Ambient UVB dose and sun enjoyment are important pedictors of vitamin D status in an older population

O'Sullivan, F., Laird, E., Kelly, D., van Geffen, J., van Weele, M., McNulty, H., Hoey, L., Healy, M., McCarroll, K., Cunningham, C., Casey, M., Ward, M., Strain, J.J., Molloy, A.M. and Zgaga, L.: 2017,
J. of Nutrition 147, no. 5, 858-868.
doi: 10.3945/jn.116.244079

Abstract

Background: UVB-induced skin synthesis is considered the key source of vitamin D, yet exposure to UVB is poorly accounted for in epidemiological studies.

Objectives: The aim of this study was to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentration with accurately measured ambient UVB dose, sun enjoyment, supplements, and other factors.

Methods: An all-Irish cohort of community-dwelling participants aged >60 y [median age: 73; 67% female; median 25(OH)D: 54.5 nmol/L] was used. Participants from this large, cross-sectional study completed a questionnaire to provide information on demographic factors and lifestyle (including supplement use and sun enjoyment). The Tropospheric Emission Monitoring Internet Service database was used to extract the daily ambient UVB dose at wavelengths that could induce vitamin D synthesis (D-UVB) over Ireland (latitude: 51°N-55°N). Blood sampling occurred throughout the year. Ambient exposure at the place of residence was calculated for each participant individually. Associations between determinants and serum 25(OH)D concentration were examined in a multivariate model. Random forest analysis was used to establish prediction models of vitamin D deficiency, and area under the curve (AUC) is shown.

Results: In total, 5138 individuals were included. Median D-UVB was 63 mJ/cm2, which varied between seasons and latitudes, despite the small latitude differential. Vitamin D supplementation (β = 27.7; P < 10·10-10), D-UVB (β = 1.58 per 1000 mJ/cm2; P < 10·10-10), and sun enjoyment (β = 6.6; P < 0.001) were strongly positively associated with serum 25(OH)D. Those who avoided sunshine were largely at risk of deficiency (<40 nmol/L), whereas those who enjoyed sunshine tended to be vitamin D sufficient (>=50 nmol/L). D-UVB and sun enjoyment improved prediction of deficiency in non-supplement-taking individuals; the overall AUC improved by 3.5%.

Conclusion: D-UVB and sun enjoyment are important predictors of vitamin D status, even in this elderly population at northern latitudes. Accurate estimation of ambient UVB can help to further clarify the role of other determinants of vitamin D status and inform sunshine recommendation guidelines.


contents

   Abstract
   Introduction
   Methods
      Study population
      Vitamin D measurement
      Ambient UVB radiation
      Descriptive analysis of D-UVB over Ireland
      Individual cumulative D-UVB estimation calculation
      Statistical analysis
   Results
      Basic cohort characteristics
      Descriptive results for D-UVB over Ireland
      The determinants of 25(OH)D concentration
      Ambient D-UVB, sun enjoyment, and vitamin D status
      Using cw-D-UVB quartiles to predict deficiency levels of individuals
   Discussion
   Acknowledgments
   References

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created: 9 May 2017
last modified: 19 August 2020