Global differences in vitamin D status and dietary intake: a review of the data

Kevin D Cashman, Kevin D Cashman

Abstract

Background: Internationally, concern has been repeatedly raised about the little notable progress in the collection, analysis and use of population micronutrient status and deficiency data globally. The need for representative status and intake data for vitamin D has been highlighted as a research priority for well over a decade.

Aim and methods: A narrative review which aims to provide a summary and assessment of vitamin D nutritional status data globally. This review divides the world into the Food and Agriculture Organisation's (FAO) major regions: the Americas, Europe, Oceania, Africa and Asia. Emphasis was placed on published data on the prevalence of serum 25-hydroxyvitamin D (25(OH)D) < 25/30 and <50 nmol/L (reflecting vitamin D deficiency and inadequacy, respectively) as well as vitamin D intake, where possible from nationally representative surveys.

Results: Collating data from the limited number of available representative surveys from individual countries might suggest a relatively low overall prevalence of vitamin D deficiency in South America, Oceania and North America, whereas there is more moderate prevalence in Europe and Asia, and possibly Africa. Overall, the prevalence of serum 25(OH)D < 25/30 and <50 nmol/L ranges from ~5 to 18% and 24 to 49%, respectively, depending on FAO world region. Usual intakes of vitamin D can also vary by FAO world region, but in general, with a few exceptions, there are very high levels of inadequacy of vitamin D intake.

Conclusions: While the burden of vitamin D deficiency and inadequacy varies by world regions and not just by UVB availability, the global burden overall translates into enormous numbers of individuals at risk.

Keywords: national surveys; serum 25(OH)D; usual vitamin D intake; vitamin D status.

Figures

Figure 1
Figure 1
The prevalence of serum 25(OH)D

Figure 2

The prevalence of serum 25(OH)D…

Figure 2

The prevalence of serum 25(OH)D < 30 nmol/L in the national surveys in the…

Figure 2
The prevalence of serum 25(OH)D

Figure 3

The prevalence of serum 25(OH)D…

Figure 3

The prevalence of serum 25(OH)D < 25(UK)/30 nmol/L in national surveys in Germany, the…

Figure 3
The prevalence of serum 25(OH)D

Figure 4

UV index scores* in capital…

Figure 4

UV index scores* in capital cities across the globe during November to March…

Figure 4
UV index scores* in capital cities across the globe during November to March (Panel A) and April to October (Panel B). *Represented by coloured ovals at the location (green, yellow, orange, red and violet representing UVI scores of 1–2, 3–5, 6–7, 8–10 and 11+, respectively).

Figure 5

The mean (or median) vitamin…

Figure 5

The mean (or median) vitamin D intake among European-based dietary surveys of adult…

Figure 5
The mean (or median) vitamin D intake among European-based dietary surveys of adult males and females.

Figure 6

The mean vitamin D intake…

Figure 6

The mean vitamin D intake among European-based dietary surveys of children aged <10…

Figure 6
The mean vitamin D intake among European-based dietary surveys of children aged
Similar articles
Cited by
References
    1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC, USA: The National Academies Press, 2011. - PubMed
    1. Cashman KD, Kiely M. Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. British Journal of Nutrition 20111061617–1627. (10.1017/S0007114511004995) - DOI - PubMed
    1. Seamans KM, Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review. American Journal of Clinical Nutrition 2009891997S–2008S. (10.3945/ajcn.2009.27230D) - DOI - PubMed
    1. Cashman KD.Vitamin D deficiency: defining, prevalence, causes, and strategies of addressing. Calcified Tissue International 202010614–29. (10.1007/s00223-019-00559-4) - DOI - PubMed
    1. Scientific Advisory Committee on Nutrition. Report on vitamin D and health, 2016. (available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa...)
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Figure 2
Figure 2
The prevalence of serum 25(OH)D

Figure 3

The prevalence of serum 25(OH)D…

Figure 3

The prevalence of serum 25(OH)D < 25(UK)/30 nmol/L in national surveys in Germany, the…

Figure 3
The prevalence of serum 25(OH)D

Figure 4

UV index scores* in capital…

Figure 4

UV index scores* in capital cities across the globe during November to March…

Figure 4
UV index scores* in capital cities across the globe during November to March (Panel A) and April to October (Panel B). *Represented by coloured ovals at the location (green, yellow, orange, red and violet representing UVI scores of 1–2, 3–5, 6–7, 8–10 and 11+, respectively).

Figure 5

The mean (or median) vitamin…

Figure 5

The mean (or median) vitamin D intake among European-based dietary surveys of adult…

Figure 5
The mean (or median) vitamin D intake among European-based dietary surveys of adult males and females.

Figure 6

The mean vitamin D intake…

Figure 6

The mean vitamin D intake among European-based dietary surveys of children aged <10…

Figure 6
The mean vitamin D intake among European-based dietary surveys of children aged
Similar articles
Cited by
References
    1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC, USA: The National Academies Press, 2011. - PubMed
    1. Cashman KD, Kiely M. Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. British Journal of Nutrition 20111061617–1627. (10.1017/S0007114511004995) - DOI - PubMed
    1. Seamans KM, Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review. American Journal of Clinical Nutrition 2009891997S–2008S. (10.3945/ajcn.2009.27230D) - DOI - PubMed
    1. Cashman KD.Vitamin D deficiency: defining, prevalence, causes, and strategies of addressing. Calcified Tissue International 202010614–29. (10.1007/s00223-019-00559-4) - DOI - PubMed
    1. Scientific Advisory Committee on Nutrition. Report on vitamin D and health, 2016. (available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa...)
Show all 85 references
Related information
LinkOut - more resources
[x]
Cite
Copy Download .nbib .nbib
Format: AMA APA MLA NLM

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MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Figure 3
Figure 3
The prevalence of serum 25(OH)D

Figure 4

UV index scores* in capital…

Figure 4

UV index scores* in capital cities across the globe during November to March…

Figure 4
UV index scores* in capital cities across the globe during November to March (Panel A) and April to October (Panel B). *Represented by coloured ovals at the location (green, yellow, orange, red and violet representing UVI scores of 1–2, 3–5, 6–7, 8–10 and 11+, respectively).

Figure 5

The mean (or median) vitamin…

Figure 5

The mean (or median) vitamin D intake among European-based dietary surveys of adult…

Figure 5
The mean (or median) vitamin D intake among European-based dietary surveys of adult males and females.

Figure 6

The mean vitamin D intake…

Figure 6

The mean vitamin D intake among European-based dietary surveys of children aged <10…

Figure 6
The mean vitamin D intake among European-based dietary surveys of children aged
Similar articles
Cited by
References
    1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC, USA: The National Academies Press, 2011. - PubMed
    1. Cashman KD, Kiely M. Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. British Journal of Nutrition 20111061617–1627. (10.1017/S0007114511004995) - DOI - PubMed
    1. Seamans KM, Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review. American Journal of Clinical Nutrition 2009891997S–2008S. (10.3945/ajcn.2009.27230D) - DOI - PubMed
    1. Cashman KD.Vitamin D deficiency: defining, prevalence, causes, and strategies of addressing. Calcified Tissue International 202010614–29. (10.1007/s00223-019-00559-4) - DOI - PubMed
    1. Scientific Advisory Committee on Nutrition. Report on vitamin D and health, 2016. (available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa...)
Show all 85 references
Related information
LinkOut - more resources
[x]
Cite
Copy Download .nbib .nbib
Format: AMA APA MLA NLM
Figure 4
Figure 4
UV index scores* in capital cities across the globe during November to March (Panel A) and April to October (Panel B). *Represented by coloured ovals at the location (green, yellow, orange, red and violet representing UVI scores of 1–2, 3–5, 6–7, 8–10 and 11+, respectively).
Figure 5
Figure 5
The mean (or median) vitamin D intake among European-based dietary surveys of adult males and females.
Figure 6
Figure 6
The mean vitamin D intake among European-based dietary surveys of children aged

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