Archives of Osteoporosis

, Volume 7, Issue 1–2, pp 155–172 | Cite as

A global representation of vitamin D status in healthy populations

  • D. A. Wahl
  • C. Cooper
  • P. R. Ebeling
  • M. Eggersdorfer
  • J. Hilger
  • K. Hoffmann
  • R. Josse
  • J. A. Kanis
  • A. Mithal
  • D. D. Pierroz
  • J. Stenmark
  • E. Stöcklin
  • B. Dawson-HughesEmail author
Original Article



This paper visualizes the available data on vitamin D status on a global map, examines the existing heterogeneities in vitamin D status and identifies research gaps.


A graphical illustration of global vitamin D status was developed based on a systematic review of the worldwide literature published between 1990 and 2011. Studies were eligible if they included samples of randomly selected males and females from the general population and assessed circulating 25-hydroxyvitamin D [25(OH)D] levels. Two different age categories were selected: children and adolescents (1–18 years) and adults (>18 years). Studies were chosen to represent a country based on a hierarchical set of criteria.


In total, 200 studies from 46 countries met the inclusion criteria, most coming from Europe. Forty-two of these studies (21 %) were classified as representative. In children, gaps in data were identified in large parts of Africa, Central and South America, Europe, and most of the Asia/Pacific region. In adults, there was lack of information in Central America, much of South America and Africa. Large regions were identified for which the mean 25(OH)D levels were below 50 nmol/L.


This study provides an overview of 25(OH)D levels around the globe. It reveals large gaps in information in children and adolescents and smaller but important gaps in adults. In view of the importance of vitamin D to musculoskeletal growth, development, and preservation, and of its potential importance in other tissues, we strongly encourage new research to clearly define 25(OH)D status around the world.


Vitamin D status Vitamin D deficiency 25(OH)D IOF 



The authors would like to thank invaluable advice from Professors Noriko Yoshimura, Edith Lau, Jean-Philippe Bonjour, Sunil Wimalawansa, Steven Boonen, Paul Lips and the late Philip Sambrook from the IOF Committee of Scientific Advisors; Professor Peter Weber, Doctors Angelika Friedel and Franz Roos from the DSM Nutrition Science & Advocacy for their intellectual input; and DSM for supporting the work through an unrestricted educational grant.

Conflicts of interest

Drs. Manfred Eggersdorfer and Elisabeth Stöcklin are employed by DSM Nutritional Products, Ltd. Professor Cyrus Cooper has received honoraria and consulting fees from Amgen, Eli Lilly, Medtronic, Merck, Novartis and Servier. All the other authors have nothing to disclose.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • D. A. Wahl
    • 2
  • C. Cooper
    • 3
  • P. R. Ebeling
    • 4
  • M. Eggersdorfer
    • 5
  • J. Hilger
    • 6
  • K. Hoffmann
    • 6
  • R. Josse
    • 7
  • J. A. Kanis
    • 9
  • A. Mithal
    • 8
  • D. D. Pierroz
    • 2
  • J. Stenmark
    • 2
  • E. Stöcklin
    • 5
  • B. Dawson-Hughes
    • 1
    Email author
  1. 1.U.S. Department of Agriculture Human Nutrition Research Center on AgingTufts UniversityBostonUSA
  2. 2.International Osteoporosis FoundationNyonSwitzerland
  3. 3.MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton and NIHR Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
  4. 4.NorthWest Academic CentreUniversity of Melbourne, Western HealthSt. AlbansAustralia
  5. 5.Nutrition Science & Advocacy and Research & Development Human NutritionDSM Nutritional ProductsKaiseraugstSwitzerland
  6. 6.Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical FacultyHeidelberg UniversityMannheimGermany
  7. 7.Division of Endocrinology and Metabolism, St Michael’s Hospital Health CentreUniversity of TorontoTorontoCanada
  8. 8.Medanta Medicity, Sector 38GurgaonIndia
  9. 9.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK

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