Differences and determinants of vitamin D deficiency among UK biobank participants: A cross-ethnic and socioeconomic study

Joshua P Sutherland; Ang Zhou; Matthew J Leach; Elina Hyppönen

doi:10.1016/j.clnu.2020.11.019

Differences and determinants of vitamin D deficiency among UK biobank participants: A cross-ethnic and socioeconomic study

Clin Nutr. 2021 May;40(5):3436-3447. doi: 10.1016/j.clnu.2020.11.019. Epub 2020 Nov 25.

Authors

Joshua P Sutherland¹, Ang Zhou², Matthew J Leach³, Elina Hyppönen⁴

Affiliations

¹ Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia. Electronic address: joshua.sutherland@mymail.unisa.edu.au.
² Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia.
³ National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, Australia.
⁴ Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia. Electronic address: elina.hypponen@unisa.edu.au.

PMID: 33309415
DOI: 10.1016/j.clnu.2020.11.019

Abstract

Background: The public health relevance of true vitamin D deficiency is undisputed, although controversy remains regarding optimal vitamin D status. Few contemporary cross-ethnic studies have investigated the prevalence and determinants of very low 25-hydroxyvitamin D [25(OH)D] concentrations.

Methods: We conducted cross-ethnic analyses on the prevalence and determinants of vitamin D deficiency (25(OH)D ≤ 25 nmol/L) using data from 440,581 UK Biobank participants, of which 415,903 identified as White European, 7880 Asian, 7602 Black African, 1383 Chinese, and 6473 of mixed ancestry. Determinants of vitamin D deficiency were examined by logistic regression.

Results: The prevalence of vitamin D deficiency was highest among participants of Asian ancestry (57.2% in winter/spring and 50.8% in summer/autumn) followed by those of Black African ancestry (38.5% and 30.8%, respectively), mixed (36.5%, 22.5%), Chinese (33.1%, 20.7%) and White European ancestry (17.5%, 5.9%). Participants with higher socioeconomic deprivation were more likely to have 25(OH)D deficiency compared to less deprived participants (P = <1 × 10^-300); this pattern was more apparent among those of White European ancestry and in summer (P_interaction ≤6.4 × 10^-5 for both). In fully-adjusted analyses, regular consumption of oily fish was associated with reduced odds of vitamin D deficiency across all ethnicities, while outdoor-time in summer was less effective for Black Africans (OR 0.89, 95% CI 0.70, 1.12) than White Europeans (OR 0.40, 95% CI 0.38, 0.42).

Conclusions: Severe vitamin D deficiency remains an issue throughout the UK, particularly in lower socioeconomic areas. In some groups, levels of deficiency are alarmingly high with one-half of Asian and one-third of Black African ancestry populations affected across seasons.

Key messages: The prevalence of vitamin D deficiency in the UK is alarming, with certain ethnic and socioeconomic groups considered particularly vulnerable.

Keywords: Ethnic groups; Nutritional status; Public health; Socioeconomic factors; Vitamin D; Vitamin D deficiency.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Databases, Factual
Diet / statistics & numerical data
Female
Humans
Male
Middle Aged
Nutritional Status / physiology
Prevalence
Socioeconomic Factors
United Kingdom / epidemiology
Vitamin D Deficiency / epidemiology*