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American Journal of Clinical Nutrition, Vol. 76, No. 1, 187-192, July 2002
© 2002 American Society for Clinical Nutrition

Original Research Communication

Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–19941,2

Shanna Nesby-O'Dell, Kelley S Scanlon, Mary E Cogswell, Cathleen Gillespie, Bruce W Hollis, Anne C Looker, Chris Allen, Cindy Doughertly, Elaine W Gunter and Barbara A Bowman

1 From the Division of Nutrition and Physical Activity (SN-O, KSS, MEC, and CG) and the Division of Diabetes Translation (BAB), National Center for Chronic Disease Prevention and Health Promotion, the CDC Drug Service, Scientific Resources Program, National Center for Infectious Disease (CA and CD), and the NHANES Laboratory, Nutritional Biochemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, (EWG), Centers for Disease Control and Prevention, Atlanta; the Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston (BWH); and the Division of Health Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (ACL).

Background: Recent reports of rickets among African American children drew attention to the vitamin D status of these infants and their mothers. African American women are at higher risk of vitamin D deficiency than are white women, but few studies have examined determinants of hypovitaminosis D in this population.

Objective: We examined the prevalence and determinants of hypovitaminosis D among African American and white women of reproductive age.

Design: We examined 1546 African American women and 1426 white women aged 15–49 y who were not pregnant and who participated in the third National Health and Nutrition Examination Survey (1988–1994). Hypovitaminosis D was defined as a serum 25-hydroxyvitamin D concentration <=37.5 nmol/L. Multiple logistic regression was used to examine the independent association of dietary, demographic, and behavioral determinants of hypovitaminosis D.

Results: The prevalence of hypovitaminosis D was 42.4 ± 3.1% ( ± SE) among African Americans and 4.2 ± 0.7% among whites. Among African Americans, hypovitaminosis D was independently associated with consumption of milk or breakfast cereal <3 times/wk, no use of vitamin D supplements, season, urban residence, low body mass index, and no use of oral contraceptives. Even among 243 African Americans who consumed the adequate intake of vitamin D from supplements (200 IU/d), 28.2 ± 2.7% had hypovitaminosis D.

Conclusions: The high prevalence of hypovitaminosis D among African American women warrants further examination of vitamin D recommendations for these women. The determinants of hypovitaminosis D among women should be considered when these women are advised on dietary intake and supplement use.

Key Words: Hypovitaminosis D • 25-hydroxyvitamin D • vitamin D deficiency • African American women • diet • body mass index • oral contraceptive pills • rickets




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