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Special Issue "Vitamin D and Public Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 30 November 2018

Special Issue Editors

Guest Editor
Prof. Peter Ebeling

Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia
Website | E-Mail
Interests: musculoskeletal; osteoporosis; bone; mineral; vitamin D; endocrine; endocrinology
Guest Editor
Dr. David Scott

Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia
Website | E-Mail
Interests: falls prevention; fractures; sarcopenia; physical activity; vitamin D; ageing; body composition

Special Issue Information

Dear Colleagues,

Vitamin D deficiency is a global public health issue. Long recognised as having an important role in bone metabolism, higher vitamin D levels have also been associated with improved immune function, muscle, reproductive and cardiometabolic health, as well as reduced risk of cancer and neurodegenerative diseases, including multiple sclerosis. Vitamin D is primarily obtained through ultraviolet-B light exposure from the sun and achieving adequate vitamin D levels is particularly challenging in specific populations including those with low sun exposure and/or darker skin, and older adults. Vitamin D supplementation is generally recommended for those with, or at increased risk of, vitamin D deficiency. To date there is limited evidence from randomised controlled trials that vitamin D supplementation is beneficial for non-skeletal health, but vitamin D screening and prescription are commonplace in the clinical setting. This Special Issue will focus of the role of vitamin D in public health and address current controversies including, but not limited to, associations of vitamin D metabolites with health outcomes, optimal target levels and response to supplemental doses of vitamin D, food fortification and vitamin D, negative outcomes of high-dose vitamin D supplementation, and health economics of vitamin D testing and supplementation.

Prof. Peter Ebeling
Dr. David Scott
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vitamin D
  • 25-hydroxyvitamin D
  • cholecalciferol
  • public health
  • disease
  • screening
  • supplementation
  • health economics

Published Papers (8 papers)

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Research

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Open AccessArticle Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia
Int. J. Environ. Res. Public Health 2018, 15(11), 2503; https://doi.org/10.3390/ijerph15112503
Received: 30 September 2018 / Revised: 2 November 2018 / Accepted: 6 November 2018 / Published: 8 November 2018
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Abstract
Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time
[...] Read more.
Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5–6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6–7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50–75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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Open AccessArticle Knowledge, Attitudes and Perceptions towards Vitamin D in a UK Adult Population: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2018, 15(11), 2387; https://doi.org/10.3390/ijerph15112387
Received: 7 September 2018 / Revised: 23 October 2018 / Accepted: 24 October 2018 / Published: 27 October 2018
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Abstract
The prevalence of vitamin D deficiency in the United Kingdom is high, despite updated Scientific Advisory Committee on Nutrition (SACN) guidelines. Therefore, our aims were to identify population knowledge, attitudes and perceptions of vitamin D supplementation and factors contributing to supplement use in
[...] Read more.
The prevalence of vitamin D deficiency in the United Kingdom is high, despite updated Scientific Advisory Committee on Nutrition (SACN) guidelines. Therefore, our aims were to identify population knowledge, attitudes and perceptions of vitamin D supplementation and factors contributing to supplement use in a UK adult population. A cross-sectional study was performed between April–June 2018 using a newly designed piloted questionnaire. Scores for knowledge were calculated as a percentage (Boland et al. 2015). Logistic regression analysis was used to predict supplement use. 209 participants (82% female), mean (±SD) age 34.9 (±12.3) completed the questionnaire. The mean (±SD) vitamin D knowledge score was 56.6% (±19.9%); only 48% were concerned about their vitamin D concentration and 57% did not take vitamin D. Most participants (86%) wished to learn more about vitamin D. Knowledge score (OR 2.5; p = 0.01; 95% CI 1.2–5.3), concern (OR 2.1; p = 0.03; 95% CI 1.0–4.2) and location (OR 0.3; p = 0.006; 95% CI 0.1–0.7) predicted supplemented use. Individuals living in England had 2.9 (95% CI 1.4–6.3) lower odds of taking vitamin D than those living in Scotland. As a result of these findings, this study suggests that vitamin D supplementation and fortification, alongside education strategies, may be an effective method for improving UK vitamin D health; however, more research is warranted. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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Open AccessArticle Vitamin D Supplementation and Nordic Walking Training Decreases Serum Homocysteine and Ferritin in Elderly Women
Int. J. Environ. Res. Public Health 2018, 15(10), 2064; https://doi.org/10.3390/ijerph15102064
Received: 7 August 2018 / Revised: 15 September 2018 / Accepted: 17 September 2018 / Published: 20 September 2018
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Abstract
The aim of the study was to verify if coupling 12 weeks of vitamin D supplementation and Nordic walking training favoured lowering the homocysteine (Hcy) level. Ninety-four elderly women were divided into three groups: Nordic walking (NW), supplemented (SG) and control (CG). The
[...] Read more.
The aim of the study was to verify if coupling 12 weeks of vitamin D supplementation and Nordic walking training favoured lowering the homocysteine (Hcy) level. Ninety-four elderly women were divided into three groups: Nordic walking (NW), supplemented (SG) and control (CG). The NW and SG groups received a weekly dose of 28,000 IU of vitamin D3. A blood analysis was performed at baseline, 1h after the first training session and at the end of the experiment. The amino acid profile (methionine and cysteine) and homocysteine concentration were determined. Additionally, the concentration of myokine was assessed. The first session of NW training reduced serum homocysteine, particularly among women with baseline homocysteine above 10 µmol·L−1: 12.37 ± 2.75 vs. 10.95 ± 3.94 µmol·L−1 (p = 0.05). These changes were accompanied by shifts in the cysteine (p = 0.09) and methionine (p = 0.01) concentration, regardless of the Hcy concentration. Twelve weeks of training significantly decreased the homocysteine (9.91 ± 2.78, vs. 8.90 ± 3.14 µmol·L−1, p = 0.05) and ferritin (94.23 ± 62.49 vs. 73.15 ± 47.04 ng·mL−1, p = 0.05) concentrations in whole NW group. Also, in the NW group, ferritin correlated with the glucose level (r = 0.51, p = 0.00). No changes in the myokine levels were observed after the intervention. Only the brain-derived neurotrophic factor dropped in the NW (42.74 ± 19.92 vs. 31.93 ± 15.91 ng·mL−1, p = 0.01) and SG (37.75 ± 8.08 vs. 16.94 ± 12.78 ng·mL−1, p = 0.00) groups. This study presents a parallel decrease of homocysteine and ferritin in response to regular training supported by vitamin D supplementation. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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Open AccessArticle Vitamin D3 Supplementation Reduces the Symptoms of Upper Respiratory Tract Infection during Winter Training in Vitamin D-Insufficient Taekwondo Athletes: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2018, 15(9), 2003; https://doi.org/10.3390/ijerph15092003
Received: 2 August 2018 / Revised: 8 September 2018 / Accepted: 10 September 2018 / Published: 14 September 2018
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Abstract
Vitamin D insufficiency may be associated with increased risk of upper respiratory tract infection (URTI) in athletes. This study examined the effects of vitamin D3 supplementation on salivary immune functions and symptoms of URTI in vitamin D-insufficient taekwondo athletes. Twenty-five male taekwondo
[...] Read more.
Vitamin D insufficiency may be associated with increased risk of upper respiratory tract infection (URTI) in athletes. This study examined the effects of vitamin D3 supplementation on salivary immune functions and symptoms of URTI in vitamin D-insufficient taekwondo athletes. Twenty-five male taekwondo athletes, aged 19–22 years with vitamin D insufficiency [serum 25-hydroxyvitamin-D concentrations (25(OH)D, 31.3 ± 1.39 nmol/L)], participated in this study. They were randomized to receive 5000 IU/day of vitamin D3 (n = 13) or placebo capsule (n = 12) during 4 weeks of winter training. Blood samples were collected two times (pre- and post-tests) for analyzing serum 25(OH)D concentration while salivary samples were obtained three times (pre-, mid-, and post-tests) for secretory immunoglobulin A (SIgA) and lactoferrin analyses. The symptoms of URTI were reported daily during the intervention. Serum 25(OH)D concentration significantly increased by 255.6% in the vitamin D group, whereas in the placebo group it did not change (p < 0.001). While the significant increase in SIgA was observed in both groups (p < 0.001), elevated salivary lactoferrin level in response to winter training was found only in the placebo group (p = 0.011). The change in serum 25(OH)D concentration was negatively associated with total URTI symptoms (r = −0.435, p = 0.015). Vitamin D3 supplementation may be effective in reducing the symptoms of URTI during winter training in vitamin D-insufficient taekwondo athletes. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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Open AccessArticle The State of Knowledge about Nutrition Sources of Vitamin D, Its Role in the Human Body, and Necessity of Supplementation among Parents in Central Poland
Int. J. Environ. Res. Public Health 2018, 15(7), 1489; https://doi.org/10.3390/ijerph15071489
Received: 2 July 2018 / Revised: 9 July 2018 / Accepted: 11 July 2018 / Published: 14 July 2018
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Abstract
The percentage of children with vitamin D deficiency in Poland is alarming. The aim of the study was to assess the knowledge about sources of food and the function of vitamin D, as well as the frequency of its supplementation. A survey was
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The percentage of children with vitamin D deficiency in Poland is alarming. The aim of the study was to assess the knowledge about sources of food and the function of vitamin D, as well as the frequency of its supplementation. A survey was conducted among the parents of children from Central Poland attending primary schools, and a questionnaire containing mainly open-ended questions was used to collect the data. Most mothers knew at least one of the functions of vitamin D in the body but had a low level of knowledge about its dietary sources. Only a small group of respondents supplemented themselves and their children with vitamin D. Statistically significant influences on the level of knowledge about the functions and sources of vitamin D were place of residence (i.e., better knowledge in the countryside) and mothers’ level of education (i.e., the better educated, the greater knowledge). In the case of monthly income level, such impact was observed only in relation to the knowledge of vitamin D functions. Concerning the frequency of supplementation, only maternal level of education had a statistically significant effect (i.e., the higher the education level, the higher the frequency of supplementation). In addition, mothers who were aware of functions of vitamin D and nutritional sources, significantly more frequently supplemented vitamin D. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)

Review

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Open AccessReview Summary Outcomes of the ODIN Project on Food Fortification for Vitamin D Deficiency Prevention
Int. J. Environ. Res. Public Health 2018, 15(11), 2342; https://doi.org/10.3390/ijerph15112342
Received: 7 September 2018 / Revised: 19 October 2018 / Accepted: 19 October 2018 / Published: 24 October 2018
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Abstract
Food-based solutions for optimal vitamin D nutrition and health through the life cycle (ODIN) was a cross-disciplinary, collaborative project, including 30 partners from 19 countries, which aimed to develop evidence-based solutions to prevent low vitamin D status (25-hydroxyvitamin D (25(OH)D) < 30 nmol/L)
[...] Read more.
Food-based solutions for optimal vitamin D nutrition and health through the life cycle (ODIN) was a cross-disciplinary, collaborative project, including 30 partners from 19 countries, which aimed to develop evidence-based solutions to prevent low vitamin D status (25-hydroxyvitamin D (25(OH)D) < 30 nmol/L) using a food-first approach. This paper provides a summary overview of some of the important ODIN outcomes and outlines some outstanding data requirements. In a study of almost 56,000 individuals, the first internationally standardised dataset of vitamin D status showed that 13% of EU residents overall, across a latitude gradient of 35° N to 69° N, had serum 25(OH)D < 30 nmol/L and 40% were < 50 nmol/L. The risk of low vitamin D status was several-fold higher among persons of ethnic minority. However, additional data from quality bio-banked sera would be required to improve these estimates. To address the question of dietary requirements for vitamin D among under-researched life-stage and population groups, four dose-response RCTs conducted in Northern Europe showed that vitamin D3 intakes of 8 and 13 μg/day prevented 25(OH)D decreasing below 30 nmol/L in white children and adolescents and 20 and 30 μg/day, respectively, achieved ≥50 nmol/L. Among white women during pregnancy, 30 μg/day is required to prevent umbilical cord 25(OH)D, representing new-born vitamin D status, below 25 nmol/L. While 8 μg/day protected white women in Finland at the 30 nmol/L cut-off, 18 μg/day was needed by women of East African descent to prevent 25(OH)D decreasing below 30 nmol/L during wintertime. Replicate RCTs are needed in young children <5 years and in school-age children, teens and pregnant women of ethnic minority. Using a series of food production studies, food-based RCTs and dietary modelling experiments, ODIN research shows that diverse fortification strategies could safely increase population intakes and prevent low vitamin D status. Building on this solid technological platform, implementation research is now warranted to scale up interventions in real-world settings to eradicate vitamin D deficiency. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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Open AccessReview The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data
Int. J. Environ. Res. Public Health 2018, 15(10), 2241; https://doi.org/10.3390/ijerph15102241
Received: 5 September 2018 / Revised: 29 September 2018 / Accepted: 29 September 2018 / Published: 12 October 2018
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Abstract
Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D
[...] Read more.
Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
Open AccessReview Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies
Int. J. Environ. Res. Public Health 2018, 15(8), 1773; https://doi.org/10.3390/ijerph15081773
Received: 18 July 2018 / Revised: 14 August 2018 / Accepted: 16 August 2018 / Published: 17 August 2018
Cited by 1 | PDF Full-text (1304 KB) | HTML Full-text | XML Full-text
Abstract
Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a
[...] Read more.
Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a second hydroxylation reaction to generate the biologically active metabolite 1,25(OH)2-VD. Extrarenal 1α-hydroxylation has also been described to have an important role in autocrine and paracrine signaling. Vitamin D deficiency (VDD) has been in the spotlight as a major public healthcare issue with an estimated prevalence of more than a billion people worldwide. Among individuals with chronic kidney disease (CKD), VDD prevalence has been reported to be as high as 80%. Classically, VD plays a pivotal role in calcium and phosphorus homeostasis. Nevertheless, there is a growing body of evidence supporting the importance of VD in many vital non-skeletal biological processes such as endothelial function, renin-angiotensin-aldosterone system modulation, redox balance and innate and adaptive immunity. In individuals with CKD, VDD has been associated with albuminuria, faster progression of kidney disease and increased all-cause mortality. Recent guidelines support VD supplementation in CKD based on extrapolation from cohorts conducted in the general population. In this review, we discuss new insights on the multifactorial pathophysiology of VDD in CKD as well as how it may negatively modulate different organs and systems. We also critically review the latest evidence and controversies of VD monitoring and supplementation in CKD patients. Full article
(This article belongs to the Special Issue Vitamin D and Public Health)
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