First EU-wide data offers ‘firm evidence’ of vitamin D deficiency

An estimated 13% of the EU population are vitamin D deficient, an EU-funded project providing the first internationally comparable data has found.

The data comes as part of the four-year EU-funded ODIN project, which began in late 2013 and consists of a multi-disciplinary team of 31 partners from 19 countries.

The team says these calculations are the first “firm evidence” of the significant risk vitamin D deficiency poses to public health.

“Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality,” they wrote in the American Journal of Clinical Nutrition.

A lack of vitamin D can lead to bone deformities such as rickets in children and osteomalacia in adults.

Scale of the problem

Irrespective of age and ethnicity, the study found 13% of the 55,844 European individuals included had average serum vitamin D levels of less than 30 nanomole (nmol) per litre throughout the year.

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© iStock.com / santol

In October to March this rose to 17.7% and fell in April to November to 8.3%.

In dark-skinned ethnic subgroups the prevalence of levels lower than 30 nmol/L was between three and 71 times higher than white populations depending on the country.

If an alternative definition of deficiency of less than 50 nmol/L was used, the overall prevalence rose to 40.4%.

Public health strategies

Strategies on vitamin D deficiency have been discussed in several EU countries in recent years.

This year Sweden expanded its list of foods subject to mandatory fortification to help tackle the problem largely due to low sunlight levels in the region.

Meanwhile an increase in cases of rickets in the UK has highlighted the need for similar initiatives on a mandatory or voluntary basis.

“Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective,” the paper concluded.

“What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.”

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© iStock.com / luchschen (Photographer:Wladimir Bulgar)

Vitamin D is linked to several important functions in the body including the regulation of calcium and phosphate in the body, key nutrients for healthy bones and teeth.

A solid platform

According to a 2014 British Nutrition Foundation (BNF) paper“In 1975 there were about 250 peer-reviewed papers published with the term ‘vitamin D’ in the paper title or its abstract but 30 years later, in 2007, this number had risen to around 1600 papers, and to 3774 in 2013.” 

Yet previous vitamin D reports on vitamin D statuses in Europe have varied in methods and therefore results.

This latest report used the Vitamin D Standardisation Program (VDSP) protocol, which the researchers said provided a solid platform upon which to build public health policy” in Europe.

This protocol was used to reanalyse subsets of serum 25(OH)D in 11 population studies and complete analysis of all samples from three population studies using liquid chromatography–tandem mass spectrometry of biobanked blood samples.

This was combined with already standardised data from four other studies, providing data on a total of 55,844 individuals.

Source: American Journal of Clinical Nutrition

Published online ahead of print, doi: 10.3945/ajcn.115.120873

“Vitamin D deficiency in Europe: pandemic?”

Authors: K. D. Cashman et al.