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Vitamin D deficiency in Europe: pandemic? 2016
Kevin D Cashman, and
Kirsten G Dowling, and
Zuzana Škrabáková, and
Marcela Gonzalez-Gross, and
Jara Valtueña, and
Stefaan De Henauw, and
Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, and k.cashman@ucc.ie.
BACKGROUND 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. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. OBJECTIVE This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe. METHODS The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. RESULTS An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. CONCLUSIONS Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. 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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Kirsten G Dowling, and
Zuzana Škrabáková, and
Marcela Gonzalez-Gross, and
Jara Valtueña, and
Stefaan De Henauw, and
Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
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Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
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Gudny Eiriksdottir, and
Vilmundur Gudnason, and
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Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
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Gail Goldberg, and
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Jacqueline M Dekker, and
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Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
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Christopher T Sempos, and
Mairead Kiely
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Gail Goldberg, and
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Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
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Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
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Karin M Swart, and
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Gudny Eiriksdottir, and
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Marcela Gonzalez-Gross, and
Jara Valtueña, and
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Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
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Gert Bm Mensink, and
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Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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Kirsten G Dowling, and
Zuzana Škrabáková, and
Marcela Gonzalez-Gross, and
Jara Valtueña, and
Stefaan De Henauw, and
Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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Clinical endocrinology,
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Kirsten G Dowling, and
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Marcela Gonzalez-Gross, and
Jara Valtueña, and
Stefaan De Henauw, and
Luis Moreno, and
Camilla T Damsgaard, and
Kim F Michaelsen, and
Christian Mølgaard, and
Rolf Jorde, and
Guri Grimnes, and
George Moschonis, and
Christina Mavrogianni, and
Yannis Manios, and
Michael Thamm, and
Gert Bm Mensink, and
Martina Rabenberg, and
Markus A Busch, and
Lorna Cox, and
Sarah Meadows, and
Gail Goldberg, and
Ann Prentice, and
Jacqueline M Dekker, and
Giel Nijpels, and
Stefan Pilz, and
Karin M Swart, and
Natasja M van Schoor, and
Paul Lips, and
Gudny Eiriksdottir, and
Vilmundur Gudnason, and
Mary Frances Cotch, and
Seppo Koskinen, and
Christel Lamberg-Allardt, and
Ramon A Durazo-Arvizu, and
Christopher T Sempos, and
Mairead Kiely
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