Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D. Bone

Department of Medicine and Therapeutics, University of Aberdeen, Medical School Buildings, Foresterhill, Aberdeen, AB25 2ZD, UK.
Bone (Impact Factor: 3.97). 06/2008; 42(5):996-1003. DOI: 10.1016/j.bone.2008.01.011
Source: PubMed


For 5 months a year the UK has insufficient sunlight for cutaneous synthesis of vitamin D and winter requirements are met from stores made the previous summer. Although there are few natural dietary sources, dietary intake may help maintain vitamin D status. We investigated the relationship between 25-hydroxyvitamin D (25(OH)D), bone health, overweight, sunlight exposure and dietary vitamin D in 3113 women (age 54.8 [SD 2.3] years) living at latitude 57 degrees N between 1998-2000. Serum 25(OH)D was measured by high performance liquid chromatography (HPLC), dietary intakes (food frequency questionnaire, n=2598), sunlight exposure (questionnaire, n=2402) and bone markers were assessed. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in all women at the sampling visit and 6 years before. Seasonal variation in 25(OH)D was not substantial with a peak in the autumn (23.7 [9.9] ng/ml) and a nadir in spring (19.7 [7.6] ng/ml). Daily intake of vitamin D was 4.2 [2.5] mug from food only and 5.8 [4.0] mug including vitamin D from cod liver oil and multivitamins. The latter was associated with 25(OH)D at each season whereas vitamin D simply from food was associated with 25(OH)D in winter and spring only. Sunlight exposure was associated with 25(OH)D in summer and autumn. 25(OH)D was negatively associated with increased bone resorption and bone loss (P<0.05) remaining significant after adjustment for confounders (age, weight, height, menopausal status/HRT use, physical activity and socio-economic status). Using an insufficiency cut-off of <28 ng/ml 25(OH)D, showed lower concentrations of bone resorption markers in the upper category (fDPD/Cr 5.1 [1.7] nmol/mmol compared to 5.3 [2.1] nmol/mmol, P=0.03) and no difference in BMD or bone loss. 25(OH)D was lower (P<0.01) and parathyroid hormone higher (P<0.01) in the top quintile of body mass index. In conclusion, low vitamin D status is associated with greater bone turnover, bone loss and obesity. Diet appears to attenuate the seasonal variation of vitamin D status in early postmenopausal women at northerly latitude where quality of sunlight for production of vitamin D is diminished.

Download full-text


Available from: William D Fraser
  • Source
    • "Results of Al-Elq et al. study found an inverse relationship between vitamin D and BMI in Saudi males but not in females which appears that obesity is protective against vitamin D deficiency [23]. While negative association was found in many studies [24-28], some observed no relationship [29,30]. The mechanism behind such an association is that elevated concentrations of 1-25-vit D stimulate lipogenesis and inhibit lipolysis in cultured human adipocytes, leading to accumulation of fat [31]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Vitamin D deficiency has been implicated in several chronic, non-communicable diseases independent of its conventional role in bone and calcium homeostasis. In this retrospective study, we determined the prevalence of vitamin D deficiency and its association to several cardiometabolic indices among patients visiting King Abdulaziz Medical City (KAMC), a tertiary hospital in Riyadh, Saudi Arabia. A total of 3475 charts of out-patient subjects who visited KAMC last September 2009 until December 2010 were reviewed and included. Variables of interest included measurements of vitamin D status, glycemic and renal profile, as well as trace elements (calcium and phosphorous). The over-all prevalence of vitamin D deficiency in the cohort studied was 78.1% in females and 72.4% in males. 25(OH) vitamin D was significantly associated with increasing age and weight (p-values < 0.0001 and 0.005, respectively). It was also positively associated with albumin, calcium and phosphorous (p-values < 0.0001, < 0.0001 and 0.0007, respectively) and negatively associated with alkaline phosphatase as well as circulating levels of PTH (p-values 0.0002 and 0.0007, respectively). In conclusion, vitamin D deficiency is overwhelmingly common among patients seen at KAMC regardless of the medical condition, and it is significantly associated with increasing age, weight and markers of calcium homeostasis. Findings of the present study further stress the spotlight on vitamin D deficiency epidemic in the country and region in general.
    Full-text · Article · Feb 2014 · BMC Public Health
  • Source
    • "Insufficient calcium and vitamin D throughout adulthood accelerate bone loss in later life, greatly increasing the risk of osteoporosis. A longitudinal survey of 3,113 post-menopausal women revealed greater bone loss and risk of obesity in those with a poor vitamin D status (Macdonald et al., 2008). A cohort study of 5,304 people aged 55 þ years reported a lower bone mineral density and higher risk of fracture when intakes of vitamins B2 and B6 were low (Yazdanpanah et al., 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose – The purpose of this paper is to examine the potential role of micronutrients and omega-3 fatty acids in promoting healthier ageing. Design/methodology/approach – A literature review was conducted using Medline and key words relevant to ageing, nutritional status, nutrient intake and disease risk. Data from the National Diet and Nutrition Survey (NDNS) were used to determine micronutrient adequacy. Findings – The NDNS showed that intakes of vitamin A, B2, B6, folic acid, iron, calcium, magnesium, zinc and iodine fell below recommended levels for groups of older people. Vitamins and mineral supplements may improve nutritional status, lower the risk of deficiency, and impact favourably on disease markers. Practical implications – The evidence suggests that dietary interventions and supplementation may become increasingly important in maintaining health and quality of life in older people. Originality/value – This paper highlights the positive role of nutrition in healthy ageing.
    Preview · Article · Oct 2011 · Nutrition & Food Science
  • Source
    • "ation between total vitamin D intake (diet and supplements) and 25(OH) D concentrations has been somewhat inconsistent [2] [3]. Low 25(OH) D levels are associated with musculoskeletal disorders , with severe deficiency resulting in the clinical syndrome of osteomalacia [4] [5] [6]. Some [7] [8] [9] but not all [10], cohort studies have associated low 25(OH) D levels with increased risk of radiographic worsening of osteoarthritis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Low 25-hydroxyvitamin D (25(OH) D) concentrations have been associated with radiologic worsening of osteoarthritis in some reports. However, the results are mixed and few studies have evaluated associations between 25(OH) D concentrations and both total vitamin D intake and clinical joint symptoms. Cross-sectional analyses of information from a subset of 1993 postmenopausal women obtained at baseline entry in the Women's Health Initiative Calcium plus Vitamin D clinical trial. 25(OH) D concentration, total vitamin D intake (diet plus supplements), presence and severity of joint pain and joint swelling. The 25(OH) D levels were commonly low with 53% having deficient (<50 nmol/L) and only 17% having sufficient (>72 nmol/L) levels. Joint pain (reported by 74%) and joint swelling (reported by 34%) were also commonly reported. 25(OH) D concentrations were modestly correlated with total vitamin D intake (R=0.29, p<0.0001); however, considerable variability in 25(OH) D concentrations for a given vitamin D intake was seen. In adjusted linear regression models, lower serum 25(OH) D concentrations were associated with higher average joint pain score (P=0.01 for trend) with differences most apparent in the lowest 25(OH) D levels sextile. Relatively low 25(OH) D levels and a high frequency of joint symptoms were common in this population of postmenopausal women. Total vitamin D intake was only modestly associated with 25(OH) D. Low serum 25(OH) D concentrations were associated with higher joint pain scores. These findings can inform the design of future intervention trials.
    Full-text · Article · Jan 2011 · Maturitas
Show more