Trends in Vitamin <scp>D</scp> Status Around the World

Lips, Paul; Jongh, Renate T. de; Schoor, Natasja M. van

doi:10.1002/jbm4.10585

Cited by 40 publications

(30 citation statements)

References 76 publications

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“…Vitamin D deficiency is prevalent worldwide (Lips et al, 2021) and low vitamin D status is associated with severe COVID-19 disease as described in over 900 papers from a variety of institutions and clinical settings (Ali, 2020;Bilezikian et al, 2020; Faul et al, 2020;Grant et al, 2020;. The observed associations support the hypothesis that a low vitamin D state impairs the human immune system, leading to poor clinical outcomes.…”

Section: Does Covid-19 Lower Serum Vitamin D Levels?mentioning

confidence: 88%

Title: Understanding a Low Vitamin D State in the Context of COVID-19

et al. 2022

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While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19. Applying the Bradford-Hill criteria, however, the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 (respiratory failure, requirement for ventilation and mortality). A biologically plausible rationale exists for these findings, given vitamin D’s role in immune regulation. The thresholds which define low, deficient, and replete vitamin D states vary according to the disease studied, underscoring the complexities for determining the goals for supplementation. All are currently unknown in the setting of COVID-19. The design of vitamin D randomised controlled trials is notoriously problematic and these trials commonly fail for a number of behavioural and methodological reasons. In Ireland, as in most other countries, low vitamin D status is common in older adults, adults in institutions, and with obesity, dark skin, low UVB exposure, diabetes and low socio-economic status. Physiological vitamin D levels for optimal immune function are considerably higher than those that can be achieved from food and sunlight exposure alone in Ireland. A window exists in which a significant number of adults could benefit from vitamin D supplementation, not least because of recent data demonstrating an association between vitamin D status and COVID-19. During the COVID pandemic, we believe that supplementation with 20-25ug (800–1000 IU)/day or more may be required for adults with apparently normal immune systems to improve immunity against SARS-CoV-2. We expect that higher monitored doses of 37.5–50 ug (1,500–2,000)/day may be needed for vulnerable groups (e.g., those with obesity, darker skin, diabetes mellitus and older adults). Such doses are within the safe daily intakes cited by international advisory agencies.

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Section: Does Covid-19 Lower Serum Vitamin D Levels?mentioning

confidence: 88%

Title: Understanding a Low Vitamin D State in the Context of COVID-19

et al. 2022

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“…There are over 94,000 publications on vitamin D listed on pubmed.gov as of 20 December 2021. Despite all this, vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) concentration <20 ng/mL) is very common, affecting about half of the world's population [1], whereas the higher concentrations necessary for optimal non-skeletal health (25(OH)D >30 ng/mL) are not so common. The reason for this is that the beneficial effects of vitamin D for non-skeletal disorders have only received widespread research attention since 2000.…”

Section: Introductionmentioning

confidence: 99%

A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health

et al. 2022

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Vitamin D3 has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. This narrative review examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes mellitus, and COVID-19 with regard to sub-optimal 25(OH)D concentrations. Evidence for the beneficial effects comes from a variety of approaches including ecological and observational studies, studies of mechanisms, and Mendelian randomization studies. Although randomized controlled trials (RCTs) are generally considered the strongest form of evidence for pharmaceutical drugs, the study designs and the conduct of RCTs performed for vitamin D have mostly been flawed for the following reasons: they have been based on vitamin D dose rather than on baseline and achieved 25(OH)D concentrations; they have involved participants with 25(OH)D concentrations above the population mean; they have given low vitamin D doses; and they have permitted other sources of vitamin D. Thus, the strongest evidence generally comes from the other types of studies. The general finding is that optimal 25(OH)D concentrations to support health and wellbeing are above 30 ng/mL (75 nmol/L) for cardiovascular disease and all-cause mortality rate, whereas the thresholds for several other outcomes appear to range up to 40 or 50 ng/mL. The most efficient way to achieve these concentrations is through vitamin D supplementation. Although additional studies are warranted, raising serum 25(OH)D concentrations to optimal concentrations will result in a significant reduction in preventable illness and death.

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“…Vitamin D deficiency remains a worldwide public health problem, affecting large proportions of the population in developed and the developing countries [ 1 ]. Vitamin D deficiency remains common in children and adults and the musculoskeletal consequences of inadequate vitamin D are well established.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency and Its Associated Factors among Female Migrants in the United Arab Emirates

et al. 2022

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Vitamin D is important for bone health, and vitamin D deficiency could be linked to noncommunicable diseases, including cardiovascular disease. The purpose of this study was to determine the prevalence of vitamin D deficiency and its associated risk factors among female migrants from Philippines, Arab, and South Asian countries residing in the United Arab Emirates (UAE). We used a cross-sectional study to recruit a random sample (N = 550) of female migrants aged 18 years and over in the city of Al Ain, UAE. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentrations ≤20 ng/mL (50 nmol/L). We used multivariable logistic regression analysis to identify risk factors associated with vitamin D deficiency. The mean age of participants was 35 years (SD ± 10). The overall prevalence rate of vitamin D deficiency was 67% (95% CI 60–73%), with the highest rate seen in Arabs (87%), followed by South Asians (83%) and the lowest in Filipinas (15%). Multivariate analyses showed that low physical activity (adjusted odds ratio (aOR) = 4.59; 95% CI 1.98, 10.63), having more than 5 years duration of residence in the UAE (aOR = 4.65; 95% CI: 1.31, 16.53) and being obese (aOR = 3.56; 95% CI 1.04, 12.20) were independently associated with vitamin D deficiency, after controlling for age and nationality. In summary, vitamin D deficiency was highly prevalent among female migrants, especially Arabs and South Asians. It is crucial that health professionals in the UAE become aware of this situation among this vulnerable subpopulation and provide intervention strategies aiming to rectify vitamin D deficiency by focusing more on sun exposure, physical activity, and supplementation.

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Trends in Vitamin D Status Around the World

Cited by 40 publications

References 76 publications

Title: Understanding a Low Vitamin D State in the Context of COVID-19

Title: Understanding a Low Vitamin D State in the Context of COVID-19

A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health

Vitamin D Deficiency and Its Associated Factors among Female Migrants in the United Arab Emirates

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