Differences in the dietary requirement for vitamin D among Caucasian and East African women at Northern latitude

  • Kevin D. CashmanEmail author
  • Christian Ritz
  • Folasade A. Adebayo
  • Kirsten G. Dowling
  • Suvi T. Itkonen
  • Taina Öhman
  • Essi Skaffari
  • Elisa M. Saarnio
  • Mairead Kiely
  • Christel Lamberg-Allardt
Original Contribution



Current vitamin D recommendations have been established based on an assumption that there are no differences between Caucasian and other ethnic/racial groups in terms of vitamin D requirements. This assumption, largely made due to the absence of data, is a key knowledge gap identified by a number of authorities.


To test whether the distribution of dietary requirements for maintaining winter serum 25-hydroxyvitamin D [25(OH)D] concentrations ≥ 30 nmol/L (a priority threshold linked to vitamin D deficiency prevention) differ between Caucasian and Somali women living at northerly latitude.


We used data from a 5-month, winter-based, vitamin D3 dose-related randomized, placebo-controlled trial in Somali (n 47) and Causcian women (n 69), aged 21–64-year old, living in Southern Finland (60°N), to model the vitamin D intake–serum 25(OH)D dose–response relationship. Regression analyses were used to predict the vitamin D intake required to maintain 97.5% (as well as 50, 90, and 95%) of women in both ethnic groups above serum 25(OH)D thresholds of 30, 40 and 50 nmol/L.


Using a model which adjusted for baseline 25(OH)D, age, and BMI, the estimated vitamin D intake that maintained serum 25(OH)D ≥ 30 nmol/L in 97.5% of Caucasian and Somali women was 8 and 18 µg/day, respectively. Ethnic differences were also evident at 40 and 50 nmol/L serum 25(OH)D thresholds.


The present study adds further evidence that ethnic differences in the dietary requirement for vitamin D do exist and that dose–response vitamin D intervention studies are required in at-risk target populations specified by ethnicity.


Vitamin D requirements Ethnic-related differences Dietary reference values RCT 



The authors thank all volunteer subjects who participated in the intervention study. We are grateful to the researchers in the Maamu study for their advice on participants’ recruitment. We also thank technician Anu Heiman-Lindh for laboratory analyses at the University of Helsinki and Dr. George Hull at the Cork Centre for Vitamin D and Nutrition Research who helped with some of the serum 25(OH)D analyses. We acknowledge Oy Verman Ab, Kerava, Finland for providing supplements and placebo tablets.

Author contribution

CLA, MK, and KDC are Grant holders and designed the study. FAA, STI, and CLA were involved in the detailed design and coordination of the study. FAA, TÖ, ES, and EMS collected the data. KGD was responsible for the serum 25(OH)D analyses at the Cork Centre for Vitamin D and Nutrition Research, University College Cork, Ireland. KDC and CR performed the statistical analysis. KDC drafted the initial version of the manuscript and all co-authors reviewed, contributed to subsequent drafts and approved the final draft of the manuscript.


This work was carried out within the ODIN project (http://www.odin-vitamin, which was funded by the European Commission (Grant agreement 613977). The funder was not involved in the design, analysis or writing of this article.

Compliance with ethical standards

Conflict of interest

The authors wish to confirm that there are no known conflicts of interest associated with this publication.

Supplementary material

394_2018_1775_MOESM1_ESM.docx (71 kb)
Supplementary material 1 (DOCX 71 KB)


  1. 1.
    Seamans KM, Cashman KD (2009) Existing and potentially novel functional markers of vitamin D status: a systematic review. Am J Clin Nutr 89, 1997S-2008SGoogle Scholar
  2. 2.
    Institute of Medicine (2011) Dietary Reference Intakes for calcium and vitamin D. The National Academies Press, WashingtonGoogle Scholar
  3. 3.
    EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies) Scientific opinion on Dietary Reference Values for vitamin D. EFSA Journal 2016
  4. 4.
    NORDEN Nordic Nutrition Recommendations (2013) 5th Edn (NNR5)—Vitamin D. Accessed Aug 2013
  5. 5.
    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society (2011) Evaluation, treatment, and prevention of vitamin d deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930Google Scholar
  6. 6.
    Munns CF, Shaw N, Kiely M et al (2016) Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab 101:394–415CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M et al (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US Population during 2007–2010. J Nutr 146:1051–1061CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Sarafin K, Durazo-Arvizu R, Tian L, Phinney KW, Tai S, Camara JE, Merkel J, Green E, Sempos CT, Brooks SP (2015) Standardizing 25-hydroxyvitamin D values from the Canadian health measures survey. Am J Clin Nutr 102:1044–1050CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, Moreno L, Damsgaard CT, Michaelsen KF, Mølgaard C et al (2016) Vitamin D deficiency in Europe—Pandemic? Am J Clin Nutr 103:1033–1044CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Cashman KD, Dowling KG, Škrabáková Z, Kiely M, Lamberg-Allardt C, Durazo-Arvizu RA, Sempos CT, Koskinen S, Lundqvist A, Sundvall J et al (2015) Standardizing serum 25-hydroxyvitamin D data from four Nordic population samples using the Vitamin D Standardization Program protocols: Shedding new light on vitamin D status in Nordic individuals. Scand J Clin Lab Invest 75:549–561CrossRefPubMedGoogle Scholar
  11. 11.
    Meyer HE, Holvik K, Lofthus CM, Tennakoon SU (2008) Vitamin D status in Sri Lankans living in Sri Lanka and Norway. Br J Nutr 99(5):941–944CrossRefPubMedGoogle Scholar
  12. 12.
    Durazo-Arvizu RA, Camacho P, Bovet P, Forrester T, Lambert EV, Plange-Rhule J, Hoofnagle AN, Aloia J, Tayo B, Dugas LR, Cooper RS, Luke A (2014) 25-Hydroxyvitamin D in African-origin populations at varying latitudes challenges the construct of a physiologic norm. Am J Clin Nutr 100(3):908–914CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Cashman KD. Vitamin D (2015) dietary requirements and food fortification as a means of helping achieve adequate vitamin D status. J Steroid Biochem Mol Biol 148:19–26CrossRefPubMedGoogle Scholar
  14. 14.
    Cashman KD, Kiely M (2014) Recommended dietary intakes for vitamin D: Where do they come from, what do they achieve and how can we meet them? J Hum Nutr Diet 27(5):434–442CrossRefPubMedGoogle Scholar
  15. 15.
    Hayes A, Cashman KD (2017) Food-based solutions for vitamin D deficiency: putting policy into practice and the key role for research. Proc Nutr Soc 76(1):54–63CrossRefPubMedGoogle Scholar
  16. 16.
    Scientific Advisory Committee on Nutrition Report on Vitamin D and Health (2016) Published online at: Accessed 28 July 2016
  17. 17.
    Gallagher JC, Peacock M, Yalamanchili V, Smith LM (2013) Effects of vitamin D supplementation in older African American women. J Clin Endocrinol Metab 98:1137–1146CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ng K, Scott JB, Drake BF, Chan AT, Hollis BW, Chandler PD, Bennett GG, Giovannucci EL, Gonzalez-Suarez E, Meyerhardt JA, Emmons KM, Fuchs CS (2014) Dose response to vitamin D supplementation in African Americans: results of a 4-arm, randomized, placebo-controlled trial. Am J Clin Nutr 99(3):587–598CrossRefPubMedGoogle Scholar
  19. 19.
    Gallagher JC, Jindal PS, Smith LM (2014) Vitamin D supplementation in young white and African American women. J Bone Miner Res 29:173–181CrossRefPubMedGoogle Scholar
  20. 20.
    Cashman KD (2014) The vitamin D RDA for African American adults: higher than that for white persons? Am J Clin Nutr 99(3):427–428CrossRefPubMedGoogle Scholar
  21. 21.
    Gallagher JC, Sai A, Templin T, Smith L (2012) Dose response to vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437CrossRefPubMedGoogle Scholar
  22. 22.
    Öhlund I, Lind T, Hernell O, Silfverdal SA, Karlsland Åkeson P (2017) Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial. Am J Clin Nutr 106(1):105–112CrossRefPubMedGoogle Scholar
  23. 23.
    Adebayo F, Itkonen ST, Ohman T et al (2018) Vitamin D intake, serum 25-hydroxyvitamin D status and response to moderate vitamin D3 supplementation: a randomised controlled trial in East African and Finnish women. Br J Nutr 119(4):431–441CrossRefPubMedGoogle Scholar
  24. 24.
    Jääskeläinen T, Itkonen ST, Lundqvist A, Erkkola M, Koskela T, Lakkala K, Dowling KG, Hull GL, Kröger H, Karppinen J, Kyllönen E, Härkänen T, Cashman KD, Männistö S, Lamberg-Allardt C (2017) The positive impact of general vitamin D food fortification policy on vitamin D status in a representative adult Finnish population: evidence from an 11-y follow-up based on standardized 25-hydroxyvitamin D data. Am J Clin Nutr 105(6):1512–1520PubMedGoogle Scholar
  25. 25.
    Cashman KD, Ritz C, Kiely M, Odin Collaborators (2017) Improved dietary guidelines for vitamin D: application of individual participant data (IPD)-level meta-regression analyses. Nutrients 9(5):E469CrossRefPubMedGoogle Scholar
  26. 26.
    Itkonen ST, Erkkola M, Skaffari E et al (2016) Development and validation of an interview-administered FFQ for assessment of vitamin D and calcium intakes in Finnish women. Br J Nutr 115:1100–1107CrossRefPubMedGoogle Scholar
  27. 27.
    Cashman KD, Kiely M, Kinsella M, Durazo-Arvizu RA, Tian L, Zhang Y, Lucey A, Flynn A, Gibney MJ, Vesper HW, Phinney KW, Coates PM, Picciano MF, Sempos CT (2013) Evaluation of Vitamin D Standardization Program protocols for standardizing serum 25-hydroxyvitamin D data: a case study of the program’s potential for national nutrition and health surveys. Am J Clin Nutr 97(6):1235–1242CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    CDC Vitamin D Standardization Certification Program. Available online at: Accessed 30 Jan 2018
  29. 29.
    Cashman KD, Hill TR, Lucey AJ, Taylor N, Seamans KM, Muldowney S, Fitzgerald AP, Flynn A, Barnes MS, Horigan G, Bonham MP, Duffy EM, Strain JJ, Wallace JM, Kiely M (2008) Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr 88(6):1535–1542CrossRefPubMedGoogle Scholar
  30. 30.
    Zittermann A, Ernst JB, Gummert JF, Börgermann J (2014) Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: a systematic review. Eur J Nutr 53(2):367–374CrossRefPubMedGoogle Scholar
  31. 31.
    R Core Team. A language and environment for statistical computing [Internet]. [cited 2013 Sep 13]. Available from:
  32. 32.
    German Nutrition Society (2012) New reference values for vitamin D. Ann Nutr Metab 60:241–246CrossRefGoogle Scholar
  33. 33.
    Islam MZ, Viljakainen HT, Kärkkäinen MU, Saarnio E, Laitinen K, Lamberg-Allardt C (2012) Prevalence of vitamin D deficiency and secondary hyperparathyroidism during winter in pre-menopausal Bangladeshi and Somali immigrant and ethnic Finnish women: associations with forearm bone mineral density. Br J Nutr 107(2):277–283CrossRefPubMedGoogle Scholar
  34. 34.
    Rajakumar K, Moore CG, Yabes J, Olabopo F, Haralam MA, Comer D, Holick MF, Greenspan SL (2016) Estimations of dietary vitamin D requirements in black and white children. Pediatr Res 80(1):14–20CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Alzaman NS, Dawson-Hughes B, Nelson J, D’Alessio D, Pittas AG (2016) Vitamin D status of black and white Americans and changes in vitamin D metabolites after varied doses of vitamin D supplementation. Am J Clin Nutr 104(1):205–214CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Aloia JF, Patel M, Dimaano R, Li-Ng M, Talwar SA, Mikhail M, Pollack S, Yeh JK (2008 Jun) Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration. Am J Clin Nutr 87(6):1952–1958CrossRefPubMedGoogle Scholar
  37. 37.
    Hansen JG, Tang W, Hootman KC, Brannon PM, Houston DK, Kritchevsky SB, Harris TB, Garcia M, Lohman K, Liu Y, de Boer IH, Kestenbaum BR, Robinson-Cohen C, Siscovick DS, Cassano PA (2015) Genetic and environmental factors are associated with serum 25 hydroxyvitamin D concentrations in older African Americans. J Nutr 145(4):799–805CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Sollid ST, Hutchinson MY, Fuskevåg OM, Joakimsen RM, Jorde R (2016) Large individual differences in serum 25-hydroxyvitamin D response to vitamin D supplementation: effects of genetic factors, body mass index, and baseline concentration. results from a randomized controlled trial. Horm Metab Res 48(1):27–34PubMedGoogle Scholar
  39. 39.
    Gebreegziabher T, Stoecker BJ (2013) Vitamin D insufficiency in a sunshine-sufficient area: Southern Ethiopia. Food Nutr Bull 34(4):429–433CrossRefPubMedGoogle Scholar
  40. 40.
    Lindsay KL, Gibney ER, McNulty BA, McAuliffe FM (2014) Pregnant immigrant Nigerian women: an exploration of dietary intakes. Public Health 128(7):647–653CrossRefPubMedGoogle Scholar
  41. 41.
    Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Jakobsen J, Lamberg-Allardt C, Ovesen L (2008) Pakistani immigrant children and adults in Denmark have severely low vitamin D status. Eur J Clin Nutr 62(5):625–634CrossRefPubMedGoogle Scholar
  42. 42.
    Darling AL, Hart KH, Gossiel F, Robertson F, Hunt J, Hill TR, Johnsen S, Berry JL, Eastell R, Vieth R, Lanham-New SA (2017) Higher bone resorption excretion in South Asian women vs. White Caucasians and increased bone loss with higher seasonal cycling of vitamin D: Results from the D-FINES cohort study. Bone 98:47–53CrossRefPubMedGoogle Scholar
  43. 43.
    USDA Dietary Supplement Ingredient Database Release 4.0 (DSID-4) (2018) Adult Multivitamin/mineral (Adult MVM-2017) Dietary Supplement National Study: Research Summary Accessed 15 June 2018
  44. 44.
    Verkaik-Kloosterman J, Seves SM, Ocké MC (2017) Vitamin D concentrations in fortified foods and dietary supplements intended for infants: implications for vitamin D intake. Food Chem 15(221):629–635CrossRefGoogle Scholar
  45. 45.
    Cashman KD (2018).Vitamin D requirements for the future-lessons learned and charting a path forward. Nutrients 10:E533CrossRefPubMedGoogle Scholar
  46. 46.
    Cashman KD, Sheehy T, O’Neill CM (2018) Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur J Nutr. CrossRefPubMedGoogle Scholar
  47. 47.
    O’Callaghan KM, Kiely ME (2017) Ethnic disparities in the dietary requirement for vitamin D during pregnancy: considerations for nutrition policy and research. Proc Nutr Soc. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kevin D. Cashman
    • 1
    • 2
    Email author
  • Christian Ritz
    • 3
  • Folasade A. Adebayo
    • 4
  • Kirsten G. Dowling
    • 1
  • Suvi T. Itkonen
    • 4
  • Taina Öhman
    • 4
  • Essi Skaffari
    • 4
  • Elisa M. Saarnio
    • 4
  • Mairead Kiely
    • 1
    • 5
  • Christel Lamberg-Allardt
    • 4
  1. 1.School of Food and Nutritional SciencesCork Centre for Vitamin D and Nutrition ResearchCorkIreland
  2. 2.Department of MedicineUniversity College CorkCorkIreland
  3. 3.Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenFrederiksberg CDenmark
  4. 4.Calcium Research Unit, Department of Food and NutritionUniversity of HelsinkiHelsinkiFinland
  5. 5.Irish Centre for Fetal and Neonatal Translational Research [INFANT]University College CorkCorkIreland

Personalised recommendations