Make vitamin D while the sun shines, take supplements when it doesn't: a longitudinal, observational study of older adults in Tasmania, Australia

PLoS One. 2013;8(3):e59063. doi: 10.1371/journal.pone.0059063. Epub 2013 Mar 18.

Abstract

Low vitamin D status has been associated with a number of chronic conditions, particularly in older adults. The aim of this study was to identify how best to maintain optimum vitamin D status throughout the year in this high-risk population. The main objectives of the study were to assess seasonal vitamin D status; identify the main determinants of vitamin D status; determine if taking part in the study led to alterations in participant behaviour and vitamin D status. A longitudinal design across four consecutive seasons observed ninety-one 60-85 year old community-dwelling adults in Tasmania (41π S) over 13 consecutive months, with a follow-up assessment at next winter's end. Associations between solar UVB exposure, sun protection behaviours, dietary and supplemental vitamin D with serum 25(OH)D concentrations were assessed. Variation in serum 25(OH)D demonstrated an identical pattern to solar UVB, lagging 8-10 weeks. Serum 25(OH)D was positively associated with summer UVB (mean 15.9 nmol/L; 95%CI 11.8-19.9 nmol/L, p<0.001) and vitamin D supplementation (100-600 IU/day: 95%CI 10.2 nmol/L; 0.8-19.6 nmol/L; p = 0.03; 800 IU/day: 21.0 nmol/L; 95%CI 8.1-34.0 nmol/L; p = 0.001). Seasonal variation in serum 25(OH)D was greatly diminished in supplement users. The most common alteration in participant behaviour after the study was ingesting vitamin D supplements. Post-study vitamin D supplementation ℘800 IU/day was seven times more likely than during the study resulting in mean difference in serum 25(OH)D between supplement and non-supplement users of 30.1 nmol/L (95%CI 19.4-40.8 nmol/L; p<0.001). The main limitation was homogeneity of participant ethnicity. Solar exposure in summer and ingestion of vitamin D supplements in other seasons are the most effective ways of achieving and maintaining year-round vitamin D sufficiency in older adults in the Southern hemisphere. Vitamin D supplementation has greatest effect on vitamin D status if ingested during and after winter, i.e. between the autumn and spring equinoxes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Calcifediol / blood
  • Dietary Supplements*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Seasons
  • Sunlight*
  • Tasmania
  • Vitamin D / blood*

Substances

  • Vitamin D
  • Calcifediol

Grants and funding

The study was partially funded by a grant from the Clifford Craig Medical Trust (http://cliffordcraig.org.au/84-balance-in-older-tasmanians/) and a University of Tasmania New Academic Research Grant. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.