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Teenage girls and elderly women living in northern Europe have low winter vitamin D status

European Journal of Clinical Nutrition volume 59, pages 533–541 (2005)Cite this article

Abstract

Objective:

To determine the vitamin D status (serum 25-hydroxyvitamin D; S-25OHD) in adolescent girls and elderly community-dwelling women living in four countries of northern Europe and to explain differences in S-25OHD concentrations between and within the countries.

Design:

A cross-sectional observational study conducted in a standardised way during February–March. S-25OHD was analysed by high-performance liquid chromatography. Vitamin D and calcium intake was calculated using a standardised food composition database.

Setting:

Denmark, Finland, Ireland, and Poland.

Subjects:

A total of 199 girls (mean (s.d.) age 12.6 (0.5) y) and 221 women (mean (s.d.) age 71.8 (1.4) y).

Results:

The median (inter quartiles) concentration of S-25OHD was 29.4 (20.3, 38.3) nmol/l for the girls and 40.7 (28.0, 54.2) nmol/l for the women. S-25OHD below 25 nmol/l was found in 37% of the girls and 17% of the women, and S-25OHD below 50 nmol/l was found in 92% of the girls and 37% of the women. Positive significant determinants for S-25OHD in girls were use of vitamin D supplements, and in women sun habits, dietary vitamin D intake, use of vitamin D and calcium supplements. Body mass index and smoking were negative determinants in women. For women predictors could explain the differences between countries (Pcountry=0.09, R2=0.39), but for girls the difference remained significant even after including predictors (Pcountry=0.03, R2=0.15).

Conclusion:

Vitamin D status is low in northern Europe during winter. More than one-third of the adolescent girls have vitamin D status below 25 nmol/l and almost all are below 50 nmol/l. Two-thirds of the elderly community-dwelling women have vitamin D status below 50 nmol/l. Use of vitamin D supplements is a significant positive determinant for S-25OHD for both girls and women (P=0.001).

Sponsorship:

The European Fifth Framework Programme (Contract No. QLK1-CT-2000-00623).

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Acknowledgements

Karin Hess Ygil, Tue Christensen and Anders Møller are acknowledged for the dietary intake calculations. The study is part of the OPTIFORD-project ‘Towards a strategy for optimal vitamin D fortification’, financed by EU, the 5th Framework Programme (QLK1-CT-2000-00623).

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Authors and Affiliations

  1. Danish Institute for Food and Veterinary Research, Denmark

    R Andersen, C Brot, J Jakobsen & L Ovesen

  2. The Royal Veterinary and Agricultural University, Denmark

    C Mølgaard

  3. University of Copenhagen, Denmark

    L T Skovgaard

  4. University College Cork, Ireland

    K D Cashman, A Flynn, M Kiely & M O'Brien

  5. National Food and Nutrition Institute, Poland

    E Chabros, J Charzewska & M Rogalska-Niedzwiedz

  6. University of Helsinki, Finland

    M Karkkainen, C Lamberg-Allardt & A M Natri

  7. University Complutense of Madrid, Spain

    O Moreiras

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  1. R Andersen
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Corresponding author

Correspondence to R Andersen.

Additional information

Guarantor: R Andersen.

Contributors: RA wrote the manuscript and undertook the statistical analyses with advice from LTS, CM and LO. CB, KDC, JC, AF, CL-A, OM, CM and LO designed the study. JC undertook the standardised protocol. RA, EC, MKä, MKi, AMN, MO'B and MR-N collected the data. JJ undertook the measurements of S-25OHD. All contributed to the manuscript.

Appendix A

Appendix A

Estimated regression coefficients (β) represent the effect on outcome for a one unit increase in the respective covariate. Since outcome (S-25OHD) was logarithmic transformed, we transformed the coefficients to ratio estimates (10β), indicating a multiplicative increase in outcome corresponding to one unit increase in the covariate. This is done for the following covariates: vitamin D and calcium supplements, sun habits, pubertal status, smoking habits, BMI, post menarche time, package year and country.

Logarithmic transformation of outcome:

Taking the antilogarithm:

One unit increase in outcome:

For the covariates that were themselves logarithmic transformed (vitamin D and calcium dietary intake), this ratio corresponds to the effect of a one unit increase on logarithmic scale, that is, a 10-fold increase on the original scale. Since it is unrealistic to increase the vitamin D and calcium intake 10-fold, we instead calculated and present effects corresponding to a 50% increase for vitamin D and calcium intake (1.5β).

Logarithmic transformation of outcome and covariate:

Taking the antilogarithm:

10-fold increase in outcome:

50% increase in outcome:

The interpreted 95% confidence limits were calculated in a similar manner. The result is shown in Tables 3 and 4.

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Andersen, R., Mølgaard, C., Skovgaard, L. et al. Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr 59, 533–541 (2005). https://doi.org/10.1038/sj.ejcn.1602108

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