[The contribution of diet and sun exposure to the nutritional status of vitamin D in elderly Spanish women: the five countries study (OPTIFORD Project)].

Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, España.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral (Impact Factor: 1.25). 01/2008; 23(6):567-76.
Source: PubMed

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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    • "Of all environmental variables involved in inflammageing diet and lifestyle are potential factors that can relatively easily be changed by the elderly themselves. Dietary patterns of the elderly can be inappropriate (Carriere et al., 2007; Elmadfa and Freisling, 2009; Rodriguez Sangrador et al., 2008; Tokarz et al., 2008; van Dam et al., 2007; Vinas et al., 2011) and intakes of vitamin D, folate, iron, vitamin B12 and calcium (Cavelaars et al., 2010) are often below what is recommended. These inadequate nutrient intakes on the contrary can be a result of excessive consumption of energyrich , micro-nutrient poor refined foods. "
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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; 136-137. DOI:10.1016/j.mad.2013.10.002 · 3.51 Impact Factor
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    • "Even though Spain is a country with many hours of sunshine,most studies in Spain show a high prevalence of vitamin D deficiency.However,many of these studies have included persons aged 65 years or over,frequently institutionalized persons peer-00602287, version 1 -22 Jun 2011 (thus,not representative of the general population and with different rates of sun exposure,activity and diet),or else involved only a few persons,with the largest study in the last ten years in the general population (Mata–Granados et al.,2008) including just 215 persons.Thus,no representative studies involving a large sample of healthy persons have been carried out in Spain.The mean levels of 25-hydroxyvitamin D in middle aged people range from 14-25.9 ng/mL,with 26% to 85.1% of persons having values below 20 ng/ml (Calatayud et al.,2009;González Solanellas et al.,2008;Mata-Granados et al.,2008).In persons aged 60 years or more,the mean 25-hydroxyvitamin D concentration is even lower: 6.95-17 ng/ml,with 46.4% to 85% having values below 20 ng/ml (Gomez-Alonso et al.,2003;Niño Martín et al.,2008 ; Pérez-Llamas et al.,2008;Rodríguez Sangrador et al.,2008;Vaquero et al.,2004). "
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    ABSTRACT: Vitamin D deficiency is common worldwide. No homogenous reference values have yet been established and no studies of values have been conducted in Spain involving a large number of participants. To study the population concentrations of vitamin D in a representative sample of the Spanish population. The study involved two cohorts from Spain, the Asturias study and the Pizarra study, which are two prospective, population-based studies involving 2260 participants. In 1262 subjects (age: 20-83 years) we studied 25-hydroxyvitamin D, intact parathyroid hormone (iPTH), calcium, phosphorus and creatinine. The median population values of 25-hydroxyvitamin D and iPTH were 22.46 ng/ml and 42.29 pg/ml, respectively. The values of 25-hydroxyvitamin D were significantly higher in summer and correlated with age (β = -0.05 ± 0.01, P < 0.0001), creatinine (β = 6.42 ± 1.17, P < 0.0001) and iPTH (-0.07 ± 0.01, P < 0.0001), but not with calcium, phosphorus or sex. The increase in iPTH with age was seen whatever the values of 25-hydroxyvitamin D, and was greater in the older persons. The concentration of iPTH rose continuously with effect from 25-hydroxyvitamin D values below ≈30 ng/ml. Values above ≈35 ng/ml were associated with a significantly lower concentration of iPTH. One-third (33.9%) of the Spanish population may be at risk for Vitamin D deficiency. The 25-hydroxyvitamin D values above 30 ng/ml can safely discard 'hyper PTH'. The increase in iPTH concentration is greater in older persons for similar values of 25-hydroxyvitamin D.
    European journal of clinical nutrition 12/2010; 65(3):321-8. DOI:10.1038/ejcn.2010.265 · 2.95 Impact Factor
  • Revista Española de Geriatría y Gerontología 01/2010; 45(5):301-2; author reply 302-3. DOI:10.1016/j.regg.2010.05.006
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