The Association between Body Mass Index and Vitamin D Supplement Use among Adults in the United States

Abstract

BackgroundObesity has been consistently associated with lower 25-hydroxyvitamin D (25(OH)D) concentrations. BMI status also has a major impact on 25(OH)D levels among vitamin D supplement users. In our cross-sectional study, we aimed to discuss the prevalence of vitamin D supplement use and its effect on 25(OH)D levels according to BMI status among US adults.MethodsThe present analysis was based on data from the National Health and Nutrition Examination Survey (NHANES) cycles 2011-2012 through 2013-2014. The prevalence of vitamin D supplement use according to BMI status among subjects aged 20 years and older by selected characteristics was analyzed. Logistic regression models were assembled to examine the independent association of BMI status and vitamin D supplement use. Similarly, general linear models were used to assess the effect of daily vitamin D supplementation doses (<400 IU, 400-800 IU, and >800 IU) on 25(OH)D concentrations according to BMI status.ResultsOf 10,076 participants with a mean age of 47.2 [standard error (SE): 0.4] years, 57.5% (SE: 1.7) of normal-weight and 63.5% (SE: 0.9) of obese subjects reported not taking vitamin D supplements over the previous 30 days. After adjustment for potential confounders, obese subjects were 1.3 times more likely to be nonusers of vitamin D supplements and were 24% less likely to take vitamin D supplements ≥400 IU/day compared with their normal-weight counterparts. In addition, significant differences in mean 25(OH)D levels of vitamin D supplementation doses were consistently seen across BMI categories. Indeed, obese and overweight participants taking >800 IU/day of vitamin D supplements had 15.5 and 8.1 nmol/L lower mean concentrations of 25(OH)D than their normal-weight counterparts on average, respectively.ConclusionObese subjects had a lower prevalence of vitamin D supplement use compared with their normal-weight counterparts. This nutritional disparity may also contribute to low 25(OH)D concentrations seen in obesity. However, a daily vitamin D supplement intake between 400 IU and 800 IU appears to be adequate among obese subjects to achieve optimal 25(OH) levels.

Protein, Calcium, Vitamin D Intake and 25(OH)D Status in Normal Weight, Overweight, and Obese Older Adults: A Systematic Review and Meta-Analysis

“…The results of the current study on vitamin D and calcium intake are in agreement with those found in another study in Americans aged ≥19 years, which reported also insufficient vitamin D intake and supplement intake and sufficient calcium intake/supplement intake across all BMI categories (55). Another study also showed that obese adults have a lower intake of dietary supplements compared to overweight, and normal weight adults (56)(57)(58). In the current study, older adults with obesity also had the highest deficiencies.…”

“…The pooled mean for vitamin D intake was 6 ug [95% CI [4][5][6][7][8][9]. For 25(OH)D, the pooled mean was 54 nmol/L [95% CI [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62], 52 nmol/L [95% CI [46][47][48][49][50][51][52][53][54][55][56][57][58], and 48 nmol/l [95% CI in normal (N = 7), combined overweight and obese (N = 12), and obese older adults (N = 4), respectively. In conclusion, older adults with overweight and obesity have a borderline sufficient protein and sufficient calcium intake, but insufficient vitamin D intake.…”

Vitamin D status in an Australian patient population: a large retrospective case series focusing on factors associated with variations in serum 25(OH)D

“…According to the Australian Bureau of Statistics, in 2017–2018, 67.0% of Australian adults were overweight and obese, an increase from 63.4% in 2014–2015 64. Current literature shows a consistent association between obesity and low vitamin D concentrations as well as lower vitamin D supplementation intake 65 66. Possible mechanisms for lower serum vitamin D status in obese individuals have been proposed,67 68 and given the growing literature on the association between obesity and low vitamin D concentrations, it would be interesting to include the body mass index of patients to elucidate this possible association.…”

The Effect of Statins on Serum Vitamin D Concentrations Among Older Adults

“…Possible explanations for these contradictory results were attributed to unmeasured predictors of vitamin D status such as vitamin D intake and sun exposure [ 15 ]. Lower 25(OH)D concentrations have been consistently reported across different latitudes in obese subjects compared with their normal-weight counterparts, which have been related to limited sun exposure, decreased bioavailability of vitamin D in fat tissue, and lower vitamin D supplements use [ 22 - 25 ]. As expected, the present results also demonstrated an inverse relationship between BMI and 25(OH)D concentrations among older adults.…”