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American Journal of Clinical Nutrition, Vol. 85, No. 3, 755-761, March 2007
© 2007 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Potentially modifiable determinants of vitamin D status in an older population in the Netherlands: the Hoorn Study1,2,3

Rob M van Dam, Marieke B Snijder, Jacqueline M Dekker, Coen DA Stehouwer, Lex M Bouter, Robert J Heine and Paul Lips

1 From the Institute for Health Sciences, Vrije Universiteit Amsterdam, Netherlands (RMvD and MBS); the Department of Nutrition, Harvard School of Public Health, Boston, MA (RMvD); the EMGO Institute (MBS, JMD, LMB, RJH, and PL) and the Department of Endocrinology (RJH and PL), VU University Medical Centre Amsterdam, Netherlands; and the Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, Netherlands (CDAS)

Background:Inadequate vitamin D status is common in many populations around the world.

Objective:The aim was to evaluate potentially modifiable determinants of vitamin D status in an older population.

Design:This was a cross-sectional study from a population-based cohort including 538 white Dutch men and women aged 60–87 y. Vitamin D status was assessed by plasma 25-hydroxyvitamin D [25(OH)D] concentrations.

Results:In the winter period, 51% of the subjects had 25(OH)D concentrations <50.0 nmol/L. Greater body fatness and less time spent on outdoor physical activity were associated with worse vitamin D status. Regular use of vitamin D–fortified margarine products [odds ratio (OR) in a comparison of intake of ≥20 g/d with none: 0.41; 95% CI: 0.20, 0.86; P for trend < 0.001], fatty fish (OR for servings of ≥2/mo versus none: 0.41; 95% CI: 0.16, 1.04; P for trend = 0.01), and vitamin D–containing supplements (OR for ≥ 1/d versus none: 0.33; 95% CI: 0.17, 0.63; P for trend < 0.001) were inversely associated with vitamin D inadequacy [25(OH)D <50.0 nmol/L]. We estimated that combined use of margarine products (20 g/d), fatty fish (100 g/wk), and vitamin D supplements (≥1/d) was associated with a 16.8 nmol/L higher 25(OH)D concentration than was the use of none of these. However, none of the participants reached these intakes for all 3 factors.

Conclusion:Because few foods are vitamin D–fortified and the amounts of vitamin D in supplements are low, it is difficult to achieve adequate vitamin D status through increasing intakes in the Netherlands and in countries with similar policies.

Key Words: Vitamin D • food fortification • supplement use • body fatness • population-based study






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