Introduction
Methods
Results
Prevalence
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean±SD a
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Madar et al. [39] | Norway, Oslo (60° N), all year round | Turkish F, mean 27 years (n = 25) | 26 ± 14, 56% < 25 | No daily use of vitamin D supplementation, education <10 years |
Holvik et al. [33] | Norway, Oslo (60° N), in spring | Turkish M, mean 39 years for all men (n = 87) | median 33, 23% < 25 | Female gender, younger age, April/May blood sample (compared to June), lower use of cod liver oil supplements, lower intake of fatty fish; in females: higher BMI, shorter educational length |
Turkish F, mean 37 years for all women (n = 101) | median 26, 46% < 25 | |||
Van der Meer et al. [1] | The Netherlands, Amsterdam, The Hague, Amersfoort, and Haarlem (52° N), all year round | Dutch M (40%)+F, median 45 years (n = 102) | median 67, 06% < 25 | Autumn or winter season, pregnant or breastfeeding, lower consumption of fatty fish, no use of vitamin D supplements, smaller area of uncovered skin, no use of tanning bed, lower consumption of margarine, no preference for sun |
Turkish M (41%)+F, median 35 years (n = 121) | median 27, 41% < 25 | |||
Grootjans-Geerts and Wielders [25] | The Netherlands, Amersfoort, end of winter | Dutch F, mean 44 years (n = 32) | 28% < 30 | – |
Turkish veiled F, mean 30 years (n = 51) | 90% < 30 | |||
Erkal et al. [2] | Germany, Giessen (50° N), end of winter | German M (50%)+F, 19–63 years (n = 101) | 29% < 50 | Female gender, veiling, having three or more children, living at higher latitude, higher BMI |
Turkish M, 18–69 years (n = 270) | Median 40 | |||
Turkish F, 16–67 years (n = 296) | Median 31 | |||
Moreno-Reyes et al. [3] | Belgium, Brussels, all year round. | Belgian M (50%)+F, mean 52 years (n = 100) | 49 ± 22, 13% < 25 | Winter season, male gender |
Turkish M (50%)+F, mean 49 years, first-generation immigrants (n = 101) | 31 ± 20, 53% < 25 | |||
Pregnant women | ||||
Van der Meer et al. [26] | The Netherlands, The Hague (52° N), at the first antenatal visit (12th week), all year round | Western, mean 30 years (n = 105) | 53 ± 22, 08% < 25 | – |
Turkish, mean 24 years (n = 79) | 15 ± 12, 84% < 25 | |||
Children | ||||
Madar et al. [39] | Norway, Oslo (60° N), all year round | Turkish M+F, mean 7 weeks (n = 25) | 37 ± 38, 56% < 25 | Exclusively breastfed infants (no supplements) |
Meulmeester et al. [27] | The Netherlands, The Hague, or Rotterdam, at the end of winter or the end of spring | Caucasian M (50%)+F, 8 years, The Hague, end of winter (n = 39) | 57 ± 16 | End of winter measurement, lower cumulative global sun radiation |
Turkish M (50%)+F, 8 years, The Hague, end of winter (n = 40) | 23 ± 10 | |||
Caucasian M (50%)+F, 8 years, Rotterdam, end of spring (n = 40) | 73 ± 14 | |||
Turkish M (50%)+F, 8 years, Rotterdam, end of spring (n = 40) | 37 ± 13 |
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean±SD a
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Erkal et al. [2] | Turkey, Mersin (36° N), Ankara (40° N), Istanbul and Unye (42° N), end of winter | Turkish M, 21–66 years (n = 85) | Median 47 | Female gender, veiling, having three or more children, living at higher latitude, higher BMI |
Turkish F, 17–69 years (n = 242) | Median 36 | |||
Guzel et al. [16] | Turkey (37º N), end of summer | Turkish F, mean 25 years, veiled (n = 30) | 83 ± 40 | Veiling, lower exposure to sunlight, longer duration of being veiled |
Turkish F, mean 25 years, unveiled (n = 30) | 135 ± 68 | |||
Alagol et al. [13] | Turkey, Istanbul (41° N), in summer | Turkish F, mean 24 years, dressed with usual areas exposed to the sun (n = 18) | 56 ± 41 | Covering clothes/veiling |
Turkish F, mean 28 years, traditional clothing, hands and face uncovered (n = 15) | 32 ± 24 | |||
Turkish F, mean 26 years, traditional clothing, covering whole body including hands and face (n = 15) | 10 ± 06 | |||
Atli et al. [15] | Turkey, Ankara (40° N), at the end of summer | Turkish M, mean 73 years, own home (n = 24) | 158 ± 108 | Female gender, living in old age home, older age, lower benefit from ultraviolet index (ratio of points for sunlight exposure and covering clothes) |
Turkish F, mean 72 years, own home (n = 171) | 103 ± 98 | |||
Turkish M, mean 76 years, old age home (n = 87) | 94 ± 72 | |||
Turkish F, mean 75 years, old age home (n = 138) | 62 ± 74 | |||
Pregnant women | ||||
Pehlivan et al. [14] | Turkey, Last trimester | Turkish, total group (n = 78) | 18 ± 10, 80% < 25 | Low educational level, insufficient intake of vitamin D within diet, “covered” dressing habits |
Turkish, with covered head and hands, not the face (n = 4) | 10 ± 05 | |||
Turkish, with covered head, not the hands or face (n = 49) | 17 ± 10 | |||
Turkish, with no cover on head, hands or face (n = 25) | 20 ± 10 | |||
Children | ||||
Olmez et al. [34] | Turkey, Izmir, end of summer or end of winter | Turkish F, 14–18 years, low socioeconomic status, end of summer (n = 32) | 52 ± 23 | End of winter measurement, low socioeconomic status |
Turkish F, 14–18 years, high socioeconomic status, end of summer (n = 32) | 65 ± 29 | |||
Turkish F, 14–18 years, low socioeconomic status, end of winter (n = 30) | 34 ± 16 | |||
Turkish F, 14–18 years, high socioeconomic status, end of winter (n = 30) | 59 ± 24 |
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean±SDa
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Van der Meer et al. [1] | The Netherlands, Amsterdam, The Hague, Amersfoort, and Haarlem (52° N) | Dutch M (40%)+F, median 45 years (n = 102) | Median 67, 06% < 25 | Autumn or winter season, pregnant or breastfeeding, lower consumption of fatty fish, no use of vitamin D supplements, smaller area of uncovered skin, no use of tanning bed, lower consumption of margarine, no preference for sun |
Moroccan M (41%)+F, median 38 years (n = 96) | ||||
Median 30, 37% < 25 | ||||
Moreno-Reyes et al. [3] | Belgium, Brussels, all year round | Belgian M (50%)+F, mean 52 years (n = 100) | 49 ± 22, 13% < 25 | Winter season, male gender |
Moroccan M (50%)+F, mean 49 years, first-generation immigrants (n = 100) | 27 ± 17, 54% < 25 | |||
Pregnant women | ||||
Van der Meer et al. [26] | The Netherlands, The Hague (52° N), at the first antenatal visit (12th week) | Western, mean 30 years (n = 105) | 53 ± 22, 08% < 25 | – |
Moroccan, mean 26 years (n = 69) | 20 ± 14, 81% < 25 | |||
Children | ||||
Meulmeester et al. [27] | The Netherlands, The Hague or Rotterdam, at the end of winter or the end of spring | Caucasian M (50%)+F, 8 years, The Hague, end of winter (n = 39) | 57 ± 16 | End of winter measurement, lower cumulative global sun radiation |
Moroccan M (50%)+F, 8 years, The Hague, end of winter (n = 38) | 30 ± 14 | |||
Caucasian M (50%)+F, 8 years, Rotterdam, end of spring (n = 40) | 73 ± 14 | |||
Moroccan M (50%)+F, 8 years, Rotterdam, end of spring (n = 42) | 38 ± 14 |
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean±SD a
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Allali et al. [17] | Morocco, Rabat, in the end of winter | Moroccan F, mean 50 years, total group (n = 415) | 45 ± 20 | Age > 55 years, calcium intake < 700 mg/d, wearing a veil, sunlight exposure < 30 min/day |
Moroccan F, mean 43 years, premenopausal (n = 108) | 47 ± 19 | |||
Moroccan F, mean 56 years, postmenopausal (n = 307) | 44 ± 20 |
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean±SD a
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Brooke-Wavell et al. [28] | United Kingdom | White European F, mean 59 years (n = 23) | 76 ± 18 | – |
South Asian F, mean 59 years (Bangladeshi, Indian n = 24) | 33 ± 13 | |||
Ward et al. [29] | United Kingdom, Manchester | White Caucasian European F, mean 30 years (n = 96) | 67 ± 34 | – |
Pakistani muslim or Gujarati Hindu F, mean 29 years (n = 95) | 20 ± 12 | |||
Ford et al. [4] | United Kingdom, Birmingham, end of summer. | Caucasian M+F, mean 59 years (1–92 years; n = 317) | 58 ± 31, 12% < 25 | In the Asian group: female gender |
Asian M+F, mean 47 years (2–87years) (n = 251) | 36 ± 26, 31% < 25 | |||
Hamson et al. [30] | United Kingdom, Leicester | White M, 33 years (n = 37) | 3% < 12.5 | – |
White F, 32 years (n = 51) | 0% < 12.5 | |||
Gujarati M, 34 years (Gujarat region India; n = 42) | 60% < 12.5 | |||
Gujarati F, 34 years (Gujarat region India; n = 71) | 51% < 12.5 | |||
Solanki et al. [31] | United Kingdom, Birmingham, end of winter. | White M, <65 years, mean 30 years men and women (n = 4) | 28 ± 12 | – |
White F, <65 years, mean 30 years men and women (n = 12) | 48 ± 29 | |||
White M, >65 years, mean 74 years men and women (n = 4) | 55 ± 14 | |||
White F, >65 years, mean 74 years men and women (n = 14) | 40 ± 21 | |||
Asian M, <65 years, mean 31 years men and women (n = 14) | 16 ± 08 | |||
Asian F, <65 years, mean 31 years men and women (n = 3) | 21 ± 07 | |||
Asian M, >65 years, mean 72 years men and women (n = 21) | 13 ± 09 | |||
Asian F, >65 years, mean 72 years men and women (n = 16) | 23 ± 20 | |||
Finch et al. [32] | United Kingdom, London, all year round. | White M (50%)+F, mean 39 years, winter (n = 30) | 39 ± 18 | Winter season (March/April), vegetarian, Hindu religion, Muslim religion (only in winter); Hindus seasonal responses are blunted, resulting in significantly lower peak values than for whites or non-vegetarian (Muslim) Asians |
White M (50%)+F, mean 39 years, summer (n = 18) | 65 ± 27 | |||
Asian M (70%)+F, mean 42 years, non-vegetarians, winter (n = 116) | 19 ± 13 | |||
Asian M (70%)+F, mean 42 years, non-vegetarians, summer (n = 22) | 45 ± 24 | |||
Asian M (40%)+F, mean 42 years, vegetarians, winter (n = 29) | 10 ± 8 | |||
Asian M (40%)+F, mean 42 years, vegetarians, summer (n = 16) | 27 ± 21 | |||
Van der Meer et al. [1] | The Netherlands, Amsterdam, The Hague, Amersfoort and Haarlem (52°N) | Dutch M (40%)+F, median 45 years (n = 102) | Median 67, 06% < 25 | Autumn or winter season, pregnant or breastfeeding, lower consumption of fatty fish, no use of vitamin D supplements, smaller area of uncovered skin, no use of tanning bed, lower consumption of margarine, no preference for sun |
Surinam South Asian M (37%)+F, median 41 years (n = 107) | Median 24, 51% < 25 | |||
Pregnant women | ||||
Datta et al. [63] | United Kingdom, Cardiff (51.5°N), at booking visit | Indian subcontinent (n = 100) | 52% < 20 | Being in Britain for more than 3 years (compared to less than 3 years and to being born in Britain) |
Children | ||||
Lawson and Thomas [40] | UK, autumn | Bangladeshi M+F, 2 years (n = 139) | 42 ± 21, 20% < 25 | Failure to take a vitamin supplement. |
Pakistani M+F, 2 years (n = 200) | 36 ± 20, 34% < 25 | |||
Indian M+F, 2 years (n = 279) | 42 ± 23, 25% < 25 | |||
Koch and Burmeister [64] | Germany, in summer | Asian M (33%)+F, 3–17 years (Birma, Sri Lanka, India; n = 9) | 28 ± 09, 44% < 25 | – |
Study | Study characteristics | Study population | Serum 25(OH)D (nmol/l) Mean ± SD a
| Determinants for lower serum 25(OH)D |
---|---|---|---|---|
Adults | ||||
Goswami et al. [19] | India, Delhi, in winter | Adult M, mean 31 years (n = 244) | 18 ± 9 | – |
Adult F, mean 35 years (n = 398) | 17 ± 11 | |||
Goswami et al. [41] | India, Agota village (29° N), in winter | Adult M, rural, mean 43 years (n = 32) | 44 ± 24 | Female gender |
Adult F, rural, mean 43 years (n = 25) | 27 ± 16 | |||
Harinarayan et al. [20] | India, Tirupati (13° N) | Adult M, urban, mean 46 years for urban M+F (n = 134) | 46 ± 22 | Urban subject |
Adult M, urban, mean 43 years for urban M+F (n = 109) | 59 ± 20 | |||
Adult F, urban, mean 46 years for urban M+F (n = 807) | 39 ± 20 | |||
Adult F, rural, mean 43 years for rural M+F (n = 96) | 48 ± 22 | |||
Zargar et al. [35] | India, Kashmir valley, all year round | Indian M, mean 29 years (n = 64) | 38 ± 30, 41% < 25 | Lower exposure to sunlight, female gender |
Indian F, mean 27 years (n = 28) | 14 ± 11, 96% < 25 | |||
Gulvady et al. [44] | India, Mumbai | Indian M, 40–68 years, senior executives (indoor workers; n = 86) | 28% < 19 | Earlier start of the workday |
Vupputuri et al. [43] | India, Delhi (28° N) | Asian Indian M, mean 43 years (for both men and women), urban, middle income, mostly working indoors (n = 51) | 27 ± 17 | – |
Asian Indian F, mean 43 years (for both men and women), urban, middle income, mostly housewives (n = 54) | 22 ± 12 | |||
Harinarayan [65] | India, Tirupati (13° N), all year round | Indian F, mean 54 years, postmenopausal (n = 164) | 37 ± 18, 30% < 25 | Higher dietary calcium intake, higher dietary phytate intake, higher phytate to calcium ratio |
Harinarayan et al. [21] | India, around Tirupati (13° N), winter to summer (Jan–Jul) | Indian, mean 44 years, rural (n = 191) | 53 ± 06, 03% < 25 | Urban subject, lower dietary calcium intake, higher phytate to calcium ratio |
Indian, mean 46 years, urban (n = 125) | 34 ± 07, 35% < 25 | |||
Goswami et al. [18] | India, Dehli (28° N), in winter or summer | Indian M, mean 25 years, soldiers, winter (n = 31) | 47 ± 12 | Less exposure to sunlight, more skin pigmentation, winter season |
Indian M (58%)+F, mean 23 years, physicians and nurses, winter (n = 19) | 08 ± 03 | |||
Indian M (67%)+F, mean 43 years, depigmented persons, winter (n = 15) | 18 ± 11 | |||
Indian M (58%)+F, mean 24 years, physicians and nurses, summer (n = 19) | 18 ± 08 | |||
Pregnant women | ||||
Sahu et al. [36] | India, Barabanki district, 32 km from Lucknow (27°), all year round | Indian, rural, mean 27 years (n = 139) | 38 ± 20, 32% < 25 | Lower summer sun exposure, measurement in winter |
Farrant et al. [66] | India, Mysore (South India) at the 30th week of pregnancy | Indian, mean 24 years (n = 559) | Median 38, 31% < 28 nmol/l | Taking calcium and vitamin D at recruitment, measurement in Mar–Aug |
Bhalala et al. [45] | Western India, at the 37th week of pregnancy, all year round | Indian, 20–35 years, middle income group (n = 42) | 57 ± 27 | Lower serum 25(OH)D in mother → lower serum 25(OH)D in cord blood |
Cord blood (n = 42) | 48 ± 24 | |||
Sachan et al. [46] | India, Lucknow (27° N), before labor, autumn | Indian, total group (n = 207) | 43% < 25 | – |
Indian, urban (n = 140) | 35 ± 24 | |||
Indian, rural (n = 67) | 35 ± 22 | |||
Goswami et al. [18] | India, Dehli (28° N), in summer | Indian, mean 23 years, poor socioeconomic class (n = 29) | 22 ± 11 | – |
Children | ||||
Sahu et al. [36] | India, Barabanki district, 32 km from Lucknow (27° N), all year round | Indian F, rural, mean 14 years, total group (n = 121) | 33 ± 16, 34% < 25 | Lower summer sun exposure, female gender, measurement in winter |
Indian M, mean 14 years, brothers of the 28 girls, in winter (n = 34) | 68 ± 29, 36% < 25 | |||
Indian F, mean 14 years, sisters of the 34 boys, in winter (n = 28) | 31 ± 14, 03% < 25 | |||
Puri et al. [37] | India, Dehli (28° N), in summer | Indian F, mean 12 years (6–18), lower socioeconomic strata (n = 193) | 35 ± 17, 31% < 25 | Higher BMI, lower sun exposure, smaller percentage of body surface area exposed |
Indian F, mean 12 years (6–18), upper socioeconomic strata (n = 211) | 29 ± 13, 39% < 25 | |||
Harinarayan et al. [20] | India, Tirupati (13° N) | Indian M, urban, mean 13 years for urban M+F (n = 30) | 39 ± 17 | – |
Indian M, rural, mean 13 years for rural M+F (n = 34) | 43 ± 22 | |||
Indian F, urban, mean 13 years for urban M+F (n = 39) | 46 ± 28 | |||
Indian F, rural, mean 13 years for rural M+F (n = 36) | 48 ± 23 | |||
Bhalala et al. [45] | Western India, all year round | Indian, 3 months, exclusively breast fed, from middle income mothers (n = 35) | 45 ± 24 | Lower serum 25(OH)D in mother |
Khadilkar et al. [67] | India, Pune (18° N), in winter | Post-menarchal F, mean 15 years (n = 50) | 70% < 30 | – |
India, Hyderabad, end of winter, summer (Mar and Jul) | Indian, M+F, 6–18 years, middle income, semi-urban (n = 328) | 26% < 25 | – | |
Marwaha et al. [42] | India, New Dehli (28° N) | Indian M, 10–18 years (n = 325) | 27% < 22.5 | Female gender, lower socioeconomic status |
Indian F, 10–18 years (n = 435) | 42% < 22.5 | |||
Indian M (39%)+F, 10–18 years, low socioeconomic group (n = 430) | 42% < 22.5 | |||
Indian M (48%)+F, 10–18 years, upper socioeconomic group (n = 330) | 27% < 22.5 | |||
Sachan et al. [46] | India, Lucknow (27° N), autumn | Indian neonates (cord blood, n = 207) | 21 ± 14 | Lower serum 25(OH)D in mother |
Tiwari and Puliyel [70] | India, Dehli, in winter or summer | 9–30 months, Sundernagari area, winter (n = 47) | 96 ± 26 | – |
9–30 months, Rajiv Colony area, winter (n = 49) | 24 ± 27 | |||
9–30 months, Rajiv Colony area, summer (n = 48) | 18 ± 22 | |||
9–30 months, Gurgaon area, summer (n = 52) | 19 ± 20 | |||
Agarwal et al. [38] | India, Dehli (28° N), end of winter | Mean 16 months (9–24), Mori Gate area (high pollution; n = 26) | 31 ± 18 | Atmospheric pollution |
Mean 16 months (9–24), Gurgaon area (low pollution; n = 31) | 68 ± 18 | |||
Goswami et al. [18] | India, Dehli (28° N), in summer | Indian M (55%)+F, newborns from mothers from poor socioeconomic class (n = 29) Cord blood | 17 ± 05 | Lower serum 25(OH)D in mother |