Original Article

Correlates of Vitamin D Insufficiency in an Affluent Adult Population

Authors: Erik Orelind, MD, MPH, Joseph Feinglass, PhD, Maureen Moran, MPH, Charles P. Zei, MA, David W. Baker, MD, MPH

Abstract

Objectives: Vitamin D is necessary for bone health and calcium metabolism. Vitamin D deficiency may play a role in coronary artery disease, some cancers, autoimmune disease, and glucose tolerance. Vitamin D deficiency may be prevalent even among affluent US adults.


Methods: We conducted a retrospective chart review study of 287 adult patients who underwent executive physical examinations between April 2009 and May 2010 in Chicago, Illinois. Data collected included age, sex, body mass index, vitamin D levels, supplement use, fish consumption, milk consumption, hours spent outdoors, and sunscreen use. Vitamin D insufficiency was defined as <30 ng/mL.


Results: The mean vitamin D level was 40.0 ng/mL (standard deviation 16.6), which varied by month. The mean vitamin D level ranged from 32.9 ng/mL in January to 55.4 ng/mL in September. Insufficient levels of vitamin D were observed in 30.3% of patients. Younger age (younger than 40 years); no milk or fish consumption; no use of multivitamins, vitamin D supplements, or calcium supplements; no sun exposure; and routine use of sunscreens were positively associated with vitamin D insufficiency.


Conclusion: Vitamin D insufficiency in almost one-third of patients presenting for executive physicals may be indicative of a widespread nutritional deficiency in the US population.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Wang L, Manson JE, Song Y, et al. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010; 152: 315–323.
 
2. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266–281.
 
3. (IOM) IoM. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press, 2011.
 
4. Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res 2011; 26: 455–457.
 
5. Bordelon P, Ghetu MV, Langan RC. Recognition and management of vitamin D deficiency. Am Fam Physician 2009; 80: 841–846.
 
6. Zadshir A, Tareen N, Pan D, et al. The prevalence of hypovitaminosis D among US adults: data from the NHANES III. Ethn Dis Autumn 2005; 15 (4 suppl 5): S5–S97, 101.
 
7. Holick MF. Sunlight and vitamin D: both good for cardiovascular health. J Gen Intern Med 2002; 17: 733–735.
 
8. Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72: 690–693.
 
9. Looker AC, Pfeiffer CM, Lacher DA, et al. Serum 25-hydroxyvitamin D status of the US population: 1988–1994 compared with 2000–2004. Am J Clin Nutr 2008; 88: 1519–1527.
 
10. Terushkin V, Bender A, Psaty EL, et al. Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes. J Am Acad Dermatol 2010; 62: 929.e1–e929, e9.
 
11. Levis S, Gomez A, Jimenez C, et al. Vitamin d deficiency and seasonal variation in an adult South Florida population. J Clin Endocrinol Metab 2005; 90: 1557–1562.