Vitamin D deficiency in Europe: pandemic?

Kevin D. Cashman; Kirsten G Dowling; Zuzana Škrabáková; Marcela Gonzalez-Gross; Jara Valtueña; Stefaan De Henauw; Luis A. Moreno; Camilla Trab Damsgaard; Kim F. Michaelsen; Christian Mølgaard; Rolf Jorde; Guri Grimnes; George Moschonis; Christina Mavrogianni; Yannis Manios; Michael Thamm; Gert BM Mensink; Martina Rabenberg; Markus A Busch; Lorna Cox; Sarah Meadows; Gail Goldberg; Ann Prentice; Jacqueline M Dekker; Giel Nijpels; Stefan Pilz; Karin M A Swart; Natasja M van Schoor; Paul Lips; Gudny Eiriksdottir; Vilmundur Gudnason; Mary Frances Cotch; Seppo Koskinen; Christel Lamberg-Allardt; Ramon A Durazo-Arvizu; Christopher T Sempos; Mairead Kiely

doi:10.3945/ajcn.115.120873

Vitamin D deficiency in Europe: pandemic?

Kevin D. Cashman, Kirsten G Dowling, Zuzana Škrabáková, Marcela Gonzalez-Gross, Jara Valtueña, Stefaan De Henauw, Luis A. Moreno, Camilla Trab Damsgaard, Kim F. Michaelsen, Christian Mølgaard, Rolf Jorde, Guri Grimnes, George Moschonis, Christina Mavrogianni, Yannis Manios, Michael Thamm, Gert BM Mensink, Martina Rabenberg, Markus A Busch, Lorna CoxSarah Meadows, Gail Goldberg, Ann Prentice, Jacqueline M Dekker, Giel Nijpels, Stefan Pilz, Karin M A Swart, Natasja M van Schoor, Paul Lips, Gudny Eiriksdottir, Vilmundur Gudnason, Mary Frances Cotch, Seppo Koskinen, Christel Lamberg-Allardt, Ramon A Durazo-Arvizu, Christopher T Sempos, Mairead Kiely

Lifecourse Nutrition & Health

496 Citations (Scopus)

Abstract

Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyVitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIHled international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of Vitamin D deficiency in Europe. Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of Vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of Vitamin D deficiency (<50 nmol/ L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure Vitamin D intakes that are protective against Vitamin D deficiency in the majority of the European population.

Original language	English
Journal	American Journal of Clinical Nutrition
Volume	103
Issue number	4
Pages (from-to)	1033-1044
Number of pages	12
ISSN	0002-9165
DOIs	https://doi.org/10.3945/ajcn.115.120873
Publication status	Published - 1 Apr 2016

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Cashman, K. D., Dowling, K. G., Škrabáková, Z., Gonzalez-Gross, M., Valtueña, J., De Henauw, S., Moreno, L. A., Damsgaard, C. T., Michaelsen, K. F., Mølgaard, C., Jorde, R., Grimnes, G., Moschonis, G., Mavrogianni, C., Manios, Y., Thamm, M., Mensink, G. BM., Rabenberg, M., Busch, M. A., ... Kiely, M. (2016). Vitamin D deficiency in Europe: pandemic? American Journal of Clinical Nutrition, 103(4), 1033-1044. https://doi.org/10.3945/ajcn.115.120873

Cashman, KD, Dowling, KG, Škrabáková, Z, Gonzalez-Gross, M, Valtueña, J, De Henauw, S, Moreno, LA, Damsgaard, CT , Michaelsen, KF , Mølgaard, C, Jorde, R, Grimnes, G, Moschonis, G, Mavrogianni, C, Manios, Y, Thamm, M, Mensink, GBM, Rabenberg, M, Busch, MA, Cox, L, Meadows, S, Goldberg, G, Prentice, A, Dekker, JM, Nijpels, G, Pilz, S, Swart, KMA, van Schoor, NM, Lips, P, Eiriksdottir, G, Gudnason, V, Cotch, MF, Koskinen, S, Lamberg-Allardt, C, Durazo-Arvizu, RA, Sempos, CT & Kiely, M 2016, 'Vitamin D deficiency in Europe: pandemic?', American Journal of Clinical Nutrition, vol. 103, no. 4, pp. 1033-1044. https://doi.org/10.3945/ajcn.115.120873

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title = "Vitamin D deficiency in Europe: pandemic?",

abstract = "Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyVitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIHled international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of Vitamin D deficiency in Europe. Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of Vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of Vitamin D deficiency (<50 nmol/ L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure Vitamin D intakes that are protective against Vitamin D deficiency in the majority of the European population.",

author = "Cashman, {Kevin D.} and Dowling, {Kirsten G} and Zuzana {\v S}krab{\'a}kov{\'a} and Marcela Gonzalez-Gross and Jara Valtue{\~n}a and {De Henauw}, Stefaan and Moreno, {Luis A.} and Damsgaard, {Camilla Trab} and Michaelsen, {Kim F.} and Christian M{\o}lgaard and Rolf Jorde and Guri Grimnes and George Moschonis and Christina Mavrogianni and Yannis Manios and Michael Thamm and Mensink, {Gert BM} and Martina Rabenberg and Busch, {Markus A} and Lorna Cox and Sarah Meadows and Gail Goldberg and Ann Prentice and Dekker, {Jacqueline M} and Giel Nijpels and Stefan Pilz and Swart, {Karin M A} and {van Schoor}, {Natasja M} and Paul Lips and Gudny Eiriksdottir and Vilmundur Gudnason and Cotch, {Mary Frances} and Seppo Koskinen and Christel Lamberg-Allardt and Durazo-Arvizu, {Ramon A} and Sempos, {Christopher T} and Mairead Kiely",

note = "CURIS 2016 NEXS 061",

year = "2016",

month = apr,

day = "1",

doi = "10.3945/ajcn.115.120873",

language = "English",

volume = "103",

pages = "1033--1044",

journal = "American Journal of Clinical Nutrition",

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TY - JOUR

T1 - Vitamin D deficiency in Europe

T2 - pandemic?

AU - Cashman, Kevin D.

AU - Dowling, Kirsten G

AU - Škrabáková, Zuzana

AU - Gonzalez-Gross, Marcela

AU - Valtueña, Jara

AU - De Henauw, Stefaan

AU - Moreno, Luis A.

AU - Damsgaard, Camilla Trab

AU - Michaelsen, Kim F.

AU - Mølgaard, Christian

AU - Jorde, Rolf

AU - Grimnes, Guri

AU - Moschonis, George

AU - Mavrogianni, Christina

AU - Manios, Yannis

AU - Thamm, Michael

AU - Mensink, Gert BM

AU - Rabenberg, Martina

AU - Busch, Markus A

AU - Cox, Lorna

AU - Meadows, Sarah

AU - Goldberg, Gail

AU - Prentice, Ann

AU - Dekker, Jacqueline M

AU - Nijpels, Giel

AU - Pilz, Stefan

AU - Swart, Karin M A

AU - van Schoor, Natasja M

AU - Lips, Paul

AU - Eiriksdottir, Gudny

AU - Gudnason, Vilmundur

AU - Cotch, Mary Frances

AU - Koskinen, Seppo

AU - Lamberg-Allardt, Christel

AU - Durazo-Arvizu, Ramon A

AU - Sempos, Christopher T

AU - Kiely, Mairead

N1 - CURIS 2016 NEXS 061

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyVitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIHled international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of Vitamin D deficiency in Europe. Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of Vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of Vitamin D deficiency (<50 nmol/ L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure Vitamin D intakes that are protective against Vitamin D deficiency in the majority of the European population.

AB - Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyVitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIHled international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of Vitamin D deficiency in Europe. Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of Vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of Vitamin D deficiency (<50 nmol/ L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure Vitamin D intakes that are protective against Vitamin D deficiency in the majority of the European population.

U2 - 10.3945/ajcn.115.120873

DO - 10.3945/ajcn.115.120873

M3 - Journal article

C2 - 26864360

SN - 0002-9165

VL - 103

SP - 1033

EP - 1044

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 4

ER -

Vitamin D deficiency in Europe: pandemic?

Abstract

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