Cited by 1,472Vitamin D Research StudiesBone health and osteoporosis researchVitamin K Research Studies

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Global vitamin D status and determinants of hypovitaminosis D

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on behalf of the IOF Committee of Scientific Advisors (CSA) Nutrition Working Group, Mithal, A., Wahl, D. A., Bonjour, J.-P., Burckhardt, P., Dawson-Hughes, B., Eisman, J. A., El-Hajj Fuleihan, G., Josse, R. G., Lips, P., Morales-Torres, J.·2009·Osteoporosis International

DOI 10.1007/s00198-009-0954-6

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Abstract

Unlabelled This review describes the vitamin D status in different regions of the world with the objective of understanding the scope of hypovitaminosis D and the factors related to its prevalence that may contribute to the pathogenesis of osteoporosis and fragility fractures.Introduction Vitamin D status has been linked to the pathogenesis of hip fractures as well as other skeletal and non-skeletal disorders. The purpose of this review is to provide a global perspective of vitamin D status across different regions of the world and to identify the common and significant determinants of hypovitaminosis D.Methods Six regions of the world were reviewed-Asia, Europe, Middle East and Africa, Latin America, North America, and Oceania-through a survey of published literature.Results The definition of vitamin D insufficiency and deficiency, as well as assay methodology for 25-hydroxyvitamin D or 25(OH)D, vary between studies. However, serum 25(OH)D levels below 75 nmol/L are prevalent in every region studied whilst levels below 25 nmol/L are most common in regions such as South Asia and the Middle East. Older age, female sex, higher latitude, winter season, darker skin pigmentation, less sunlight exposure, dietary habits, and absence of vitamin D fortification are the main factors that are significantly associated with lower 25(OH)D levels.Conclusion Reports from across the world indicate that hypovitaminosis D is widespread and is re-emerging as a major health problem globally.

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“Vitamin D is influenced by many factors such as old age, high body mass index (BMI), high latitude, cold seasons, low sunlight exposure, and dark skin pigmentation which are associated with hypovitaminosis D (8).”
Background
Adverse effects of imatinib in children with chronic myelogenous leukemia
Choeyprasert, W., Yansomdet, T., Natesirinilkul, R., Wejaphikul, K., & Charoenkwan, P. (2016) · Pediatrics International · doi:10.1111/ped.13136 · Cited by 25
Association of Brain-Derived Neurotrophic Factor and Vitamin D with Depression and Obesity: A Population-Based Study
Goltz, A., Janowitz, D., Hannemann, A., Nauck, M. A., Hoffmann, J. C., Seyfart, T., Völzke, H., Terock, J., & Grabe, H. J. (2017) · Neuropsychobiology · doi:10.1159/000489864 · Cited by 25
High prevalence and seasonal variation of hypovitaminosis D in patients scheduled for lower extremity total joint arthroplasty
Piuzzi, N. S., George, J., Khlopas, A., Klika, A. K., Mont, M. A., Muschler, G. F., & Higuera, C. A. (2018) · Annals of Translational Medicine · doi:10.21037/atm.2018.08.21 · Cited by 25
Vitamin D concentration and deficiency across different ages and genders
Lippi, G., Montagnana, M., Meschi, T., & Borghi, L. (2012) · Aging Clinical and Experimental Research · doi:10.1007/bf03654812 · Cited by 25
Micro-Scratch Based Tribological Characterization of Hydroxyapatite (HAp) Fabricated through Fish Scales
Prasad, A., Devendar, B., Sankar, M. R., & Robi, P. S. (2015) · Materials Today Proceedings · doi:10.1016/j.matpr.2015.07.034 · Cited by 24
Temperature stability of vitamin D2 and color changes during drying of UVB-treated mushrooms
Nölle, N., Argyropoulos, D., Müller, J., & Biesalski, H. K. (2017) · Drying Technology · doi:10.1080/07373937.2017.1326501 · Cited by 24
Fetal vitamin D concentration and growth, adiposity and neurodevelopment during infancy
Wang, H., Yu, X., Huang, L., Chen, Q., Ouyang, F., Wang, X., & Zhang, J. (2018) · European Journal of Clinical Nutrition · doi:10.1038/s41430-017-0075-9 · Cited by 24
“In model 3, we additionally adjusted for the birth season of the children, birth weight, maternal outside activity during pregnancy, paternal smoking, mode of delivery, gestational age, vitamin D supplement during pregnancy and exposure to antepartum obstetric complications (including gestational diabetes mellitus, pr…”
Method
Older Age Is Associated with Decreased Levels of VDR, CYP27B1, and CYP24A1 and Increased Levels of PTH in Human Parathyroid Glands
Jiang, Y., Liao, L., Li, J., Wang, L. L., & Xie, Z. (2020) · International Journal of Endocrinology · doi:10.1155/2020/7257913 · Cited by 24
“Vitamin D levels may be affected by a number of factors including age, cultural behavior, latitude and season, and outdoor activity [35].”
Background
Insufficiency of B vitamins with its possible clinical implications
Tanaka, K., Ao, M., & Kuwabara, A. (2020) · Journal of Clinical Biochemistry and Nutrition · doi:10.3164/jcbn.20-56 · Cited by 23
Prevalence of Vitamin D Deficiency Among Infants in Northern India: A Hospital Based Prospective Study
Chacham, S., Rajput, S., Gurnurkar, S., Mirza, A. A., Saxena, V., Dakshinamurthy, S., Chaturvedi, J., Goyal, J. P., & Chegondi, M. (2020) · Cureus · doi:10.7759/cureus.11353 · Cited by 24
Cohort profile: the Westlake BioBank for Chinese (WBBC) pilot project
Zhu, X.-W., Liu, K.-Q., Wang, P., Liu, J.-Q., Chen, J., Xu, X.-J., Xu, J., Qiu, M.-C., Sun, Y., Liu, C., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045564 · Cited by 24
Breastfeeding and vitamin D
Heo, J. S., Ahn, Y. M., Kim, E. A., Shin, S. M., & for the Korean Society of Breastfeeding Medicine (2021) · Korean Journal of Pediatrics · doi:10.3345/cep.2021.00444 · Cited by 24
Fok I and Bsm I gene polymorphism of vitamin D receptor and essential hypertension: a mechanistic link
Awasthi, R., Manger, P. T., & Khare, R. K. (2023) · Clinical Hypertension · doi:10.1186/s40885-022-00229-y · Cited by 24
“Furthermore, just 10 to 20% of vitamin D comes from the diet as vitamin D2 or vitamin D3 [8].”
Background
Lower bone turnover markers in metabolic syndrome and diabetes: The population-based Study of Health in Pomerania
Lerchbaum, E., Schwetz, V., Nauck, M. A., Völzke, H., Wallaschofski, H., & Hannemann, A. (2015) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2015.02.002 · Cited by 24
Vitamin D and primary hyperparathyroidism (PHPT)
Souberbielle, J., Bienaimé, F., Cavalier, E., & Cormier, C. (2012) · Annales d Endocrinologie · doi:10.1016/j.ando.2012.04.008 · Cited by 24
Effect of 25-hydroxyvitamin D on metabolic parameters and insulin resistance in patients with polycystic ovarian syndrome
Hassan, N. E. S., Orabi, H. E., Eid, Y. M., & Mohammed, N. R. (2012) · Middle East Fertility Society Journal · doi:10.1016/j.mefs.2012.04.005 · Cited by 24
Vitamin D status and physical function in older Finnish people: A one-year follow-up study
Salminen, M. J., Saaristo, P., Salonoja, M., Vaapio, S., Vahlberg, T. J., Lamberg-Allardt, C. J. E., Aarnio, P. T. T., & Kivelä, S. (2015) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2015.08.014 · Cited by 24
Seasonal variation of serum vitamin D and the effect of vitamin D supplementation in Irish community-dwelling older people
Romero‐Ortuño, R., Cogan, L., Browne, J., Healy, M., Casey, M. C., Cunningham, C. J., Walsh, J. B., & Kenny, R. A. (2010) · Age and Ageing · doi:10.1093/ageing/afq138 · Cited by 24
Epilepsy treatment by sacrificing vitamin D
Cebeci, A. N., & Ekici, B. (2014) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2014.905742 · Cited by 24
The relationship between obesity indices and serum vitamin D levels in Chinese adults from urban settings.
Zhang, Y., Zhang, X., Wang, F., Zhang, W., Wang, C., Yu, C., Zhao, J., Gao, L., & Xu, J. (2016) · PubMed · doi:10.6133/apjcn.2016.25.2.15 · Cited by 24
“Serum vitamin D levels can be affected by age, gender, ethnicity, diet, sun exposure and other factors.(7,8) Qiao et al reported that the incidence of vitamin D deficiency among the urban population living in the Guiyang area of China was 52.”
Background
Nutritional deficiencies in homeless persons with problematic drinking: a systematic review
Ijaz, S., Jackson, J., Thorley, H., Porter, K., Fleming, C., Richards, A., BONNER, A. B., & Savović, J. (2017) · International Journal for Equity in Health · doi:10.1186/s12939-017-0564-4 · Cited by 27
Low serum 25-hydroxyvitamin D is associated with low grip strength in an older Japanese population
Kitsu, T., Kabasawa, K., Ito, Y., Kitamura, K., Watanabe, Y., Tanaka, J., Nakamura, K., & Narita, I. (2019) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-019-01040-w · Cited by 24
Nationwide vitamin D status in older Brazilian adults and its determinants: The Brazilian Longitudinal Study of Aging (ELSI)
Lima‐Costa, M. F., Mambrini, J. V. D. M., Júnior, P. R. B. D. S., de Andrade, F. B., Peixoto, S. V., Vidigal, C. M., de Oliveira, C. M., & Vidigal, P. G. (2020) · Scientific Reports · doi:10.1038/s41598-020-70329-y · Cited by 24
The anti-thrombotic effects of vitamin D and their possible relationship with antiphospholipid syndrome
García‐Carrasco, M., Jiménez-Herrera, E. A., Gálvez-Romero, J. L., Pinto, C. M., Méndez‐Martínez, S., Etchegaray‐Morales, I., Munguía‐Realpozo, P., de Lara, L. G. V., Cruz, F. J., & Cervera, R. (2018) · Lupus · doi:10.1177/0961203318801520 · Cited by 24
Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis
Jeyakumar, A., Shinde, V., & Ravindran, R. (2021) · Journal of Health Population and Nutrition · doi:10.1186/s41043-021-00253-y · Cited by 24
Evaluation of HbA1C and serum levels of vitamin D in diabetic patients
Ahmadi, M. H., Ghavam, S., Panah, A., & Kazeminezhad, B. (2018) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_73_18 · Cited by 23
Evaluation of Vitamin D Levels and Response to Therapy of Childhood Migraine
Kılıç, B., & Kılıç, M. (2019) · Medicina · doi:10.3390/medicina55070321 · Cited by 23
Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings from the ERICA survey
de Oliveira, C. L., Cureau, F. V., Rodrigues, C. D. S. C., Giannini, D. T., Bloch, K. V., Kuschnir, M. C. C., de Carvalho, K. M. B., & Schaan, B. D. (2020) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2020.105609 · Cited by 23
Identifying the threshold for vitamin D insufficiency in relation to cardiometabolic markers
Tepper, S., Shahar, D. R., Geva, D., Avizohar, O., Nodelman, M., Segal, E., & Ish‐Shalom, S. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2013.10.025 · Cited by 23
Low Vitamin D and Cardiovascular Risk Factors in Males and Females from a Sunny, Rich Country
El-Menyar, A. A., Rahil, A., Dousa, K. M., Ibrahim, W., Ibrahim, T., Khalifa, R., & Rahman, M. O. A. (2012) · The Open Cardiovascular Medicine Journal · doi:10.2174/1874192401206010076 · Cited by 23
Vitamin D and antiphospholipid syndrome: A retrospective cohort study and meta-analysis
Riancho‐Zarrabeitia, L., Cubería, M., Muñoz, P., López‐Hoyos, M., García-Canale, S., García‐Unzueta, M. T., Hernández, J. L., & Martínez-Taboada, V. M. (2017) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2017.10.007 · Cited by 23
“Orbach 2007# [11] Klack 2010# [12] Paupitz 2010[13] Agmon Levin 2010[10] Andreoli 2012[14] RianchoZarrabeitia [17] Study design Cohort Cohort Case controls Case controls Case controls Case controls Population ND Brazil Brazil European Italian Spanish Number of patients 160 46 23 179 (113 primary APS, 66 secondary APS)…”
BackgroundMethodInfluential
Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia
Judistiani, R. T. D., Gumilang, L., Nirmala, S. A., Irianti, S., Wirhana, D., Permana, I., Sofjan, L., Duhita, H., Tambunan, L. A., Gurnadi, J. I., et al. (2018) · Anemia · doi:10.1155/2018/2047981 · Cited by 24
Non-Linear Relationship between Serum 25-Hydroxyvitamin D and Hemoglobin in Korean Females: The Korean National Health and Nutrition Examination Survey 2010–2011
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Prevalence and predictors of hypovitaminosis D among the elderly in subtropical region
Huang, C., Huang, Y., Lai, Y., & Sun, C. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181063 · Cited by 23
Influence of external, intrinsic and individual behaviour variables on serum 25(OH)D in a German survey
Richter, K., Breitner, S., Webb, A. R., Huth, C., Thorand, B., Kift, R., Linseisen, J., Schuh, A., Kratzsch, J., Mielck, A., et al. (2014) · Journal of Photochemistry and Photobiology B Biology · doi:10.1016/j.jphotobiol.2014.07.018 · Cited by 22
Vitamin D Deficiency in Unselected Patients from Swiss Primary Care: A Cross-Sectional Study in Two Seasons
Merlo, C., Trummler, M., Essig, S., & Zeller, A. (2015) · PLoS ONE · doi:10.1371/journal.pone.0138613 · Cited by 22
RCTS are the only appropriate way to demonstrate the role of vitamin D in health
Jorde, R. (2017) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2017.05.004 · Cited by 22
Time spent outdoors through childhood and adolescence – assessed by 25‐hydroxyvitamin D concentration – and risk of myopia at 20 years
Lingham, G., Mackey, D. A., Zhu, K., Lucas, R. M., Black, L. J., Oddy, W. H., Holt, P. G., Walsh, J. P., Sanfilippo, P. G., Ping‐Delfos, W. C. S., et al. (2021) · Acta Ophthalmologica · doi:10.1111/aos.14709 · Cited by 22
The Relationship Between Low Serum Vitamin D Level and Early Dental Implant Failure: A Systematic Review
Alsulaimani, L. A., Alqarni, A., Almarghlani, A. A., & Hassoubah, M. N. (2022) · Cureus · doi:10.7759/cureus.21264 · Cited by 22

Authors: on behalf of the IOF Committee of Scientific Advisors (CSA) Nutrition Working Group, Mithal, A., Wahl, D. A., Bonjour, J.-P., Burckhardt, P., Dawson-Hughes, B., Eisman, J. A., El-Hajj Fuleihan, G., Josse, R. G., Lips, P., & Morales-Torres, J.
Affiliations: Indraprastha Apollo Hospitals (IN)
International Osteoporosis Foundation (CH)
University of Geneva (CH)
Hirslanden Clinique Bois-Cerf (CH)
Garvan Institute of Medical Research (AU)
St. Michael's Hospital (CA)
Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
Corresponding author: Mithal, A.
ORCID: Mithal, A.
Burckhardt, P.
Eisman, J. A.
Josse, R. G.
Lips, P.
Venue: Osteoporosis International
Publisher: Springer Science and Business Media LLC
Published: 2009-06-19
Volume: 20
Issue: 11
Pages: 1807-1820
ISSN: 0937-941X (ISSN-L)
1433-2965
DOI: 10.1007/s00198-009-0954-6
OpenAlex: W2106647095
Cited by: 1,472
References: 156
Citations by year: 2026: 31 · 2025: 49 · 2024: 63 · 2023: 67 · 2022: 87 · 2021: 97 · 2020: 103 · 2019: 93 · 2018: 99 · 2017: 103 · 2016: 100 · 2015: 116 · 2014: 121 · 2013: 123 · 2012: 94
FWCI: 8.67
Type: journal article
Language: en
Open access: green
research.vumc.nl
Licence: other-oa
www.springer.com/tdm (tdm)
Locations: Osteoporosis International (publishedVersion)
PubMed (publishedVersion)
Archive ouverte UNIGE (University of Geneva) (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
Pure Amsterdam UMC (submittedVersion, other-oa)
Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: International Osteoporosis Foundation
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Vitamin D Research Studies
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Nursing › Nutrition and Dietetics › Vitamin K Research Studies
Keywords: vitamin D status, vitamin D deficiency, 25-hydroxyvitamin D, osteoporosis, fragility fractures, hip fracture, risk factors, sun exposure, skin pigmentation, latitude, seasonal variation, dietary habits, vitamin D fortification, global prevalence
MeSH terms: Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Cross-Cultural Comparison, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Risk Factors, Sex Factors, Vitamin D, Vitamin D Deficiency, Global Health, Prevalence, Genetic Predisposition to Disease, Young Adult

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Global vitamin D status and determinants of hypovitaminosis D

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