make little or no difference to the risk of preterm birth (RR 1.25, 95% CI 0.92 to 1.69; 4 trials; 2294 participants; low-certainty evidence); and may make little or no difference to the risk of low birthweight (RR 0.90, 95% CI 0.66 to 1.24; 4 trials; 1550 participants; very low-certainty evidence) compared to women receiving 600 IU/d or less.Comparison 2. 4000 IU or more versus 3999 IU or less of vitamin D alone (15 trials; 4763 participants)Supplementation with 4000 IU/d or more of vitamin D during pregnancy may make little or no difference to the risk of: pre-eclampsia (RR 0.87, 95% CI 0.62 to 1.22; 4 trials, 1903 participants, low-certainty evidence); gestational diabetes (RR 0.89, 95% CI 0.56 to 1.42; 5 trials, 2276 participants; low-certainty evidence); preterm birth (RR 0.85, 95% CI 0.64 to 1.12; 6 trials, 2948 participants, low-certainty evidence); and low birthweight (RR 0.92, 95% CI 0.49 to 1.70; 2 trials; 1099 participants; low-certainty evidence) compared to women receiving 3999 IU/d or less.Adverse events (such as hypercalcaemia, hypocalcaemia, hypercalciuria, and hypovitaminosis D) were reported differently in most trials; however, in general, there was little to no side effects reported or similar cases between groups. AUTHORS' CONCLUSIONS Supplementing pregnant women with more than the current vitamin D recommendation may reduce the risk of gestational diabetes; however, it may make little or no difference to the risk of pre-eclampsia, preterm birth and low birthweight. Supplementing pregnant women with more than the current upper limit for vitamin D seems not to increase the risk of the outcomes evaluated. In general, the GRADE was considered low certainty for most of the primary outcomes due to serious risk of bias and imprecision of results. With respect to safety, it appears that vitamin D supplementation is a safe intervention during pregnancy, although the parameters used to determine this were either not reported or not consistent between trials. Future trials should be consistent in their reports of adverse events. There are 16 ongoing trials that when published, will increase the body of knowledge.
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Affiliation(s)
- Cristina Palacios
- Robert Stempel College of Public Health and Social Work, Florida International UniversityDepartment of Dietetics and Nutrition11200 SW 8th Street, AHC 5 – 323MiamiFloridaUSA33199
| | - Maria Angelica Trak‐Fellermeier
- University of Puerto RicoCenter for Clinical Research and Health PromotionMedical Science Campus Suite A107, PO Box 365067San JuanPuerto RicoPR00935
| | | | - Lucero Lopez‐Perez
- WHO ConsultantIsla del Socorro 7Col. Prado VallejoTlalnepantlaMexico54170
| | - Paul Lips
- VU University Medical CenterInternal Medicine, Endocrine SectionP.O. Box 7057AmsterdamNetherlands1071 MC
| | - James A Salisi
- WHO Regional Office of the Western PacificNutrition Unit, Division of Non‐communicable Diseases and Health through the Life‐courseUN AvenueManilaPhilippines1000
| | - Jessica C John
- Eat, Drink and Be Healthy173 Eastern Main RoadTunapunaTrinidad and Tobago
| | - Juan Pablo Peña‐Rosas
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and Development20 Avenue AppiaGenevaGESwitzerland1211
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17
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Piccolo BD, Hall LM, Stephensen CB, Gertz ER, Van Loan MD. Circulating 25-Hydroxyvitamin D Concentrations in Overweight and Obese Adults Are Explained by Sun Exposure, Skin Reflectance, and Body Composition. Curr Dev Nutr 2019; 3:nzz065. [PMID: 31304455 PMCID: PMC6616201 DOI: 10.1093/cdn/nzz065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/10/2019] [Accepted: 05/23/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Obese individuals are known to be at higher risk for vitamin D deficiency than normal-weight individuals. Cutaneous synthesis is a major source of vitamin D; however, objective measurements of sun exposure are lacking in this population. OBJECTIVE To assess the validity of a regression model using sun exposure in lean individuals to estimate serum 25-hydroxyvitamin D [25(OH)D] in overweight and obese individuals, and to develop a prediction equation for serum 25(OH)D in overweight and obese adults. METHODS This study was a secondary analysis of a 15-wk controlled feeding study investigating the effects of dairy consumption on body composition. Information regarding sun exposure, including day, hour, time outside, and clothing, were self-assessed in sun exposure diaries. Personal sun exposure energy (joules) was assessed by downloading time-specific ultraviolet B energy data from climate stations. Skin reflectance was measured using a Minolta 2500d spectrophotometer. Dietary intake of vitamin D was known. Serum 25(OH)D concentration was measured by radioimmunoassay. Body composition was determined from whole-body dual energy x-ray absorptiometry and computed tomography scans. RESULTS Sun exposure was positively related to serum 25(OH)D (r = 0.26; P ≤ 0.05) and inversely related to total fat mass, android fat, and BMI (r = -0.25, -0.30, and -0.32, respectively). The modified Hall model significantly overestimated serum 25(OH)D in overweight and obese adults by 27.33-80.98 nmol/L, depending on the sun exposure calculation. A new regression model was developed for overweight and obese persons that explained 29.1% of the variance in postintervention 25(OH)D concentrations and included sun exposure, skin reflectance, total fat mass, total lean mass, and intra-abdominal adipose tissue as predictors. CONCLUSION Major determinants of serum 25(OH)D concentration in healthy overweight and obese individuals include sun exposure, skin reflectance, and adiposity. Addition of adiposity terms to the prior model significantly improved predictive ability in overweight and obese men and women. (clinicaltrials.gov: NCT00858312).
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Affiliation(s)
- Brian D Piccolo
- Arkansas Children's Nutrition Center, Little Rock, AR
- University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Charles B Stephensen
- University of California, Davis, CA
- USDA, ARS, Western Human Nutrition Research Center, Davis, CA
| | - Erik R Gertz
- USDA, ARS, Western Human Nutrition Research Center, Davis, CA
| | - Marta D Van Loan
- University of California, Davis, CA
- USDA, ARS, Western Human Nutrition Research Center, Davis, CA
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18
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Woon FC, Chin YS, Ismail IH, Batterham M, Abdul Latiff AH, Gan WY, Appannah G, Mohammed Hussien SH, Edi M, Tan ML, Chan YM. Vitamin D deficiency during pregnancy and its associated factors among third trimester Malaysian pregnant women. PLoS One 2019; 14:e0216439. [PMID: 31233513 PMCID: PMC6590777 DOI: 10.1371/journal.pone.0216439] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/12/2019] [Indexed: 01/09/2023] Open
Abstract
Background Despite perennial sunshine, vitamin D deficiency is prevalent among Malaysians especially pregnant women. This study determines the vitamin D status and its associated factors among third trimester pregnant women attending government health clinics in Selangor and Kuala Lumpur, Malaysia. Methods Information on socio-demographic characteristics, obstetrical history, and sun exposure were obtained through face-to-face interviews. Vitamin D intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Serum 25-hydroxyvitamin D concentration was measured and classified as deficient (< 30 nmol/L), insufficient (30–50 nmol/L), and sufficient (≥ 50 nmol/L). Results Of the 535 pregnant women recruited, 42.6% were vitamin D deficient. They consumed an average of 8.7 ± 6.7 μg of vitamin D daily. A total of 80.4% of the vitamin D were obtained from the food sources, while 19.6% were from dietary supplements. Fish and fish products showed the highest contribution to vitamin D intake (35.8%). The multivariable generalized linear mixed models, with clinic as a random effect, indicates that higher intake of vitamin D is associated with lower odds of vitamin D deficiency among pregnant women (OR = 0.96; 95% CI = 0.93–0.99). The odds of having vitamin D deficiency was reduced by 87% in non-Malays (OR = 0.14; 95% CI = 0.05–0.41) compared to Malays. No associations were found between age, educational level, monthly household income, work status, gravidity, parity, pre-pregnancy body mass index, total hours of sun exposure, total percentage of body surface area, and sun exposure index per day with vitamin D deficiency. Conclusion Vitamin D deficiency is prevalent among Malaysian pregnant women. Considering the possible adverse obstetric and fetal outcomes of vitamin D deficiency during pregnancy, future nutrition education should emphasise on vitamin D-fortified foods consumption among pregnant women by taking into consideration ethnic differences.
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Affiliation(s)
- Fui Chee Woon
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail:
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Marijka Batterham
- National Institute for Applied Statistics Research Australia, University of Wollongong, Northfields Ave Wollongong, NSW Australia
| | | | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siti Huzaifah Mohammed Hussien
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Muliana Edi
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Meng Lee Tan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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19
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Schmidt RJ, Niu Q, Eyles DW, Hansen RL, Iosif AM. Neonatal vitamin D status in relation to autism spectrum disorder and developmental delay in the CHARGE case-control study. Autism Res 2019; 12:976-988. [PMID: 31094097 PMCID: PMC6546420 DOI: 10.1002/aur.2118] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/22/2019] [Accepted: 04/21/2019] [Indexed: 12/19/2022]
Abstract
Vitamin D appears essential for normal neurodevelopment and cognitive and behavioral function. We examined neonatal vitamin D in relation to the child's later diagnosis of autism spectrum disorder (ASD) or developmental delay (DD). Children aged 24-60 months enrolled in the population-based CHARGE case-control study were evaluated clinically for ASD (n = 357), DD (n = 134), or typical development (TD, n = 234) at the MIND Institute (Sacramento, CA) using standardized assessments. Total 25-hydroxyvitamin D (25[OH]D) was measured using sensitive isotope dilution liquid chromatography-tandem mass spectrometry in archived dried blood spots collected for the California Department of Public Health's Newborn Screening Program. Multinomial logistic regression was used to calculate ORs as measures of the associations between 25 nmol/L change in 25(OH)D and ASD and DD. Associations between 25(OH)D and scores on Mullen Scales of Early Learning and Vineland Adaptive Behavior Scales were assessed using robust linear regression. Effect modification was examined using stratified models and interaction product terms. Unadjusted mean (SD) 25(OH)D was lower for DD (73.2 [37.6]) than for TD (82.7 [39.3]) and ASD (80.1 [37.4]). After adjustment for maternal prepregnancy body mass index and education, a 25 nmol/L increase in total 25(OH)D was not associated with ASD (OR = 0.97; CI: 0.87-1.08) or DD (OR = 0.91; 95% CI: 0.78-1.06). Neonatal 25(OH)D was associated with significantly reduced ASD only in females (adjusted OR = 0.74; 95% CI: 0.55-0.99, Pinteraction = 0.03), and significantly reduced DD only in non-Hispanic white children (adjusted OR = 0.79; 95% CI: 0.63-0.98, Pinteraction = 0.11 for Hispanic, Pinteraction = 0.31 for other), driven by DD children with trisomy 21. This study provides evidence that neonatal vitamin D could be associated with ASD in females and with DD in non-Hispanic white children. Autism Res 2019, 12: 976-988. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Vitamin D appears essential for brain development and function. We examined neonatal total 25-hydroxyvitamin D (25[OH]D) measured in dried blood spots in relation to later diagnoses of autism spectrum disorder (ASD) or developmental delay (DD) and related assessment scores. Higher neonatal 25(OH)D was associated with a 26% reduction in the odds for ASD only in females. After taking into account factors that could contribute to vitamin D status, a significant association with 21% reduced odds for DD was found only in non-Hispanic white children. Though results were nonsignificant overall, certain subgroups might benefit from higher neonatal vitamin D.
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Affiliation(s)
- Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
| | - Qiaojuan Niu
- Graduate Group in Biostatistics, University of California, Davis, Davis, California
| | - Darryl W Eyles
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Robin L Hansen
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, California
| | - Ana-Maria Iosif
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California
- The MIND Institute, School of Medicine, University of California, Davis, Sacramento, California
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Fayet-Moore F, Brock KE, Wright J, Ridges L, Small P, Seibel MJ, Conigrave AD, Mason RS. Determinants of vitamin D status of healthy office workers in Sydney, Australia. J Steroid Biochem Mol Biol 2019; 189:127-134. [PMID: 30831196 DOI: 10.1016/j.jsbmb.2019.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/06/2019] [Accepted: 02/28/2019] [Indexed: 01/04/2023]
Abstract
Low vitamin D status, measured as 25-hydroxyvitamin D (25OHD), has been linked to increased risk of osteoporosis and other disorders. Due to the indoor nature of office work, there may be an increased risk of 25OHD deficiency in this group. The aim of the current study was to evaluate seasonal variations of 25OHD in a population of healthy office workers, and to assess the effect of sun exposure behaviour, skin pigmentation, physical activity (PA) and dietary intake on serum 25OHD concentrations. We assessed the vitamin D status of healthy office workers in Sydney, Australia, at the end of summer (n = 103) and then at the end of winter (n = 71). Data on anthropometry, PA, dietary intake, sun exposure and skin phototype were collected along with blood samples. Serum 25OHD was measured by radioimmunoassay. Mean 25OHD concentration in late summer was 68 ± 27 nmol/L (range: 24-160 nmol/L), and in late winter was 59 ± 32 nmol/L (range: 15-174 nmol/L). 25OHD deficiency (<50 nmol/L) was observed in 29% and 42% of participants at end-summer and end-winter, respectively. Almost 10% of individuals were extremely deficient (<25 nmol/L) at end-winter, particularly those with dark skin (phototypes 5 and 6). Independent predictors of end-summer 25OHD were skin phototype (p < 0.02), summer sun exposure (p < 0.001) and skin area exposed (p = 0.005). The strongest predictor of end-winter 25OHD was end-summer 25OHD concentration (p < 0.001). If this was excluded from the model, the independent predictors of end-winter 25OHD were skin phototype (p < 0.01), sun exposure in winter (p = 0.01) and oily fish consumption (p < 0.05). Sunscreen use was significantly associated with higher vitamin D status (p < 0.05) as those who used sunscreen were also more likely to spend time outdoors. We conclude that sun exposure is beneficial for vitamin D status even with sunscreen use. Vitamin D supplements should be targeted to individuals who are darker skinned or unable to obtain adequate sun exposure, particularly during the winter months.
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Affiliation(s)
- Flavia Fayet-Moore
- School of Molecular Bioscience, University of Sydney, NSW, 2006, Australia; Nutrition Research Australia, Sydney NSW, 2000, Australia
| | - Kaye E Brock
- Faculty of Health Sciences, University of Sydney, NSW, 2006, Australia; Physiology, School of Medical Sciences, University of Sydney, NSW, 2006, Australia
| | - Jutta Wright
- Nestlé Australia Ltd., Rhodes NSW, 2138, Australia
| | - Leisa Ridges
- Nestlé Australia Ltd., Rhodes NSW, 2138, Australia
| | | | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW, 2006, Australia
| | - Arthur D Conigrave
- School of Molecular Bioscience, University of Sydney, NSW, 2006, Australia; Bosch Institute for Medical Research, University of Sydney, NSW, 2006, Australia
| | - Rebecca S Mason
- Bosch Institute for Medical Research, University of Sydney, NSW, 2006, Australia; Physiology, School of Medical Sciences, University of Sydney, NSW, 2006, Australia.
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Sulimani RA. Celiac disease and severe vitamin D deficiency: the case for anti-tissue transglutaminase antibody screening. Arch Osteoporos 2019; 14:30. [PMID: 30828751 DOI: 10.1007/s11657-018-0554-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 12/05/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D-deficient Saudi adolescent girls were screened for anti-tissue transglutaminase (IgA-tTG) antibodies to determine whether the presence of severe vitamin D deficiency was associated with celiac disease. All 9 participants who were positive for IgA-tTG antibodies had severe vitamin D deficiency (25(OH)D < 12.5 nmol/l), suggesting that this population should be screened for celiac disease. PURPOSE The current cross-sectional study aimed to see if severe vitamin D deficiency is associated with celiac disease (CD) among Saudi adolescent girls. METHODS A total 200 adolescent females aged 13-19 years old with vitamin D deficiency (serum 25(OH)D < 50 nmol/l) were screened for IgA tTG (anti-tissue transglutaminase antibodies). RESULTS Of the 200 girls, 9 (4.5%) were positive for IgA tTG antibodies; all of whom had serum 25(OH)D < 12.5 nmol/l. A strong significant inverse association was observed between tTG antibody levels and serum 25(OH)D (R = - 0.53; p < 0.001) among antibody negative participants. Finally, participants with positive IgA tTG antibodies was 37.2 times higher for participants with 25(OH)D < 12.5 nmol/l than those whose vitamin D status was higher [OR = 37.2 (95% CI 4.6-299.7) (p = 0.0002)]. CONCLUSION The data suggests that CD maybe a risk factor for severe vitamin D deficiency and that patients presenting with very low levels of 25(OH)D of less than 12.5 nmol/l-in the absence of an obvious cause-may need to be screened for CD.
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Affiliation(s)
- Riad A Sulimani
- Department of Internal Medicine, College of Medicine, King Saud University, P.O Box 7805, Riyadh, 11472, Saudi Arabia.
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Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L. Vitamin D and Falls in Older African American Women: The PODA Randomized Clinical Trial. J Am Geriatr Soc 2019; 67:1043-1049. [PMID: 30698279 DOI: 10.1111/jgs.15760] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Limited information is available on the influence of vitamin D on falls in older high-functioning black American women. Endocrine Society guidelines propose serum 25(OH)D levels over 30 ng/mL. OBJECTIVE To determine if maintenance of serum 25(OH)D above 30 ng/mL protects against falls. DESIGN The Physical Performance, Osteoporosis and Vitamin D in African American Women (PODA) trial had a prospective, randomized, placebo-controlled, double-dummy design with two arms: one with placebo and one with vitamin D3 adjusted to maintain serum 25(OH)D above 30 ng/mL. The primary outcomes were the prevention of bone loss and the decline in physical performance. PATIENTS The target population was healthy black women older than 60 years with serum 25(OH)D between 8 and 26 ng/mL. The trial was 3 years in duration with a falls questionnaire administered every 3 months. A total of 260 women entered the study, and 184 completed the 3 years. Mean age was 68.2 years. SETTING Research center in an academic health center. MAIN OUTCOMES MEASURE Prevention of falls. INTERVENTION Participants were randomly assigned to placebo or active vitamin D. Vitamin D3 dose was adjusted to maintain serum 25(OH)D above 30 ng/mL in the active group using a double-dummy design. RESULTS Baseline 25(OH)D was 22 ng/mL. Mean serum 25(OH)D reached 47 ng/mL in the active group compared with 21 ng/mL in the placebo group. There were 14.2% falls in the previous year recalled at baseline. During the study, 46% reported falling in the treatment group compared with 47% in the placebo group. There was no association of serum 25(OH)D or vitamin D dose with the risk of falling. CONCLUSIONS There is no benefit of maintaining serum 25(OH)D above 30 ng/mL compared with the Institute of Medicine recommendation (20 ng/mL) in preventing falls in healthy older black American women. J Am Geriatr Soc 67:1043-1049, 2019.
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Zarei S, Eggert J, Franqui-Dominguez L, Carl Y, Boria F, Stukova M, Avila A, Rubi C, Chinea A. Comprehensive review of neuromyelitis optica and clinical characteristics of neuromyelitis optica patients in Puerto Rico. Surg Neurol Int 2018; 9:242. [PMID: 30603227 PMCID: PMC6293609 DOI: 10.4103/sni.sni_224_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/21/2018] [Indexed: 12/14/2022] Open
Abstract
Neuromyelitis optica (NMO) is an immune-mediated inflammatory disorder of the central nervous system. It is characterized by concurrent inflammation and demyelination of the optic nerve (optic neuritis [ON]) and the spinal cord (myelitis). Multiple studies show variations in prevalence, clinical, and demographic features of NMO among different populations. In addition, ethnicity and race are known as important factors on disease phenotype and clinical outcomes. There are little data on information about NMO patients in underserved groups, including Puerto Rico (PR). In this research, we will provide a comprehensive overview of all aspects of NMO, including epidemiology, environmental risk factors, genetic factors, molecular mechanism, symptoms, comorbidities and clinical differentiation, diagnosis, treatment, its management, and prognosis. We will also evaluate the demographic features and clinical phenotype of NMO patients in PR. This will provide a better understanding of NMO and establish a basis of knowledge that can be used to improve care. Furthermore, this type of population-based study can distinguish the clinical features variation among NMO patients and will provide insight into the potential mechanisms that cause these variations.
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Affiliation(s)
- Sara Zarei
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - James Eggert
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | | | - Yonatan Carl
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - Fernando Boria
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | - Marina Stukova
- San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA
| | | | - Cristina Rubi
- Caribbean Neurological Center, Guaynabo, Puerto Rico, USA
| | - Angel Chinea
- Caribbean Neurological Center, Guaynabo, Puerto Rico, USA
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Asghari G, Farhadnejad H, Hosseinpanah F, Moslehi N, Mirmiran P, Azizi F. Effect of vitamin D supplementation on serum 25-hydroxyvitamin D concentration in children and adolescents: a systematic review and meta-analysis protocol. BMJ Open 2018; 8:e021636. [PMID: 30232105 PMCID: PMC6150138 DOI: 10.1136/bmjopen-2018-021636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The importance of vitamin D for bone health as well as its role in non-skeletal functions has long been documented. However, review investigations on the effect of vitamin D supplementation on serum 25-hydroxyvitamin D (25(OH)D) levels in children and adolescents are scarce. The aims of the current study were to assess the impact of various doses of vitamin D supplementation on serum 25(OH)D concentrations in children and adolescents, and to identify relevant determinants of variations in the effect of vitamin D supplementation. METHODS PubMed, Scopus, ISI Web of Science and Cochrane Central Register of Controlled Trials databases up to 27 September 2017 will systematically be searched for randomised controlled trials of vitamin D supplementation. We considered articles with the following control groups as eligible: placebo control, control group without any supplementation or a comparative arm investigation. Two reviewers will assess articles for eligibility according to prespecified selection criteria, after which data extraction and quality appraisal will be conducted by two independent reviewers. The quality assessment will be assessed using the Jadad scale. Meta-analyses will be conducted where appropriate. We will express continuous measures (ie, serum 25(OH)D concentration) as mean differences with 95% CIs. Heterogeneity of the data will be investigated via visual inspection of the forest plots and using χ2 test on N-1 df, with a significance level of α=0.1. We will also assess individual study and subgroup characteristics and perform a sensitivity analysis. Publication bias will be assessed using funnel plot and statistical analysis of Egger's test. ETHICS AND DISSEMINATION Ethics approval is not required because the work will be carried out on published documents. The authors will publish findings from this review through peer-reviewed publication or conference presentations. PROSPERO REGISTRATION NUMBER CRD42017067179.
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Affiliation(s)
- Golaleh Asghari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Farhadnejad
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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25
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Woon FC, Chin YS, Ismail IH, Chan YM, Batterham M, Abdul Latiff AH, Gan WY, Appannah G. Contribution of early nutrition on the development of malnutrition and allergic diseases in the first year of life: a study protocol for the Mother and Infant Cohort Study (MICOS). BMC Pediatr 2018; 18:233. [PMID: 30021541 PMCID: PMC6052551 DOI: 10.1186/s12887-018-1219-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutrition and environmental factors are essential for the education of the neonatal immune system. Epidemiological evidence has shown that malnutrition and allergic diseases that occur during early childhood share similar protective and risk factors. This paper describes the protocol of the Mother and Infant Cohort Study (MICOS), which aims to determine the contribution of early nutrition to the development of malnutrition and allergic diseases in infants' first year of life. METHODS MICOS is a prospective cohort study conducted at selected government health clinics in two states, namely Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Women in their third trimester of pregnancy are recruited into the study and their infants will be followed-up at 3, 6, and 12 months of age. Information on prenatal factors including socio-demographic characteristics, obstetric history, pre-pregnancy body mass index, gestational weight gain, smoking, family history of allergic diseases, maternal dietary intake and sunlight exposure during pregnancy are obtained through face-to-face interviews. Postnatal factors including dietary intake, sun exposure, and anthropometric measurements of the mothers, as well as feeding practices, dietary intake, anthropometric measurements, and development of allergic diseases of the infants are assessed at each follow-up. Blood samples are collected from the mothers in the third trimester to determine 25-hydroxyvitamin D levels as well as from the infants at age 12 months to determine atopic sensitisation. DISCUSSION The concept of developmental origins of health and disease (DOHaD) which emphasises on the role of early life environments in shaping future health and disease susceptibility in adulthood has gained a huge interest in recent years. The DOHaD paradigm has influenced many fields of research including malnutrition and allergic diseases. While findings from the developed countries remain controversial, such studies are scarce in developing countries including Malaysia. The present study will determine the cause and effect relationship between early nutrition and the development of malnutrition and allergic diseases in infants' first year of life.
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Affiliation(s)
- Fui Chee Woon
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
| | - Marijka Batterham
- National Institute for Applied Statistics Research Australia, University of Wollongong, Northfields Ave, Wollongong, NSW 2522 Australia
| | | | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
| | - Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Malaysia
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Schmalwieser AW, Siani AM. Review on Nonoccupational Personal Solar UV Exposure Measurements. Photochem Photobiol 2018; 94:900-915. [PMID: 29856894 DOI: 10.1111/php.12946] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/25/2018] [Indexed: 01/22/2023]
Abstract
Solar ultraviolet (UV) radiation follows people during their whole life. Exposure to UV radiation is vital but holds serious risks, too. The quantification of human UV exposure is a complex issue. UV exposure is directly related to incoming UV radiation as well as to a variety of factors such as the orientation of the exposed anatomical site with respect to the sun and the duration of exposure. The use of badge-sensors allows assessing the UV exposure of differently oriented body sites. Such UV devices have been available for over 40 years, and a variety of measuring campaigns have been undertaken since then. This study provides an overview of those studies which reported measurements of the personal UV exposure (PE) during outdoor activities of people not related to their occupation. This overview is given chronologically to show the progress of knowledge in this research and is given with respect to different activities. Special focus is put on the ratio of personal exposure to ambient UV radiation. This ratio, when given as a function of solar elevation, allows estimating PE at any other location or date if ambient UV radiation is known.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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Ganji V, Martineau B, Van Fleit WE. Association of serum vitamin D concentrations with dietary patterns in children and adolescents. Nutr J 2018; 17:58. [PMID: 29866150 PMCID: PMC5987485 DOI: 10.1186/s12937-018-0365-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/24/2018] [Indexed: 11/26/2022] Open
Abstract
Background Because children have been advised on the dangers of sun exposure, diet is an important contributor of serum 25 hydroxyvitamin D [25(OH)D] concentrations. Aim of this study was to determine whether serum 25(OH)D concentrations were associated with any specific dietary patterns in US children. Methods Data from 2 cycles of National Health and Nutrition Examination Survey (NHANES) 2003–2004 and 2005–2006 for individuals aged 2 to ≤19 y, were used to study relation between dietary patterns and serum 25(OH)D. We derived 2 major dietary patterns based on the food frequency questionnaire data. These were labeled as High-Fat-Low-Vegetable Dietary (HFLVD) pattern and Prudent Dietary (PD) pattern. Results In multivariate adjusted analysis, there was no significant relationship between serum 25(OH)D concentrations and tertiles of HFLVD and PD dietary pattern scores in all subjects, boys, and girls. When dietary patterns scores were used as a continuous variable in adjusted analysis, children (all) with higher PD contribution scores to overall diet showed a significant positive relation with serum 25(OH)D (β = 59.1, P = 0.017). When data were stratified by sex, a significant positive relation was observed in girls between serum 25(OH)D concentration and PD pattern scores (β = 82.1, P = 0.015). A significant negative relation was observed in girls between serum 25(OH)D and HFLVD pattern scores (β = − 88.5, P = 0.016). Conclusion Overall, serum 25(OH)D were associated with PD pattern but not with HFLVD pattern in US children. In public health perspective, it is important to encourage children, especially girls who are consuming HFLVD pattern to shift to healthier diet.
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Affiliation(s)
- Vijay Ganji
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar.
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Abstract
PURPOSE OF REVIEW Although low vitamin D levels have been shown to be a risk factor for adverse outcomes in critical care, it is not clear to date if supplementation can alter such outcomes in all ICU patients. The focus of vitamin D research now is on interventional trials to identify a critically ill patient subset who may benefit from high-dose vitamin D supplementation. RECENT FINDINGS The VITdAL-ICU trial, a randomized, double-blind, placebo-controlled, single center trial of 475 heterogeneous critically ill patients, did not show improvement in hospital length of stay or overall mortality but did demonstrate in a secondary outcome that high-dose oral vitamin D3 improved mortality in patients with severe vitamin D deficiency. SUMMARY Vitamin D supplementation may represent a personalized and targeted therapy for critical illness. Vitamin D regulates over 1000 genes in the human genome, and the mechanism of action is influenced by gene polymorphisms and epigenetics. The study of the metabolomics, transcriptomics and epigenetics of vitamin D status and supplementation holds promise generating insights into critical illness outcomes.
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Zareef TA, Jackson RT, Alkahtani AA. Vitamin D Intake among Premenopausal Women Living in Jeddah: Food Sources and Relationship to Demographic Factors and Bone Health. J Nutr Metab 2018; 2018:8570986. [PMID: 29750126 PMCID: PMC5884207 DOI: 10.1155/2018/8570986] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/12/2017] [Accepted: 12/28/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Saudi women depend on food sources to maintain their serum 25(OH) D concentrations because covering by traditional clothing and time spent indoors limit their sun exposure. Little is known about vitamin D intake and its main food sources in Saudi Arabia. In addition, the association between vitamin D and calcium intake and bone mineral density (BMD) in young women is not well researched. OBJECTIVES To assess the adequacy of vitamin D intake among Saudi women as compared to the estimated average requirements (EARs), to identify dietary vitamin D sources, to examine potential determinants of vitamin D intake, and to assess bone health and the association of calcium and vitamin D intake with BMD. METHODS This cross-sectional study was conducted in 257 premenopausal women aged 20-50 years in Jeddah, Saudi Arabia. Dietary vitamin D and calcium were assessed by the Semiquantitative Food Frequency Questionnaire. BMD was measured using dual-energy X-ray absorptiometry (DXA) in a subset of women (n=102) at the lumbar spine and femur neck. RESULTS Sixty-five percent of women were below the EAR for vitamin D, and 61% fell below the EAR for calcium. Dairy products, supplements, and fish contributed most to vitamin D intake. Increased age was an independent determinant of sufficient vitamin D intake (p < 0.001). The prevalence of osteopenia was 33% in the lumbar spine and 30% in the femur neck. There was a significant positive association between calcium intake and BMD at the lumbar spine (p=0.043) after controlling for body mass index and energy intake. Vitamin D intake was not significantly different between women with low and normal bone mass. CONCLUSION Premenopausal women in Jeddah have insufficient vitamin D and calcium intakes. Public health strategies to improve nutrition in young women are needed, and expanding fortification programs to include all dairy products would be useful.
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Affiliation(s)
- Tahani A. Zareef
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Robert T. Jackson
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Abdulkareem A. Alkahtani
- Department of Nuclear Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Patwardhan VG, Mughal ZM, Chiplonkar SA, Webb AR, Kift R, Khadilkar VV, Padidela R, Khadilkar AV. Duration of Casual Sunlight Exposure Necessary for Adequate Vitamin D Status in Indian Men. Indian J Endocrinol Metab 2018; 22:249-255. [PMID: 29911040 PMCID: PMC5972483 DOI: 10.4103/ijem.ijem_473_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To investigate the duration of casual sunlight ultraviolet-B (UVB) exposure required to maintain optimal Vitamin D status (25-hydroxyvitamin-D [25(OH)D]) >50 nmol/L in urban Indian men, using polysulfone (PSU) dosimeters and a sunlight exposure questionnaire. METHODS In healthy men (aged 40-60 years) from Pune (18.52° N, 73.86° E), India, serum 25(OH)D was measured using enzyme-linked immunosorbent assay. Sunlight exposure was assessed using PSU dosimeter and by questionnaire. RESULTS Of 160 men (48.3 ± 5.6 years), 26.8% were deficient and 40.6% had insufficient Vitamin D concentrations. A hyperbolic function for the relationship between PSU measured sunlight exposure in standard erythema dose (SED) and serum 25(OH)D concentrations (r = 0.87, P < 0.01) revealed that daily exposure of 1 SED was sufficient to maintain serum 25(OH)D concentrations over 50 nmol/L. The curve plateaued around 5 SED (80 nmol/L) and extrapolation of the curve (>5 SED) did not increase 25(OH)D concentrations above 90 nmol/L. Receiver operating curve analysis confirmed that 1 SED-UV exposure was sufficient to maintain 25(OH)D concentrations over 50 nmol/L. Based on the questionnaire data, >1 h of midday casual sunlight exposure was required to maintain serum 25(OH)D concentrations above 50 nmol/L. Duration of sunlight exposure assessed by questionnaire and PSU dosimeter showed a significant correlation (r = 0.517, P < 0.01). CONCLUSION In urban Indian men, >1 h of casual midday sunlight exposure daily was required to maintain serum 25(OH)D concentrations above 50 nmol/L, and >2 h of casual sunlight exposure was needed to maintain 25(OH)D concentrations above 75 nmol/L. Excess sunlight did not increase 25(OH)D linearly. The sunlight exposure questionnaire was validated for use in clinical studies and surveys.
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Affiliation(s)
- Vivek G. Patwardhan
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Zulf M. Mughal
- Department of Pediatrics Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
| | - Shashi A. Chiplonkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Ann R. Webb
- School of Earth, Atmospheric and Environmental Sciences, University of Manchester, Manchester, UK
| | - Richard Kift
- School of Earth, Atmospheric and Environmental Sciences, University of Manchester, Manchester, UK
| | - Vaman V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Raja Padidela
- Department of Pediatrics Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
| | - Anuradha V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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Baldiviez LM, Keim NL, Laugero KD, Hwang DH, Huang L, Woodhouse LR, Burnett DJ, Zerofsky MS, Bonnel EL, Allen LH, Newman JW, Stephensen CB. Design and implementation of a cross-sectional nutritional phenotyping study in healthy US adults. BMC Nutr 2017; 3:79. [PMID: 32153856 PMCID: PMC7050916 DOI: 10.1186/s40795-017-0197-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/03/2017] [Indexed: 11/30/2022] Open
Abstract
Background Metabolic imbalance is a key determinant of risk of chronic diseases. Metabolic health cannot be assessed solely by body mass calculations or by static, fasted state biochemical readouts. Although previous studies have described temporal responses to dietary challenges, these studies fail to assess the environmental factors associated with certain metabolic phenotypes and therefore, provide little scientific rationale for potentially effective intervention strategies. Methods/design In this phenotyping study of healthy US adults, we are evaluating lifestyle, biological and environmental factors in addition to metabolic parameters to determine the factors associated with variations in metabolic health. A series of practical fitness, dietary, and emotional challenges are introduced and temporal responses in various areas of specialization, including immunology, metabolomics, and endocrinology, are monitored. We expect that this study will identify key factors related to healthy or unhealthy metabolic phenotypes (metabotypes) that may be modifiable targets for the prevention of chronic diseases in an individual. Discussion This study will provide novel insights into metabolic variability among healthy adults in balanced strata defined by sex, age and body mass index. Usual dietary intake and physical activity will be evaluated across these strata to determine how diet is associated with health status defined using many indicators including immune function, metabolism, body composition, physiology, response to exercise andmeal challenges and neuroendocrine assessment. A principal study goal is to identify dietary and other personal factors that will differentiate different levels of "health" among study participants. Trial registration ClinicalTrials.gov NCT02367287.
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Affiliation(s)
- Lacey M Baldiviez
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Nancy L Keim
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Kevin D Laugero
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Daniel H Hwang
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Liping Huang
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Leslie R Woodhouse
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Dustin J Burnett
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Melissa S Zerofsky
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA
| | - Ellen L Bonnel
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - Lindsay H Allen
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
| | - John W Newman
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA.,NIH West Coast Metabolomics Center, Davis, CA USA
| | - Charles B Stephensen
- 1United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA USA.,2Department of Nutrition, University of California Davis, Davis, CA USA
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Smith GS, Messier KP, Crooks JL, Wade TJ, Lin CJ, Hilborn ED. Extreme precipitation and emergency room visits for influenza in Massachusetts: a case-crossover analysis. Environ Health 2017; 16:108. [PMID: 29041975 PMCID: PMC5645981 DOI: 10.1186/s12940-017-0312-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/26/2017] [Indexed: 05/28/2023]
Abstract
BACKGROUND Influenza peaks during the wintertime in temperate regions and during the annual rainy season in tropical regions - however reasons for the observed differences in disease ecology are poorly understood. We hypothesize that episodes of extreme precipitation also result in increased influenza in the Northeastern United States, but this association is not readily apparent, as no defined 'rainy season' occurs. Our objective was to evaluate the association between extreme precipitation (≥ 99th percentile) events and risk of emergency room (ER) visit for influenza in Massachusetts during 2002-2008. METHODS A case-crossover analysis of extreme precipitation events and influenza ER visits was conducted using hospital administrative data including patient town of residence, date of visit, age, sex, and associated diagnostic codes. Daily precipitation estimates were generated for each town based upon data from the National Oceanic and Atmospheric Administration. Odds ratio (OR) and 95% confidence intervals (CI) for associations between extreme precipitation and ER visits for influenza were estimated using conditional logistic regression. RESULTS Extreme precipitation events were associated with an OR = 1.23 (95%CI: 1.16, 1.30) for ER visits for influenza at lag days 0-6. There was significant effect modification by race, with the strongest association observed among Blacks (OR = 1.48 (1.30, 1.68)). CONCLUSIONS We observed a positive association between extreme precipitation events and ER visits for influenza, particularly among Blacks. Our results suggest that influenza is associated with extreme precipitation in a temperate area; this association could be a result of disease ecology, behavioral changes such as indoor crowding, or both. Extreme precipitation events are expected to increase in the Northeastern United States as climate change progresses. Additional research exploring the basis of this association can inform potential interventions for extreme weather events and influenza transmission.
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Affiliation(s)
- Genee S. Smith
- Oak Ridge Institute for Science and Education, Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - Kyle P. Messier
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC USA
| | - James L. Crooks
- National Jewish Health, Division of Biostatistics and Bioinformatics, Denver, CO USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA
| | - Timothy J. Wade
- United States Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, MD 58A, Research Triangle Park, Chapel Hill, NC 27711 USA
| | - Cynthia J. Lin
- Oak Ridge Institute for Science and Education, Oak Ridge National Laboratory, Oak Ridge, TN USA
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC USA
| | - Elizabeth D. Hilborn
- United States Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, MD 58A, Research Triangle Park, Chapel Hill, NC 27711 USA
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Association of Sun Exposure, Skin Colour and Body Mass Index with Vitamin D Status in Individuals Who Are Morbidly Obese. Nutrients 2017; 9:nu9101094. [PMID: 28976930 PMCID: PMC5691711 DOI: 10.3390/nu9101094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency is a common issue, particularly in obese populations, and is tested by assessing serum 25(OH)D concentrations. This study aimed to identify factors that contribute to the vitamin D status in fifty morbidly obese individuals recruited prior to bariatric surgery. Data collected included serum 25(OH)D concentrations, dietary and supplement intake of vitamin D, sun exposure measures, skin colour via spectrophotometry, and genotype analysis of several single nucleotide polymorphisms in the vitamin D metabolism pathway. Results showed a significant correlation between serum 25(OH)D concentrations and age, and serum 25(OH)D and ITAC score (natural skin colour). Natural skin colour accounted for 13.5% of variation in serum 25(OH)D, with every 10° increase in ITAC score (i.e., lighter skin) leading to a 9 nmol/L decrease in serum 25(OH)D. Multiple linear regression using age, ITAC score, and average UV index in the three months prior to testing, significantly predicted serum 25(OH)D concentrations (R² = 29.7%). Single nucleotide polymorphisms for all vitamin D genes tested, showed lower serum 25(OH)D for those with the rare genotype compared to the common genotype; this was most pronounced for fok1 and rs4588, where those with the rare genotype were insufficient (<50 nmol/L), and those with the common genotype were sufficient (≥50 nmol/L). Assessing vitamin D status in individuals with morbid obesity requires testing of 25(OH)D, but potential risk factors for this population include natural skin colour and age.
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Aceña A, Franco-Peláez JA, Gutierrez-Landaluce C, Pello AM, Cristóbal C, Tarín N, Huelmos A, Carda R, Martín-Mariscal ML, Alonso J, González-Parra E, González-Casaus ML, Lorenzo Ó, López Bescos L, Egido J, Tuñón J. Sun exposure influences the prognostic power of components of mineral metabolism in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2017; 27:762-767. [PMID: 28803689 DOI: 10.1016/j.numecd.2017.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/28/2017] [Accepted: 06/08/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Calcidiol (vitamin D metabolite) plasma levels vary with sun exposure (SE). However, it is not known if SE influences its prognostic ability. We have studied the effect of SE on plasma levels of the components of mineral metabolism (calcidiol, fibroblast growth factor-23 [FGF-23], parathormone [PTH], and phosphate [P]) and on their prognostic value in patients with coronary artery disease (CAD). METHODS AND RESULTS We studied prospectively 704 patients with stable CAD. Clinical variables and baseline calcidiol, FGF-23, PTH, and P plasma levels were assessed. We divided the population in two subgroups, according to the period of plasma extraction: High SE (HSE) (April-September) and low SE (LSE) (October-March). The outcome was the development of acute ischemic events (acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Mean follow-up was 2.15 ± 0.99 years. Calcidiol and P levels were higher in HSE group. In the whole population, calcidiol (HR = 0.84 for each 5 ng/ml increase, 95% CI = 0.71-0.99; p = 0.038) and FGF-23 (HR = 1.14 for each 100 RU/ml increase, 95% CI = 1.05-1.23; p = 0.009) were predictors of the outcome, along with age, hypertension, body-mass index, peripheral artery disease, and P levels. In the LSE subgroup, calcidiol (HR = 0.75; 95% CI = 0.57-0.99; p = 0.034) and FGF-23 (HR = 1.34; 95% CI = 1.13-1.58; p = 0.003) remained as predictors of the outcome. In the HSE group calcidiol and FGF-23 had not independent prognostic value. CONCLUSIONS In patients with stable CAD, low calcidiol and high FGF-23 plasma levels predict an adverse prognosis only when the sample is obtained during the months with LSE. SE should be taken into account in the clinical practice.
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Affiliation(s)
- A Aceña
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain
| | - J A Franco-Peláez
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain
| | | | - A M Pello
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain
| | - C Cristóbal
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain; Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - N Tarín
- Department of Cardiology, Hospital Universitario de Móstoles, Madrid, Spain
| | - A Huelmos
- Department of Cardiology, Fundación Hospital de Alcorcón, Madrid, Spain
| | - R Carda
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain
| | | | - J Alonso
- Department of Cardiology, Hospital de Getafe, Madrid, Spain
| | - E González-Parra
- Autónoma University, Madrid, Spain; Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain
| | - M L González-Casaus
- Laboratory of Nephrology and Mineral Metabolism, Hospital Gómez-Ulla, Madrid, Spain
| | - Ó Lorenzo
- Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | | | - J Egido
- Autónoma University, Madrid, Spain; Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain; Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | - J Tuñón
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain; Autónoma University, Madrid, Spain; Laboratory of Vascular Pathology, IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain.
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Johns LE, Ferguson KK, Cantonwine DE, McElrath TF, Mukherjee B, Meeker JD. Urinary BPA and Phthalate Metabolite Concentrations and Plasma Vitamin D Levels in Pregnant Women: A Repeated Measures Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087026. [PMID: 28934718 PMCID: PMC5783673 DOI: 10.1289/ehp1178] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 05/05/2023]
Abstract
BACKGROUND In addition to its well-established role in maintaining skeletal health, vitamin D has essential regulatory functions in female reproductive and pregnancy outcomes. Phthalates and bisphenol A (BPA) are endocrine disruptors, and previous research has suggested that these chemical agents may disrupt circulating levels of total 25(OH)D in adults. OBJECTIVES We investigated the relationships between repeated measures of urinary phthalate metabolites and BPA and circulating total 25(OH)D in a prospective cohort of pregnant women. METHODS The present study population includes participants (n=477) in a nested case-control study of preterm birth drawn from a prospective birth cohort of pregnant women at Brigham and Women's Hospital in Boston, Massachusetts. Urine and blood samples were collected for biomarker measurements at median 10 wk and 26 wk of gestation. RESULTS In repeated measures analysis, we observed that an interquartile range (IQR) increase in urinary mono-3-carboxypropyl phthalate (MCPP) was associated with a 4.48% decrease [95% confidence interval (CI): -7.37, -1.58] in total 25(OH)D. We also detected inverse associations for metabolites of di(2-ethylhexyl) phthalate (DEHP) [percent difference (%Δ)=-2.83 to -2.16]. For BPA, we observed a nonsignificant inverse association with total 25(OH)D in the overall population. Our sensitivity analysis revealed that the associations for some metabolites (e.g., MEHP) varied by race/ethnicity, which may reflect potential differences in susceptibility. In agreement with findings from repeated measures analysis, we reported that DEHP metabolites and BPA were significantly associated with an approximate 20% increase in the odds of vitamin D deficiency (≤20 ng/mL) [odds ratio (95% CI): 1.19 (1.06, 1.35) for molar sum of DEHP metabolites and 1.22 (1.01, 1.47) for BPA] at median 10 wk and 26 wk, respectively. CONCLUSIONS Our results provide suggestive evidence of the potential for environmental exposure to phthalates and/or BPA to disrupt circulating vitamin D levels in pregnancy. https://doi.org/10.1289/EHP1178.
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Affiliation(s)
- Lauren E Johns
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - Kelly K Ferguson
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
| | - David E Cantonwine
- Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Thomas F McElrath
- Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Bhramar Mukherjee
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA
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Kim HS, Hwang HS, Kwon HS, Lim JY, Sohn IS. A comparative analysis of maternal and fetal 25-hydroxyvitamin D in pregnant women with and without gestational diabetes mellitus. J Matern Fetal Neonatal Med 2017; 31:2748-2755. [DOI: 10.1080/14767058.2017.1355899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Hee-Sun Kim
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Kyeogi-do, Korea
| | - Han-Sung Hwang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Han-Sung Kwon
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Ji-Young Lim
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - In-Sook Sohn
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
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Pierrot-Deseilligny C, Souberbielle JC. Vitamin D and multiple sclerosis: An update. Mult Scler Relat Disord 2017; 14:35-45. [PMID: 28619429 DOI: 10.1016/j.msard.2017.03.014] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 12/12/2022]
Abstract
The most recent findings linking exposure to sun and vitamin D insufficiency to multiple sclerosis (MS) are reviewed. Due to insufficient sunshine and changing lifestyles, hypovitaminosis D is widespread in temperate countries. Numerous epidemiological studies have strongly suggested that sunshine and vitamin D insufficiency contributes to MS risk in these countries. Moreover, several large genetic studies in MS patients have recently stated unequivocally that diverse abnormalities involving vitamin D metabolism are related to the risk of the disease. The important implications of such results are discussed here. Then, the interactions of hypovitaminosis D with the other genetic and environmental protective and risk factors, such as the allele HLA DRB1*1501, Epstein-Barr virus infection, obesity, smoking and sexual hormones, are summarized. Vitamin D insufficiency and sufficiency could be a risk and a protective factor, respectively, among many other factors possibly continuously modulating the global MS risk from the mother's pregnancy to the triggering of MS in adulthood. However, many interactions between these different factors occur more particularly between conception and the end of adolescence, which corresponds to the period of maturation of the immune system and thymus and may be related to the dysimmune nature of the disease. The main mechanisms of action of vitamin D in MS appear to be immunomodulatory, involving the various categories of T and B lymphocytes in the general immune system, but neuroprotector and neurotrophic mechanisms could also be exerted at the central nervous system level. Furthermore, several controlled immunological studies performed in MS patients have recently confirmed that vitamin D supplementation has multiple beneficial immunomodulatory effects. However, there is still an enduring absence of major conclusive randomized clinical trials testing vitamin D supplementation in MS patients because of the quasi-insurmountable practical difficulties that exist nowadays in conducting and completing over several years such studies involving the use of a vitamin. Nevertheless, it should be noted that similar robust statistical models used in five different association studies have already predicted a favorable vitamin D effect reducing relapses by 50-70%. If there is now little doubt that vitamin D exerts a beneficial action on the inflammatory component of MS, the results are as yet much less clear for the progressive degenerative component. Lastly, until more information becomes available, vitamin D supplementation of MS patients, using a moderate physiological dose essentially correcting their vitamin insufficiency, is recommended.
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Affiliation(s)
- Charles Pierrot-Deseilligny
- Département de Neurologie, Hôpital de la Salpêtrière, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie (Paris VI), 47 bd de l'Hôpital, 75013 Paris, France.
| | - Jean-Claude Souberbielle
- Service d'explorations fonctionnelles, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Université René Descartes (Paris V),149 rue de Sèvres, 75915 Paris, France.
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Vitamin D deficiency and sufficiency among Canadian children residing at high latitude following the revision of the RDA of vitamin D intake in 2010. Br J Nutr 2017; 117:457-465. [PMID: 28245892 DOI: 10.1017/s0007114517000320] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Recently, countries at high latitudes have updated their vitamin D recommendations to ensure adequate intake for the musculoskeletal
health of their respective populations. In 2010, the dietary guidelines for vitamin D for Canadians and Americans aged 1–70 years
increased from 5 μg/d to 15 μg/d, whereas in 2016 for citizens of the UK aged ≥4 years 10 μg/d is recommended. The vitamin D status
of Canadian children following the revised dietary guidelines is unknown. Therefore, this study aimed to assess the prevalence and
determinants of vitamin D deficiency and sufficiency among Canadian children. For this study, we assumed serum 25-hydroxy vitamin
D (25(OH)D) concentrations <30 nmol/l as ‘deficient’ and ≥50 nmol/l as ‘sufficient’. Data from children aged 3–18 years (n 2270) who
participated in the 2012/2013 Canadian Health Measures Survey were analysed. Of all children, 5·6% were vitamin D deficient and
71% were vitamin D sufficient. Children who consumed vitamin D-fortified milk daily (77 %) were more likely to be sufficient than
those who consumed it less frequently (OR 2·4; 95% CI 1·7, 3·3). The 9% of children who reported taking vitamin D-containing
supplements in the previous month had higher 25(OH)D concentrations (β 5·9 nmol/l; 95% CI 1·3, 12·1 nmol/l) relative to those who
did not. Children who were older, obese, of non-white ethnicity and from low-income households were less likely to be vitamin D
sufficient. To improve vitamin D status, consumption of vitamin D-rich foods should be promoted, and fortification of more food items
or formal recommendations for vitamin D supplementation should be considered.
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Meena P, Dabas A, Shah D, Malhotra RK, Madhu SV, Gupta P. Sunlight exposure and vitamin D status in breastfed infants. Indian Pediatr 2016; 54:105-111. [DOI: 10.1007/s13312-017-1010-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Collins A. Evaluation and treatment of vitamin D deficiency. Nurse Pract 2016; 41:1-6. [PMID: 27764070 DOI: 10.1097/01.npr.0000502797.81231.c6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although evidence is inconsistent regarding the relationship between vitamin D deficiency and the causality of many chronic disease processes, the functions of vitamin D impact more than just bone health. By understanding basic vitamin D concepts and varied recommendations, nurse practitioners can provide safe, individualized, effective evaluation and treatment of each patient's vitamin D status to promote positive health outcomes.
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Affiliation(s)
- Andrea Collins
- Andrea Collins is a practicing family NP and assistant professor at Samford University, Birmingham, Ala
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Goodman S, Morrongiello B, Meckling K. A randomized, controlled trial evaluating the efficacy of an online intervention targeting vitamin D intake, knowledge and status among young adults. Int J Behav Nutr Phys Act 2016; 13:116. [PMID: 27836017 PMCID: PMC5106840 DOI: 10.1186/s12966-016-0443-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 11/02/2016] [Indexed: 12/23/2022] Open
Abstract
Background Vitamin D plays a key role in bone health. Consuming adequate vitamin D during young adulthood is important due to the development of peak bone mass; however, many Canadian young adults do not meet vitamin D recommendations. This study aimed to improve knowledge, perceptions, dietary intake and blood concentrations of vitamin D among a sample of young adults. Methods Using a pre-post design, 90 Ontario adults (38 men, 52 women; 18–25 years), were randomly assigned to intervention or control groups. Participants completed a socio-demographic survey, pre-post food frequency questionnaire, and a vitamin D knowledge questionnaire (3 time-points). The intervention group watched a video, received online information and tracked intake of vitamin D using a mobile application for 12 weeks. A sub-sample of participants completed pre-post blood 25(OH)D3 tests. Univariate ANOVA tested pre-post between-group differences in vitamin D intake and status. Repeated-measures ANOVA tested between-group differences in vitamin D knowledge and perceptions across 3 time-points. Results Mean vitamin D intake in the sample increased significantly from pre-test (M = 407, SD = 460 IU) to post-test (M = 619, SD = 655 IU), t(88) = 5.37, p < 0.001. Mean intake increased significantly more in the intervention than control group after controlling for gender and education, F(1, 85) = 4.09, p = 0.046. Mean blood vitamin D3 was significantly higher among non-Caucasian than Caucasian participants at baseline, t(56.7) = 3.49, p = 0.001. Mean blood vitamin D3 increased significantly from pre-test (M = 28, SD = 16 nmol/L) to post-test (M = 43, SD = 29 nmol/L), t(53) = 11.36, p < 0.001, but did not differ significantly between groups. The increase in vitamin D knowledge from time 1–3 was significantly higher in the intervention than control group (t(88) = 2.26, p = 0.03). The intervention group (M = 3.52, SE = 0.13) had higher overall perceived importance of vitamin D supplementation than the control (M = 3.16, SE = 0.12), F(1, 88) = 4.38, p = 0.04, ηp2 = 0.05. Conclusions Although recommendations suggest blood 25(OH)D3 concentrations of ≥50-75 nmol/L, vitamin D status was below national recommendations. While participating in an intervention did not improve vitamin D status, it led to increased vitamin D intake, knowledge and perceived importance of supplementation. Trial registration ClinicalTrails.gov registration #: NCT02118129. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0443-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samantha Goodman
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, N1G2W1, ON, Canada.
| | - Barbara Morrongiello
- Department of Psychology, University of Guelph, 50 Stone Road East, Guelph, N1G 2 W1, ON, Canada
| | - Kelly Meckling
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, N1G2W1, ON, Canada
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Zerofsky MS, Jacoby BN, Pedersen TL, Stephensen CB. Daily Cholecalciferol Supplementation during Pregnancy Alters Markers of Regulatory Immunity, Inflammation, and Clinical Outcomes in a Randomized Controlled Trial. J Nutr 2016; 146:2388-2397. [PMID: 27655755 DOI: 10.3945/jn.116.231480] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/23/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is widespread in pregnancy and has been associated with adverse health conditions in mothers and infants. Vitamin D supplementation in pregnancy may support the maintenance of pregnancy by its effects on innate and adaptive immunity. OBJECTIVE We assessed the effects of vitamin D supplementation during pregnancy on vitamin D status and markers of immune function associated with adverse pregnancy outcomes. METHODS We conducted a randomized, controlled, double-blind intervention of 2 doses of cholecalciferol (400 and 2000 IU/d) from <20 wk to delivery in 57 pregnant women. Vitamin D status, regulatory and inflammatory T cells, markers of innate immunity and systemic inflammation, and clinical outcomes including maternal blood pressure and birth weight were assessed at 26 and 36 wk of pregnancy. RESULTS Supplementation with 2000 IU/d vitamin D had a greater effect on the change in vitamin D status over pregnancy (P < 0.0001) and the final value at 36 wk (P < 0.0001) than 400 IU/d, increasing serum 25-hydroxyvitamin D from 81.1 nmol/L at baseline to 116 nmol/L at 36 wk and from 69.6 nmol/L at baseline to 85.6 nmol/L at 36 wk, respectively. The 2000-IU/d group had 36% more interleukin-10+ regulatory CD4+ T cells at 36 wk than did the 400-IU/d group (P < 0.007). The daily intake of 2000 compared with 400 IU/d tended to dampen the pregnancy-related increase in diastolic blood pressure by 1.3-fold (P = 0.06) and increase birth weight by 8.6% (P = 0.06), but these differences were not statistically significant. CONCLUSIONS Supplementation with 2000 IU/d is more effective at increasing vitamin D status in pregnant women than 400 IU/d and is associated with increased regulatory T cell immunity that may prevent adverse outcomes caused by excess inflammation. This trial was registered at clinicaltrials.gov as NCT01417351.
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Affiliation(s)
- Melissa S Zerofsky
- Graduate Group in Nutritional Biology and .,USDA Western Human Nutrition Research Center, Davis, CA
| | - Bryon N Jacoby
- Division of Maternal/Fetal Medicine, Davis Medical Center, University of California, Davis, Davis, CA; and
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Dix CF, Robinson A, Bauer JD, Wright ORL. Vitamin D: Australian dietitian's knowledge and practices. Nutr Diet 2016; 74:396-407. [PMID: 28901695 DOI: 10.1111/1747-0080.12291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/22/2016] [Accepted: 04/09/2016] [Indexed: 11/28/2022]
Abstract
AIM To survey dietitians on their knowledge and practices regarding vitamin D (VitD) intake, sources, supplementation and effect on disease state. METHODS An online survey was disseminated to members of the Dietitian Association Australia via the weekly online state newsletter during April 2015. Response rate was 3%, with 134 respondents completing the survey. The survey included questions about knowledge and current practices. Descriptive statistics were used to analyse the results. RESULTS Dietitians have good knowledge regarding dietary sources of VitD and roles in the body, but there is confusion around supplement doses for treatment and prevention of deficiency and sun exposure guidelines. CONCLUSIONS Dietitians are well positioned to provide patients with advice on VitD supplementation and sun exposure practices, but not all are confident to provide this care. There is a need for clear and well-disseminated guidelines for VitD management by dietitians.
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Affiliation(s)
- Clare F Dix
- Centre for Dietetics Research, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alex Robinson
- Centre for Dietetics Research, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Judith D Bauer
- Centre for Dietetics Research, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Olivia R L Wright
- Centre for Dietetics Research, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
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Fields AJ, Linnville SE, Hoyt RE. Correlation of objectively measured light exposure and serum vitamin D in men aged over 60 years. Health Psychol Open 2016; 3:2055102916648679. [PMID: 28070400 PMCID: PMC5193309 DOI: 10.1177/2055102916648679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diminished vitamin D is common among older individuals. Sunlight contributes more to vitamin D synthesis than diet or supplementation. This study examined associations between objectively measured light exposure, vitamin D serum levels, and bone biomarkers in 100 men aged over 60 years. Light exposure was measured in lux via Actigraph monitors for 1 week. Significantly, greater levels of vitamin D were observed in participants with higher light exposure. Seasonal differences in lux were also noted. Significant differences in bone markers were not found. Objective measurement of light exposure is an inexpensive, simple, and effective way to address vitamin D deficiency.
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Affiliation(s)
| | | | - Robert E Hoyt
- Robert E. Mitchell Center for Prisoner of War Studies, USA
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Tuffaha M, El Bcheraoui C, Daoud F, Al Hussaini HA, Alamri F, Al Saeedi M, Basulaiman M, Memish ZA, AlMazroa MA, Al Rabeeah AA, Mokdad AH. Deficiencies Under Plenty of Sun: Vitamin D Status among Adults in the Kingdom of Saudi Arabia, 2013. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:467-75. [PMID: 26713293 PMCID: PMC4677472 DOI: 10.4103/1947-2714.168675] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vitamin D deficiency has been correlated with several diseases and injuries including diabetes, osteoporosis, fractures, and falls. In the Kingdom of Saudi Arabia (KSA), current data on vitamin D status are lacking. AIMS To inform Saudi public health authorities on the current status of blood levels vitamin D deficiency, we analyzed data from the Saudi Health Interview Survey. MATERIALS AND METHODS The Saudi Health Interview Survey (SHIS) is a cross-sectional national multistage survey of individuals aged 15 years and above on sociodemographic characteristics, tobacco consumption, diet, physical activity, health care utilization, different health-related behaviors, and self-reported chronic conditions. A total of 10,735 participants completed a health questionnaire and were invited to the local health clinics for biomedical exams. RESULTS 62.65% of female Saudis and 40.6% of male Saudis aged 15 years and above are deficient in vitamin D. Out of them, less than 1% males and less than 2% females consume vitamin D supplements. Women who have never married and obese individuals are more likely to be deficient in vitamin D, compared to men who were currently married and nonobese individuals. Those consuming vitamin D supplements are less likely to be deficient in vitamin D. CONCLUSIONS Our study showed a high prevalence of vitamin D deficiency among Saudi men and women, and the results call for an increased awareness to ensure adequate levels of vitamin D for better health in Saudi Arabia. Moreover, our findings are certainly relevant for other countries in the Gulf region or countries with similar cultures, clothing, and religions.
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Affiliation(s)
- Marwa Tuffaha
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Fahad Alamri
- Ministry of Health of the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | | | | | - Ziad A Memish
- Ministry of Health of the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | | | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Abstract
UNLABELLED This manuscript is the result of work supported by the use of resources and facilities at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, specifically, the Geriatric Research Education and Clinical Center (GRECC). BACKGROUND Deficiency in 25-hydroxyvitamin D (25[OH]D) is common, especially in the elderly and African Americans (AA). While 25(OH) D deficiency is associated with multiple negative health outcomes, current recommendations for supplementation of this deficiency may be insufficient. OBJECTIVE To determine the prevalence of 25(OH)D deficiency, the extent of vitamin D supplementation, and the effect of supplementation on 25(OH) D levels in an elderly Veteran population. The study also focused specifically on the role of race in the risk for 25(OH)D deficiency and in the response to vitamin D supplementation. METHODS A retrospective chart review was conducted of information including 25(OH)D serum levels pre and post-supplementation, race, and vitamin D supplementation. Subjects were community-dwelling Veterans (≥60years) followed by a VA geriatric clinic. A total of 234 charts were reviewed (124 Caucasian, 78 AA, 32 other/unknown race). Information collected through the chart review was analyzed by comparing the means of 25(OH)D levels pre and post-supplementation across races and across times. RESULTS At Baseline 206 subjects (88%) were 25(OH)D deficient (<32ng/ml). While 80.6% of them were supplemented, only 10.24% (17 of 166) achieved normal 25(OH)D serum levels. AAs (n=78) had significantly lower Baseline levels compared to Caucasians (n=124) and differences were consistent across time. Fewer AAs than Caucasians increased to normal (AA:6.3%; Caucasian:12.8%). CONCLUSIONS Conservative oral vitamin D supplementation is largely ineffective at achieving therapeutic serum levels, especially for AAs. Future research is needed to focus on individualized supplementation strategies and targeted risk factors such as race.
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Sham L, Yeh EA, Magalhaes S, Parra EJ, Gozdzik A, Banwell B, Hanwell HE. Evaluation of fall Sun Exposure Score in predicting vitamin D status in young Canadian adults, and the influence of ancestry. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 145:25-9. [PMID: 25752862 DOI: 10.1016/j.jphotobiol.2015.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/19/2015] [Accepted: 02/05/2015] [Indexed: 11/17/2022]
Abstract
Query of sun-related habits or ancestry could help screen for risk of vitamin D insufficiency (serum 25-hydroxyvitamin D<75nmol/L). We evaluated the association between Sun Exposure Score (calculated from recall of Time Exposed to Sun and Skin Exposed to Sun in the previous week), demographics and anthropometrics (including self-reported ancestry and skin melanin reflectometry), and serum 25(OH)D levels in healthy young Canadian adults in the Greater Toronto Area (GTA; 43°N) during fall. 310 adults (67% female) of European, East Asian, and South Asian ancestries were evaluated. The median (interquartile range) 25(OH)D level was 49.7nmol/L (36.7-70.3) and 80% of participants were vitamin D insufficient. The vast majority of those of East and South Asian ancestry were vitamin D insufficient (91% and 97%, respectively), as were 55% of those of European ancestry. Sun Exposure Score and 25(OH)D concentrations were not associated after accounting for confounders. A multivariable model showed ancestry, recent summer sun exposure, sex, melanin, vitamin D intake, age and year of study significantly predicted 25(OH)D concentration; ancestry was the strongest independent predictor (adjusted R(2)=43%). Although Sun Exposure Score was not a significant predictor of serum 25(OH)D levels, inquiry of ancestry has potential use in screening for vitamin D insufficiency.
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Affiliation(s)
- Lauren Sham
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - E Ann Yeh
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Magalhaes
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Esteban J Parra
- Department of Anthropology, University of Toronto at Mississauga, Mississauga, Ontario, Canada
| | - Agnes Gozdzik
- Department of Anthropology, University of Toronto at Mississauga, Mississauga, Ontario, Canada
| | - Brenda Banwell
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather E Hanwell
- Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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High prevalence of vitamin D deficiency in patients with xeroderma pigmetosum-A under strict sun protection. Eur J Clin Nutr 2015; 69:693-6. [PMID: 25669318 DOI: 10.1038/ejcn.2015.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 12/09/2014] [Accepted: 12/21/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Xeroderma pigmentosum (XP) is a rare autosomal recessive disease characterized by defective repair of ultraviolet (UV) irradiation-induced DNA damage and high risk of skin cancer. Thus, these patients require strict photoprotection. Considering the importance of UV-mediated cutaneous vitamin D production, such rigorous photoprotection would cause vitamin D deficiency. Then, we have studied the vitamin D status in patients with XP-A, a group requiring the most strict photoprotection. SUBJECTS/METHODS Twenty-one patients with XP-A (aged 6-25) were evaluated for their vitamin D intake, serum levels of 25-hydroxy-vitamin D (25OHD) and parathyroid hormone (PTH). Vitamin D intake was assessed by a 2-day food weighing method. RESULTS Median dietary intake of vitamin D was 4.1 μg/day, and the median concentrations of serum 25OHD and PTH were 7.7 and 49.9 pg/ml, respectively. In 76% of the patients, serum 25OHD level was lower than 10 ng/ml, indicating vitamin D deficiency. Vitamin D intake and serum 25OHD level were significantly lower in patients under enteral nutrition (EN) than those with oral intake (OI). Multivariate analyses revealed that EN was a significant predictor of decreased serum 25OHD level (β coefficient=-0.59, P=0.03). CONCLUSIONS Vitamin D deficiency is highly prevalent in XP-A patients, and supplementation should be considered to avoid unfavorable skeletal consequences in these patients. In addition, determination of dietary vitamin D requirement has been a difficult work issue in the decision of dietary reference intakes (DRIs) because of its cutaneous production. Data from XP patients would yield useful information for the determination of DRIs for vitamin D.
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Rice S, Carpenter M, Fityan A, Vearncombe L, Ardern-Jones M, Jackson A, Cooper C, Baird J, Healy E. Limited exposure to ambient ultraviolet radiation and 25-hydroxyvitamin D levels: a systematic review. Br J Dermatol 2015; 172:652-61. [DOI: 10.1111/bjd.13575] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 02/06/2023]
Affiliation(s)
- S.A. Rice
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - M. Carpenter
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - A. Fityan
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - L.M. Vearncombe
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - M. Ardern-Jones
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
| | - A.A. Jackson
- NIHR Biomedical Research Centre (Nutrition); University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - C. Cooper
- MRC Lifecourse Epidemiology Unit; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- NIHR Musculoskeletal BRU; University of Oxford; Windmill Road Headington Oxford OX3 7LD U.K
| | - J. Baird
- MRC Lifecourse Epidemiology Unit; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
| | - E. Healy
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton General Hospital; Tremona Road Southampton SO16 6YD U.K
- Southampton Dermatology Centre; Royal South Hants Hospital; University Hospitals Southampton NHS Foundation Trust; Brintons Terrace Southampton SO14 0YG U.K
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Abstract
Vitamin D deficiency is common among patients with Crohn's disease. Serum 25-hydroxyvitamin D (25(OH)D) is the best measure of an individual's vitamin D status and current cut-off ranges for sufficiency are debatable. Several factors contribute to vitamin D deficiency in Crohn's disease. These include inadequate exposure to sunlight, inadequate dietary intake, impaired conversion of vitamin D to its active metabolite, increased catabolism, increased excretion and genetic variants in vitamin D hydroxylation and transport. The effects of low 25(OH)D on outcomes other than bone health are understudied in Crohn's disease. The aim of the present review is to discuss the potential roles of vitamin D and the possible levels required to achieve them. Emerging evidence suggests that vitamin D may have roles in innate and adaptive immunity, in the immune-pathogenesis of Crohn's disease, prevention of Crohn's disease-related hospitalisations and surgery, in reducing disease severity and in colon cancer prevention. The present literature appears to suggest that 25(OH)D concentrations of ≥75 nmol/l may be required for non-skeletal effects; however, further research on optimal levels is required.
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