The role of sunlight exposure in determining the vitamin D status of the UK white Caucasian adult population

School of Earth Atmospheric and Environmental Sciences, University of Manchester, Manchester M13 9PL, UK.
British Journal of Dermatology (Impact Factor: 4.28). 11/2010; 163(5):1050-5. DOI: 10.1111/j.1365-2133.2010.09975.x
Source: PubMed


Vitamin D is necessary for bone health and is potentially protective against a range of malignancies. Opinions are divided on whether the proposed optimal circulating 25-hydroxyvitamin D [25(OH)D] level (≥ 32 ng mL⁻¹) is an appropriate and feasible target at population level.
We examined whether personal sunlight exposure levels can provide vitamin D sufficient (≥ 20 ng mL⁻¹) and optimal status in the U.K. public.
This prospective cohort study measured circulating 25(OH)D monthly for 12 months in 125 white adults aged 20-60 years in Greater Manchester. Dietary vitamin D and personal ultraviolet radiation (UVR) exposure were assessed over 1-2 weeks in each season. The primary analysis determined the post-summer peak 25(OH)D required to maintain sufficiency in wintertime.
Dietary vitamin D remained low in all seasons (median 3·27 μg daily, range 2·76-4·15) while personal UVR exposure levels were high in spring and summer, low in autumn and negligible in winter. Mean 25(OH)D levels were highest in September [28·4 ng mL⁻¹; 28% optimal, zero deficient (<5 ng mL⁻¹)], and lowest in February (18·3 ng mL⁻¹; 7% optimal, 5% deficient). A February 25(OH)D level of 20 ng mL⁻¹ was achieved following a mean (95% confidence interval) late summer level of 30·4 (25·6-35·2) and 34·9 (27·9-41·9) ng mL⁻¹ in women and men, respectively, with 62% of variance explained by gender and September levels.
Late summer 25(OH)D levels approximating the optimal range are required to retain sufficiency throughout the U.K. winter. Currently the majority of the population fails to reach this post-summer level and becomes vitamin D insufficient during the winter.

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    • "Thus, good quality measurements of the spectral UV irradiance and the main 15 factors controlling its levels at the earth's surface are of great importance for achieving better understanding and more accurate modeling of the interactions among UV radiation , ozone, aerosols, clouds and surface reflectivity (García et al., 2015;Kreuter et al., 2014;Mayer and Kylling, 2005;Schwander et al., 1997). Accurate knowledge of the levels of spectral surface UV irradiance is necessary in 20 order to quantify effects on the health of humans (Kazantzidis et al., 2015;Webb et al., 2010) and ecosystems (Ballare et al., 2011;Hader et al., 2011), and prevent potential impacts from over-or under-exposure to UV radiation (Lucas et al., 2015). Additionally, reliable estimations of the trends of spectral surface UV irradiance provide useful information for assessing these impacts and for adopting proper measures (Morgenstern 25 et al., 2008;Newman and McKenzie, 2011;van Dijk et al., 2013). "
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    ABSTRACT: In this study, we discuss the short- and the long-term variability of spectral UV irradiance at Thessaloniki, Greece using a long, quality-controlled data set from two Brewer spectrophotometers. Long-term changes in spectral UV irradiance at 307.5, 324 and 350 nm for the period 1994–2014 are presented for different solar zenith angles and discussed in association to changes in total ozone column (TOC), aerosol optical depth (AOD) and cloudiness observed in the same period. Positive changes in annual mean anomalies of UV irradiance, ranging from 2 to 6 % per decade, have been detected both for clear- and all-sky conditions. The changes are generally greater for larger solar zenith angles and for shorter wavelengths. For clear skies, these changes are, in most cases, statistically significant at the 95 % confidence limit. Decreases in the aerosol load and weakening of the attenuation by clouds lead to increases in UV irradiance in the summer, of 7–9 % per decade for 64° solar zenith angle. The increasing TOC in winter counteracts the effect of decreasing AOD for this particular season, leading to small, statistically insignificant, negative long-term changes in irradiance at 307.5 nm. Annual mean UV irradiance levels are increasing from 1994 to 2006 and remain relatively stable thereafter, possibly due to the combined changes in the amount and optical properties of aerosols. However, no statistically significant corresponding turning point has been detected in the long-term changes of AOD. Trends in irradiance during the two sub-periods are not discussed, because the length of the two datasets is too short for deriving statistically significant estimates. The absence of signatures of changes in AOD in the short-term variability of irradiance in the UV-A may have been caused by changes in the single scattering albedo of aerosols, which may counteract the effects of changes in AOD on irradiance. The anti-correlation between the year-to-year variability of the irradiance at 307.5 nm and TOC is clear and becomes clearer as the AOD decreases.
    Full-text · Article · Dec 2015
    • "Both forms are hydroxylated in the liver to 25-hydroxyvi- tamin D (25-OH-D) and serum levels are used as a measure of vitamin D status. If sunlight exposure is limited, there is increased dependence on dietary sources to provide adequate intakes (Webb et al., 2010), especially in vulnerable groups, during winter months (Glerup, 2000; Webb et al., 2010). However, there are only a few foods that are naturally rich in vitamin D; good sources include liver and fatty fish such as salmon, mackerel and sardines, whereas other foods such as red meat and eggs provide marginal amounts (O'Connor & Benelam, 2011). "
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    ABSTRACT: Background Dietary intakes of vitamin D are very low in the UK. Dietary calcium is also necessary to promote bone health. The fortification of foods with vitamin D could be a safe and effective way of increasing intake.Methods Diets of preschool children, 755 at 18 months and 3.5 years, from the Avon Longitudinal Study of Parents and Children were assessed using dietary records completed by parents. Energy, vitamin D and calcium intakes were calculated. Multinomial logistic regression was used to estimate the odds ratio for being in the highest/lowest quartile of intake. Intakes were recalculated to test different fortification regimes.ResultsVitamin D intakes were low; all children were below the UK and US dietary recommendations. Calcium intakes decreased between the two ages as a result of reduced milk consumption. Children in the lowest quartile for vitamin D intake at 18 months were twice as likely to remain in that quartile at 3.5 years (odds ratio = 2.35; 95% confidence interval = 1.56–3.55). The majority of foods provide no vitamin D with fat spreads and milk as the main sources. The contribution from breakfast cereals increased, from 6% to 12%, as a result of the increased consumption of fortified cereals. Dairy foods provided the highest contribution to calcium at 18 months but were less important at 3.5 years. Theoretical intakes from different fortification regimens suggest that milk fortified at 2 μg 100 g–1 vitamin D would provide most children with adequate but not excessive intakes.Conclusions Dietary vitamin D intakes were very low and calcium intakes were mostly adequate. Fortification of milk with vitamin D could be a good way to boost intakes.
    No preview · Article · Sep 2014 · Journal of Human Nutrition and Dietetics
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    • "In this group ultraviolet light may not be the only key in the prevention of different condition but the role of dietary vitamin D intake, supplement vitamin D and calcium come into play [62-64]. In our study, the highest levels of serum 25OHD3 were seen during the summer and in the autumn and these are in agreement with previous studies [65-69]. This is also to be expected as during this season the solar UV radiation reaches adequate levels to have a sufficient vitamin D production (ibid). "
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    ABSTRACT: Low blood levels of vitamin D (25-hydroxy D3, 25OHD3) in women have been associated with an increased risk of several diseases. A large part of the population may have suboptimal 25OHD3 levels but high-risk groups are not well known. The aim of the present study was to identify determinants for serum levels of 25OHD3 in women, i.e. factors such as lifestyle, menopausal status, diet and selected biochemical variables. The study was based on women from the Malmo Diet and Cancer Study (MDCS), a prospective, population-based cohort study in Malmo, Sweden. In a previous case--control study on breast cancer, 25OHD3 concentrations had been measured in 727 women. In these, quartiles of serum 25OHD3 were compared with regard to age at baseline, BMI (Body Max Index), menopausal status, use of oral contraceptives or menopausal hormone therapy (MHT) , life-style (e.g. smoking and alcohol consumption), socio-demographic factors, season, biochemical variables (i.e. calcium, PTH, albumin, creatinine, and phosphate), and dietary intake of vitamin D and calcium. In order to test differences in mean vitamin D concentrations between different categories of the studied factors, an ANOVA test was used followed by a t-test. The relation between different factors and 25OHD3 was further investigated using multiple linear regression analysis and a logistic regression analysis. We found a positive association between serum levels of 25OHD3 and age, oral contraceptive use, moderate alcohol consumption, blood collection during summer/ autumn, creatinine, phosphate, calcium, and a high intake of vitamin D. Low vitamin D levels were associated with obesity, being born outside Sweden and high PTH levels. The present population-based study found a positive association between serum levels of 25OHD3 and to several socio-demographic, life-style and biochemical factors. The study may have implications e. g. for dietary recommendations. However, the analysis is a cross-sectional and it is difficult to suggest Lifestyle changes as cause- effect relationships are difficult to assess.
    Full-text · Article · Aug 2013 · BMC Women's Health
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