Vitamin D deficiency is a major public health problem worldwide in all age groups, even in those residing in countries with low latitude, where it was generally assumed that UV radiation was adequate enough to prevent this deficiency, and in industrialized countries, where vitamin D fortification has been implemented now for years. However, most countries are still lacking data, particularly population representative data, with very limited information in infants, children, adolescents and pregnant women. Since the number of recent publications is escalating, with a broadening of the geographic diversity, the objective of the present report was to conduct a more recent systematic review of global vitamin D status, with particular emphasis in at risk groups. A systematic review was conducted in PubMed/Medline in April-June 2013 to identify articles on vitamin D status worldwide published in the last 10 years in apparently healthy individuals. Only studies with vitamin D status prevalence were included. If available, the first source selected was population-based or representative samples studies. Clinical trials, case-control studies, case reports or series, reviews, validation studies, letters, editorials, or qualitative studies were excluded. A total of 103 articles were eligible and included in the present report. Maps were created for each age group, providing an updated overview of global vitamin D status. In areas with available data, the prevalence of low vitamin D status is a global problem in all age groups, in particular in girls and women from the Middle East. These maps also evidenced the regions with missing data for each specific population groups. There is striking lack of data in infants, children and adolescents worldwide, and in most countries of South America and Africa. In conclusion, vitamin D deficiency is a global public health problem in all age groups, particularly in those from the Middle East.

Studies show that vitamin D status is associated to obesity but data in Hispanic individuals is scarce. The aim of this study was to assess the association between vitamin D status and obesity in a clinic-based sample in Puerto Rico. We hypothesized that subjects with a higher adiposity would have a lower vitamin D status. We extracted the following data from medical records of a private clinic: age, gender, serum 25(OH)D levels, weight, height, and waist circumference. BMI (kg/m2) and waist-to-height ratio were calculated and categorized according to standard guidelines. Statistical analyses included ANCOVA, Pearson correlations and Chi-square test. From 797 individuals (mean age 53.7±15.4y; 63.5% females), 35.6% were overweight and 43.7% obese. Mean 25(OH)D levels were 24.7±8.7 ng/mL; 5.3% had levels <12 ng/mL, 30.6% had levels 12–20 ng/mL, and 43.5% had levels 21–30 ng/mL. Mean 25(OH)D levels were significantly higher in normal weight and overweight males compared to obese males (p<0.05); and in overweight females compared to obese females (p<0.05). Levels were also higher in those with low-risk compared to high-risk of waist circumference and waist-to-height ratio (p<0.001). BMI, waist circumference, and waist-to-height ratio were inversely correlated to 25(OH)D levels (p<0.001). A greater proportion of obese individuals (41.4%) were vitamin D deficient or insufficient compared to the normal weight (33.9%) and overweight individuals (30.3%) (p<0.05). In conclusion, in this clinic-based sample of Puerto Rican adults, those with higher BMI, WC, and WHtR had a significantly lower vitamin D status.

High density lipoprotein cholesterol levels are linearly and significantly increased when living at a higher altitude. This fact should be taken into account when comparing cardiovascular risk in populations living at different altitudes.

In this clinic-based sample, the odds of MetSyn increased as serum 25(OH)D levels decreased. These results have important public health implications for developing recommendations directed to increase vitamin D status in this sample.

Background Vitamin D deficiency is a public health problem around the world. Diabetes has been associated with vitamin D deficiency. We aimed to examine the association between the vitamin D status and diabetes in a clinic based sample of Hispanic adults in Puerto Rico. Methods Demographics and laboratory test results for serum 25(OH)D, Fasting Blood Glucose (FBG), and Haemoglobin A1C (HbAlc) were extracted from medical records. Vitamin D status was classified as deficient (<12 ng/ml); inadequate (12–20 ng/ml); insufficient (21–29 ng/ml) and optimal (≥30 ng/ml) using serum 25(OH)D levels. Results A total of 716 records were included in the analyses. Most were females (63.3%), with mean age of 54.1±14.9 y, mean BMI 30.1±6.3 kg/m2 and mean serum 25(OH)D levels of 24.3±8.6 ng/ml. Most were classified as diabetics (41.1%). Those with diabetes had lower 25(OH)D levels compared to pre-diabetic and normal glucose status (p<0.05). Serum 25(OH) D levels were inversely correlated to FBG and HbA1c in the total sample and in men (p<0.05). After adjusting for age, gender, BMI and seasonality, there was a greater risk of diabetes, but not prediabetes, in those with serum 25(OH)D levels <30 ng/ml. This risk increased from 1.8 times in those with vitamin D insufficiency to 4.2 times in those with vitamin D deficiency (<12 ng/ml). Conclusion Diabetes risk significantly increased as serum 25(OH)D levels decreased in this group of Hispanic adults, underscoring the importance of routinely screening high risk individuals for vitamin D deficiency and offer supplementation to normalize serum levels.