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Effects of a healthy Nordic diet on plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome: a randomized, placebo-controlled trial (SYSDIET)

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European Journal of Nutrition Aims and scope Submit manuscript

An Erratum to this article was published on 30 March 2014

Abstract

Purpose

At northern latitudes, vitamin D is not synthesized endogenously during winter, causing low plasma 25-hydroxyvitamin D (25(OH)D) concentrations. Therefore, we evaluated the effects of a healthy Nordic diet based on Nordic nutrition recommendations (NNR) on plasma 25(OH)D and explored its dietary predictors.

Methods

In a Nordic multi-centre trial, subjects (n = 213) with metabolic syndrome were randomized to a control or a healthy Nordic diet favouring fish (≥300 g/week, including ≥200 g/week fatty fish), whole-grain products, berries, fruits, vegetables, rapeseed oil and low-fat dairy products. Plasma 25(OH)D and parathyroid hormone were analysed before and after 18- to 24-week intervention.

Results

At baseline, 45 % had vitamin D inadequacy (<50 nmol/l), whereas 8 % had deficiency (<25 nmol/l). Dietary vitamin D intake was increased by the healthy Nordic diet (P < 0.001). The healthy Nordic and the control diet reduced the prevalence of vitamin D inadequacy by 42 % (P < 0.001) and 19 % (P = 0.002), respectively, without between-group difference (P = 0.142). Compared with control, plasma 25(OH)D (P = 0.208) and parathyroid hormone (P = 0.207) were not altered by the healthy Nordic diet. Predictors for 25(OH)D were intake of vitamin D, eicosapentaenoic acids (EPA), docosahexaenoic acids (DHA), vitamin D supplement, plasma EPA and plasma DHA. Nevertheless, only vitamin D intake and season predicted the 25(OH)D changes.

Conclusion

Consuming a healthy Nordic diet based on NNR increased vitamin D intake but not plasma 25(OH)D concentration. The reason why fish consumption did not improve vitamin D status might be that many fish are farmed and might contain little vitamin D or that frying fish may result in vitamin D extraction. Additional ways to improve vitamin D status in Nordic countries may be needed.

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Abbreviations

25(OH)D:

25-Hydroxyvitamin D

BMI:

Body mass index

DHA:

Docosahexaenoic acids

EPA:

Eicosapentaenoic acids

MetS:

Metabolic syndrome

MUFA:

Monounsaturated fatty acids

NNR:

Nordic nutrition recommendations

PTH:

Parathyroid hormone

PUFA:

Polyunsaturated fatty acids

RC:

Regression coefficient

SD:

Standard deviation

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Acknowledgments

This work was supported by NordForsk NCoE in Food Nutrition and Health: Project 070014 SYSDIET (Systems biology in controlled dietary interventions and cohort studies) and by the Academy of Finland, Finnish Diabetes Research Foundation, Finnish Foundation for Cardiovascular Research, The Sigrid Juselius Foundation and EVO funding from Kuopio University Hospital (Finland); the Druvan Foundation, ESPEN and Skåne University Hospital, The Heart–Lung Foundation, Diabetesfonden and Foundation Cerealia (Sweden); The Danish Council for Strategic Research (DairyHealth, BioFunCarb), Aarhus University (Denmark), The Agricultural Productivity Fund (Iceland) and the Icelandic Research Fund for graduate students (1206880061). The following companies provided foods for the study participants: Kesko Food Ltd., Raisio Group (Finland); Belico Food AB, Fazer Bageri Sverige, Lantmännen, Oatly AB, Olle Svensson AB, Procordia Food AB, Pågen AB, Unilever, Wasabröd AB (Sweden); Lantmännen Food R&D, Jan Import A/S, Ardo A/S, Scandic Food A/S, WASA, Glyngøre Limfjord A/S, Royal Greenland A/S, Arla Foods (Denmark); The Mother Earth Farm at Vallanes (Iceland), and Unilever Nordic (Sweden, Denmark, Iceland). The companies had no influence on design, implementation, analysis or interpretation of the data.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, 8000, Århus C, Denmark

    Lea Brader, Lars Rejnmark & Kjeld Hermansen

  2. Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland

    Carsten Carlberg

  3. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    Ursula Schwab, Marjukka Kolehmainen, Kaisa S. Poutanen & Matti Uusitupa

  4. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden

    Fredrik Rosqvist & Ulf Risérus

  5. Biomedical Nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden

    Lieselotte Cloetens

  6. Department of Endocrinology, Skåne University Hospital, Lund, Sweden

    Mona Landin-Olsson

  7. Unit for Nutrition Research, Landspitali - The National University of Iceland, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavík, Iceland

    Ingibjorg Gunnarsdottir & Inga Thorsdottir

  8. Department of Physiology and Biocenter of Oulu, Institute of Biomedicine, Oulu University, Oulu, Finland

    Karl-Heinz Herzig

  9. Medical Research Centre Oulu, Oulu University Hospital, Oulu, Finland

    Karl-Heinz Herzig

  10. Department of Internal Medicine and Biocenter, Institute of Clinical Medicine, University of Oulu, Oulu, Finland

    Markku J. Savolainen

  11. Clinical Research Centre, Oulu University Hospital, Oulu, Finland

    Markku J. Savolainen

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  1. Lea Brader
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Correspondence to Lea Brader.

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Brader, L., Rejnmark, L., Carlberg, C. et al. Effects of a healthy Nordic diet on plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome: a randomized, placebo-controlled trial (SYSDIET). Eur J Nutr 53, 1123–1134 (2014). https://doi.org/10.1007/s00394-014-0674-3

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