European Journal of Nutrition

, Volume 53, Issue 4, pp 1123–1134 | Cite as

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

  • Lea Brader
  • Lars Rejnmark
  • Carsten Carlberg
  • Ursula Schwab
  • Marjukka Kolehmainen
  • Fredrik Rosqvist
  • Lieselotte Cloetens
  • Mona Landin-Olsson
  • Ingibjorg Gunnarsdottir
  • Kaisa S. Poutanen
  • Karl-Heinz Herzig
  • Ulf Risérus
  • Markku J. Savolainen
  • Inga Thorsdottir
  • Matti Uusitupa
  • Kjeld Hermansen
Original Contribution

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.

Keywords

Vitamin D 25-hydroxyvitamin D Healthy Nordic diet Nordic nutrition recommendations Metabolic syndrome 

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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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lea Brader
    • 1
  • Lars Rejnmark
    • 1
  • Carsten Carlberg
    • 2
  • Ursula Schwab
    • 3
  • Marjukka Kolehmainen
    • 3
  • Fredrik Rosqvist
    • 4
  • Lieselotte Cloetens
    • 5
  • Mona Landin-Olsson
    • 6
  • Ingibjorg Gunnarsdottir
    • 7
  • Kaisa S. Poutanen
    • 3
  • Karl-Heinz Herzig
    • 8
    • 9
  • Ulf Risérus
    • 4
  • Markku J. Savolainen
    • 10
    • 11
  • Inga Thorsdottir
    • 7
  • Matti Uusitupa
    • 3
  • Kjeld Hermansen
    • 1
  1. 1.Department of Endocrinology and Internal MedicineAarhus University HospitalÅrhus CDenmark
  2. 2.Institute of BiomedicineUniversity of Eastern FinlandKuopioFinland
  3. 3.Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
  4. 4.Department of Public Health and Caring Sciences, Clinical Nutrition and MetabolismUppsala UniversityUppsalaSweden
  5. 5.Biomedical Nutrition, Pure and Applied BiochemistryLund UniversityLundSweden
  6. 6.Department of EndocrinologySkåne University HospitalLundSweden
  7. 7.Unit for Nutrition Research, Landspitali - The National University of Iceland, Faculty of Food Science and Nutrition, School of Health SciencesUniversity of IcelandReykjavíkIceland
  8. 8.Department of Physiology and Biocenter of Oulu, Institute of BiomedicineOulu UniversityOuluFinland
  9. 9.Medical Research Centre OuluOulu University HospitalOuluFinland
  10. 10.Department of Internal Medicine and Biocenter, Institute of Clinical MedicineUniversity of OuluOuluFinland
  11. 11.Clinical Research CentreOulu University HospitalOuluFinland

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