Objectively measured physical activity and vitamin D status in older people from Germany

Klenk, Jochen; Rapp, Kilian; Denkinger, Michael; Nagel, Gabriële; Nikolaus, Thorsten; Peter, Richard; Boehm, Bernhard O.; Köenig, Wolfgang; Rothenbacher, Dietrich

doi:10.1136/jech-2014-204632

Cited by 20 publications

(12 citation statements)

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“…Being physically inactive and overweight were risk factors of lower serum 25(OH)D level in the US, but not in China. Several studies reported the positive association between physical activity and serum 25(OH)D level 37,38 . Physical activity increases sun exposure, and prevents loss of muscle strength and mass, which are the essential determinants of serum 25(OH)D level 38 .…”

Section: Discussionmentioning

confidence: 99%

“…Physical activity increases sun exposure, and prevents loss of muscle strength and mass, which are the essential determinants of serum 25(OH)D level 38 . However, evidence found that vitamin D insufficiency was still common among people who were highly physically active in Germany 37 . This probably partly contributes to the difference between China and the US.…”

Section: Discussionmentioning

confidence: 99%

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A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States

Wei

Zhu

2019

Sci Rep

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Vitamin D deficiency is a common health concern worldwide. We aim to compare the prevalence of vitamin D deficiency among older adults (65+) in China and the United States (US). We used data from the 2011 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in China (n = 2180), and 2011–2014 National Health and Nutrition Examination Survey (NHANES) in the US (n = 2283). Serum 25-hydroxyvitamin D [25(OH)D] was measured and a level of under 30/50 nmol/L was defined as vitamin D severe deficiency/deficiency. Risk factors of vitamin D deficiency were examined by multivariate regression models. We found that the mean 25(OH)D concentration was lower in China than in the US (45.1 vs. 83.5 nmol/L), with Chinese elderly lower than American elderly for every age group. 70.3% in China and 17.4% in the US were considered as vitamin D deficiency (30.6% and 3.4% were considered as severe deficiency). Older age, females, ethnic minorities, higher household income, self-rated “very bad” health, and never drinkers, were statistically significant in predicting lower serum 25(OH)D levels in China. In the US, males, ethnic minorities, lower income, self-rated “very bad” health, physically inactive, overweight, and obese were related to lower serum 25(OH)D levels. Our findings suggest that different interventional strategies are needed to improve vitamin D deficiency and its associated negative health outcomes in China and the US.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States

Wei

Zhu

2019

Sci Rep

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“…Time spent outdoors in summer as well in winter are positive predictors. Because of the low intensity of the sun in winter, we do not think that this is a direct effect, but that it might be a reflection of physical activity and general health as well [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of insufficient serum vitamin D status in older women: a validated model

et al. 2018

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SummaryWe developed an externally validated simple prediction model to predict serum 25(OH)D levels < 30, < 40, < 50 and 60 nmol/L in older women with risk factors for fractures. The benefit of the model reduces when a higher 25(OH)D threshold is chosen.IntroductionVitamin D deficiency is associated with increased fracture risk in older persons. General supplementation of all older women with vitamin D could cause medicalization and costs. We developed a clinical model to identify insufficient serum 25-hydroxyvitamin D (25(OH)D) status in older women at risk for fractures.MethodsIn a sample of 2689 women ≥ 65 years selected from general practices, with at least one risk factor for fractures, a questionnaire was administered and serum 25(OH)D was measured. Multivariable logistic regression models with backward selection were developed to select predictors for insufficient serum 25(OH)D status, using separate thresholds 30, 40, 50 and 60 nmol/L. Internal and external model validations were performed.ResultsPredictors in the models were as follows: age, BMI, vitamin D supplementation, multivitamin supplementation, calcium supplementation, daily use of margarine, fatty fish ≥ 2×/week, ≥ 1 hours/day outdoors in summer, season of blood sampling, the use of a walking aid and smoking. The AUC was 0.77 for the model using a 30 nmol/L threshold and decreased in the models with higher thresholds to 0.72 for 60 nmol/L. We demonstrate that the model can help to distinguish patients with or without insufficient serum 25(OH)D levels at thresholds of 30 and 40 nmol/L, but not when a threshold of 50 nmol/L is demanded.ConclusionsThis externally validated model can predict the presence of vitamin D insufficiency in women at risk for fractures. The potential clinical benefit of this tool is highly dependent of the chosen 25(OH)D threshold and decreases when a higher threshold is used.

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“…For example, lower amounts of physical activity are associated with both lower 25(OH)D[12, 26] and lower HDL-C.[27] Although we adjusted for physical activity in our analyses, this may not have fully accounted for the interaction between activity, 25(OH)D, and HDL-C. Few studies have thoroughly examined the relationship between 25(OH)D and HDL-C and our study adds to the literature by showing that further work needs to be done to investigate the potentially clinically meaningful impact of this association.…”

Section: Discussionmentioning

confidence: 99%

Serum vitamin D and change in lipid levels over 5 y: The Atherosclerosis Risk in Communities study

et al. 2017

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Background 25-hydroxyvitamin D [25(OH)D] deficiency is associated with increased cardiovascular disease risk, perhaps mediated through dyslipidemia. Deficient 25(OH)D is cross-sectionally associated with dyslipidemia, but little is known about longitudinal lipid changes. Our objective was to determine the association of 25(OH)D deficiency with longitudinal lipid changes and risk of incident dyslipidemia. Research Methods This is a longitudinal community-based study of 13,039 ARIC participants who had 25(OH)D and lipids measured at baseline (1990–1992) and lipids re-measured in 1993–1994 and 1996–1998. Mixed-effect models were used to assess associations of 25(OH)D with lipid trends after adjusting for clinical characteristics and for baseline or incident use of lipid-lowering therapy. Risk of incident dyslipidemia was determined for those without baseline dyslipidemia. Results Baseline mean±SD age was 57±6 years and 25(OH)D was 24±9 ng/ml. Participants were 57% women, 24% black. Over a mean follow-up of 5.2 years, the fully-adjusted average differences (95% CI) comparing deficient (<20 ng/ml) to optimal (≥30 ng/ml) 25(OH)D were: total cholesterol (TC) −2.40 mg/dl (−4.21, −0.60), HDL-cholesterol -3.02 mg/dl (−3.73, −2.32) and TC/HDL-C ratio 0.18 (0.11, 0.26). Those with deficient 25(OH)D compared to optimal had modestly increased risk of incident dyslipidemia in demographic-adjusted models [RR 1.19 (1.02–1.39)], which was attenuated in fully-adjusted models [1.12 (0.95–1.32)]. Conclusions Deficient 25(OH)D was prospectively associated with lower TC and HDL-C and greater TC/HDL-C ratio after considering factors such as diabetes and adiposity. Further work including randomized controlled trials is needed to better assess how 25(OH)D may impact lipids and cardiovascular risk.

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Objectively measured physical activity and vitamin D status in older people from Germany

Abstract: Although a positive dose-response relationship was seen between walking duration and the 25(OH)D serum level for most seasons, vitamin D insufficiency was still very prevalent even in high-active persons during all seasons.

Cited by 20 publications

References 20 publications

A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States

A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States

Prediction of insufficient serum vitamin D status in older women: a validated model

Serum vitamin D and change in lipid levels over 5 y: The Atherosclerosis Risk in Communities study

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