[The contribution of diet and sun exposure to the nutritional status of vitamin D in elderly Spanish women: the five countries study (OPTIFORD Project)].
ABSTRACT Vitamin D deficiency represents an important public health problem, especially among elderly people, by increasing the morbimortality. Because of the importance of this, in the year 2001 the "Five Countries Study" was put in place, within the European OPTIFORD project (Towards a strategy for optimal vitamin D fortification). This cross-sectional and observational study aims at knowing the vitamin D status in adolescent and elder women from five European countries, including Spain, according to different dietary and behavioral habits.
This work analyzes the relative contribution of sun exposure and diet to the vitamin D status in 53 Caucasian Spanish elder women (72 +/- 1.6 years), with an autonomous life, participating at the Five Countries Study.
The information was gathered in summer and winter time, by using homologated and validated questionnaires: health status and life style questionnaire; assessment of sun exposure by a standardized test and using a Viospor UV dosimeter (only in summer time); biochemical analysis of 25 hydroxyvitamin D (S-25-OHD) and parathyroid hormone; and questionnaire of frequency of selective intake.
We observed a direct relationship between sun exposure measured with the dosimeter (741 +/- 624 J/m2) and the number of hours outdoors during the measuring week (3.4 +/- 1.9 hours/day) (p < 0.0001). The serum levels of S-25-OHD were higher in summer time than during the winter (40.32 +/- 20.39 nmol/L and 30.08 +/- 17.39 nmol/L, respectively), and 40% of the participants had worse vitamin status in winter as compared with summer time (p < 0.001). During the summer time, vitamin D deficiency (S-25-OHD < or = 25 nmol/L) affected 28% of the population, being virtually twice as much during the winter time. The higher the sun exposure, as assessed by the dosimeter, the higher the value of S-25-OHD, with clear differences between participants in the S-25-OHD < or = 25 nmol/L group and those in the S-25-OHD > 50 nmol/L (p = 0.01). There is also a direct association between the number of hours outdoors and S-25-OHD (p = 0.09), with differences between the participants in the S-25-OHD < or = 25 nmol/L group and the S-25-OHD > 50 nmol/L group. In more than 95% of the sample, mean dietary intakes of vitamin D (5.17 +/- 4.84 microg/day in summer time and 4.70+/- 4.72 microg/day in winter time), the main source of which being fish, did not cover the Recommended Allowances. We did not observe a relationship between the dietary intake and blood levels of vitamin D. By contrast, those participants taking vitamin D supplements presented higher S-25-OHD levels (summer = 69.64 nmol/L and winter = 55 nmol/L) than those not consuming it (summer = 36.83 nmol/L and winter = 25.82 nmol/L) (psummer =0.0003 and p winter < 0.001).
The deficient status of vitamin D among the elderly female population has to be corrected, whenever possible, with appropriate sun exposure and an increase in vitamin D intake through the diet, assessing at each particular case the benefits of pharmacological supplementation.
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ABSTRACT: The proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. The NU-AGE study is a parallel randomized one year trial in 1,250 apparently healthy, independently living European participants aged 65 to 80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium. C-reactive protein is measured as primary outcome. The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.Mechanisms of ageing and development 11/2013; DOI:10.1016/j.mad.2013.10.002 · 4.18 Impact Factor
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ABSTRACT: Introduction Vitamin D deficiency is common in the elderly, especially among institutionalized and/or hip fracture patients. However, there are few population studies on the prevalence of this deficiency in the general population over 64 years in our environment. The aim of this study was to determine the prevalence of vitamin D deficiency in an urban population cohort of over 64 years, and analyze its relationship with sociodemographic, climatic, and health factors. Material and methods Cross-sectional study from «Peñagrande cohort», a population-based cohort consisting of people over 64 years. We determined 25-hydroxyvitamin D levels, and recorded sociodemographic data (age, sex, marital status, education, socioeconomic status), season of measurement and health variables (comorbidity, obesity, malnutrition, renal failure, cognitive impairment, vitamin D supplements, and disability). Results A total of 468 individuals with a mean age of 76.0 years (SD: 7.7) were included, of which 53.4% were women. The mean value of vitamin D was 20.3 ± 11.7 ng/mL. The large majority (86.3%, 95% CI: 83.0-89.5) had a vitamin insufficiency (≤ 30 ng/ml), and 35.2% (95% CI: 30.8-39.7) showed severe vitamin deficiency (≤ 15 ng/ml). Vitamin insufficiency increases linearly with age (OR 1.06; 95% CI: 1.01-1.11), and was associated with low socioeconomic status (OR 3.29; 95% CI: 1.55-6.95). Severe vitamin D deficiency increases with age (OR 1.06; 95% CI: 1.02-1.09), female gender (OR 1.80; 95% CI: 1.18-2.75) and with cognitive impairment (OR 1.71; 95% CI: 1.04-2.83). Conclusion The prevalence of vitamin D deficiency in people over 65 years of age in our community is high. It would be advisable to determine the vitamin D values in the high risk elderly in order to introduce measures of pharmacological supplementation in those with inadequate levels.Revista Española de Geriatría y Gerontología 09/2014; DOI:10.1016/j.regg.2013.11.004
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ABSTRACT: VITAMIN D STATUS AND STRATEGIES TO MEET THE DIETARY REFERENCE INTAKES Abstract Vitamin D is an essential nutrient for the organism and in the recent years its importance has risen because, besides its role in the metabolism of calcium and phosphorus, also it has been related to the prevention and control of various chronic diseases, such as cardiovascular disease, diabetes, some types of cancer and osteoporosis. The main source of the vitamin is cutaneous synthesis through sun exposure of the skin. However, there are different biological and environmental factors, such as age, race, use of sunscreen, type of clothes worn, etc., that may determine its production. Therefore, the contribution from foods that naturally contain the vitamin, fortified foods and dietary supplements, acquires a fundamental role in order to meet the dietary reference intakes in the population and maintain the optimal vitamin status. Several studies highlight the problem of deficiency in different groups of the Spanish population, due to inadequate cutaneous synthesis and insufficient intake, influenced by a low intake of foods that contain vitamin D and supplements. It is necessary to implement strategies to prevent and control the problem in the population, as promote the consumption of the main food sources of the vitamin, increase the availability of fortified foods, both animal and vegetable origin, and consider the use of supplements, especially in those groups at risk of deficiency such as children and the elderly.Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 10/2014; 30((Supl.2)):39-46. · 1.25 Impact Factor