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Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study.
J Steroid Biochem Mol Biol. 2016 11; 164:168-176.JS

Abstract

BACKGROUND/OBJECTIVES

The prevalence of vitamin D deficiency among seniors is high. Whereas sun exposure, vitamin D intake, genes, demographics, and lifestyle have been identified as being important determinants of vitamin D status, the impact of these factors is expected to differ across populations. To improve current prevention and treatment strategies, this study aimed to explore the main determinants of vitamin D status and its relative importance in a population of community-dwelling Dutch older adults.

METHODS/SUBJECTS

Serum 25-hydroxyvitamin D (25(OH)D) was measured in 2857 adults aged ≥65 years. Sun exposure was assessed with a structured questionnaire (n=1012), vitamin D intake using a Food Frequency Questionnaire (n=596), and data on genetic variation that may affect 25(OH)D status was obtained for 4 genes, DHCR7 (rs12785878), CYP2R1 (rs10741657), GC (rs2282679), and CYP24A1 (rs6013897) (n=2530).

RESULTS

Serum 25(OH)D concentrations <50nmol/L were observed in 45% of the population; only 6% of these participants used vitamin D supplements. Sun exposure (being outside daily during summer: 66±25nmol/L vs not being outside daily during summer: 58±27nmol/L, P=0.02) and vitamin D intake (per unit μg/day during winter/spring: 3.1±0.75nmol/L, P<0.0001) were associated with higher 25(OH)D concentrations. Major allele carriers of SNPs related to DHCR7, CYP24A1, and GC, as well as CYP2R1 minor allele carriers had the highest 25(OH)D concentrations. Together, sun (R2=0.29), vitamin D intake (R2=0.24), and genes (R2=0.28) explained 35% (R2=0.35) of the variation in 25(OH)D concentrations during summer/autumn period, when adjusted for age, sex, BMI, education, alcohol consumption, smoking, physical activity, and self-rated health status (n=185).

CONCLUSION

The investigated determinants explained 35% of 25(OH)D status. Of the three main determinants under study, sun exposure still appeared to be an important determinant of serum 25(OH)D in older individuals, closely followed by genes, and vitamin D intake. Given the low frequency of vitamin D supplement use in this population, promoting supplement use may be an inexpensive, easy, and effective strategy to fight vitamin D deficiency.

Authors+Show Affiliations

Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands. Electronic address: elske.brouwer-brolsma@wur.nl.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands.Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands.Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands; Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O.Box 7057, 1007 MB Amsterdam, The Netherlands.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26275945

Citation

Brouwer-Brolsma, Elske M., et al. "Relative Importance of Summer Sun Exposure, Vitamin D Intake, and Genes to Vitamin D Status in Dutch Older Adults: the B-PROOF Study." The Journal of Steroid Biochemistry and Molecular Biology, vol. 164, 2016, pp. 168-176.
Brouwer-Brolsma EM, Vaes AMM, van der Zwaluw NL, et al. Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. J Steroid Biochem Mol Biol. 2016;164:168-176.
Brouwer-Brolsma, E. M., Vaes, A. M. M., van der Zwaluw, N. L., van Wijngaarden, J. P., Swart, K. M. A., Ham, A. C., van Dijk, S. C., Enneman, A. W., Sohl, E., van Schoor, N. M., van der Velde, N., Uitterlinden, A. G., Lips, P., Feskens, E. J. M., Dhonukshe-Rutten, R. A. M., & de Groot, L. C. P. G. M. (2016). Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. The Journal of Steroid Biochemistry and Molecular Biology, 164, 168-176. https://doi.org/10.1016/j.jsbmb.2015.08.008
Brouwer-Brolsma EM, et al. Relative Importance of Summer Sun Exposure, Vitamin D Intake, and Genes to Vitamin D Status in Dutch Older Adults: the B-PROOF Study. J Steroid Biochem Mol Biol. 2016;164:168-176. PubMed PMID: 26275945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. AU - Brouwer-Brolsma,Elske M, AU - Vaes,Anouk M M, AU - van der Zwaluw,Nikita L, AU - van Wijngaarden,Janneke P, AU - Swart,Karin M A, AU - Ham,Annelies C, AU - van Dijk,Suzanne C, AU - Enneman,Anke W, AU - Sohl,Evelien, AU - van Schoor,Natasja M, AU - van der Velde,Nathalie, AU - Uitterlinden,Andre G, AU - Lips,Paul, AU - Feskens,Edith J M, AU - Dhonukshe-Rutten,Rosalie A M, AU - de Groot,Lisette C P G M, Y1 - 2015/08/11/ PY - 2015/06/13/received PY - 2015/08/02/revised PY - 2015/08/10/accepted PY - 2015/8/16/pubmed PY - 2017/6/20/medline PY - 2015/8/16/entrez KW - Serum 25-hydroxyvitamin D KW - Sunlight KW - Vitamin D intake KW - Vitamin D related genetic variation KW - Vitamin D supplement SP - 168 EP - 176 JF - The Journal of steroid biochemistry and molecular biology JO - J. Steroid Biochem. Mol. Biol. VL - 164 N2 - BACKGROUND/OBJECTIVES: The prevalence of vitamin D deficiency among seniors is high. Whereas sun exposure, vitamin D intake, genes, demographics, and lifestyle have been identified as being important determinants of vitamin D status, the impact of these factors is expected to differ across populations. To improve current prevention and treatment strategies, this study aimed to explore the main determinants of vitamin D status and its relative importance in a population of community-dwelling Dutch older adults. METHODS/SUBJECTS: Serum 25-hydroxyvitamin D (25(OH)D) was measured in 2857 adults aged ≥65 years. Sun exposure was assessed with a structured questionnaire (n=1012), vitamin D intake using a Food Frequency Questionnaire (n=596), and data on genetic variation that may affect 25(OH)D status was obtained for 4 genes, DHCR7 (rs12785878), CYP2R1 (rs10741657), GC (rs2282679), and CYP24A1 (rs6013897) (n=2530). RESULTS: Serum 25(OH)D concentrations <50nmol/L were observed in 45% of the population; only 6% of these participants used vitamin D supplements. Sun exposure (being outside daily during summer: 66±25nmol/L vs not being outside daily during summer: 58±27nmol/L, P=0.02) and vitamin D intake (per unit μg/day during winter/spring: 3.1±0.75nmol/L, P<0.0001) were associated with higher 25(OH)D concentrations. Major allele carriers of SNPs related to DHCR7, CYP24A1, and GC, as well as CYP2R1 minor allele carriers had the highest 25(OH)D concentrations. Together, sun (R2=0.29), vitamin D intake (R2=0.24), and genes (R2=0.28) explained 35% (R2=0.35) of the variation in 25(OH)D concentrations during summer/autumn period, when adjusted for age, sex, BMI, education, alcohol consumption, smoking, physical activity, and self-rated health status (n=185). CONCLUSION: The investigated determinants explained 35% of 25(OH)D status. Of the three main determinants under study, sun exposure still appeared to be an important determinant of serum 25(OH)D in older individuals, closely followed by genes, and vitamin D intake. Given the low frequency of vitamin D supplement use in this population, promoting supplement use may be an inexpensive, easy, and effective strategy to fight vitamin D deficiency. SN - 1879-1220 UR - https://www.unboundmedicine.com/medline/citation/26275945/Relative_importance_of_summer_sun_exposure_vitamin_D_intake_and_genes_to_vitamin_D_status_in_Dutch_older_adults:_The_B_PROOF_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-0760(15)30045-5 DB - PRIME DP - Unbound Medicine ER -