The journal of nutrition, health & aging

, Volume 19, Issue 10, pp 980–985 | Cite as

BMI and body fat mass is inversely associated with vitamin D levels in older individuals

  • S. Oliai Araghi
  • S. C. van Dijk
  • A. C. Ham
  • E. M. Brouwer-Brolsma
  • A. W. Enneman
  • E. Sohl
  • K. M. A. Swart
  • N. L. van der Zwaluw
  • J. P. van Wijngaarden
  • R. A. M. Dhonukshe-Rutten
  • N. M. van Schoor
  • M. C. Zillikens
  • P. Lips
  • L. de Groot
  • A. G. Uitterlinden
  • Nathalie van der VeldeEmail author



To assess the association between obesity (measured by Body Mass Index (BMI) and fat percentage) and serum 25(OH)D levels in older persons.


Cross-sectional analysis of data from ‘the B-PROOF study’ (B-vitamins for the Prevention Of Osteoporotic Fractures).


2842 participants aged 65 years and older.


BMI and fat percentage, measured by Dual Energy X-ray, and serum 25(OH) D levels.


Mean age was 74 years (6.5 SD), with 50% women. Mean serum 25(OH)D levels were 55.8 nmol/L (25 SD). BMI and total body fat percentage were significant inversely associated with serum 25(OH)D levels after adjustment for confouders (β−0.93; 95%CI [−1.15; −0.71], p<0.001 and β−0.84; 95%CI [−1.04; −0.64], p<0.001). This association was most prominent in individuals with a BMI in the ‘overweight’ and ‘obesity’ range (β−1.25 and −0.96 respectively) and fat percentage in the last two upper quartiles (β−1.86 and −1.37 respectively).


In this study, higher BMI and higher body fat percentage were significantly associated with lower serum 25(OH)D levels in older persons. This association was particularly present in individuals with overweight, and higher fat percentages, suggesting that these persons are at increased risk of vitamin D insufficiency.

Key words

BMI fat percentage vitamin D elderly people 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Mathus-Vliegen EM. Obesity and the elderly. J Clin Gastroenterol. Aug 2012;46(7):533–544.CrossRefGoogle Scholar
  2. 2.
    Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. Feb 12 2011;377(9765):557–567.CrossRefGoogle Scholar
  3. 3.
    Pi-Sunyer FX. Comorbidities of overweight and obesity: current evidence and research issues. Med Sci Sports Exerc. Nov 1999;31(11 Suppl):S602–608.CrossRefGoogle Scholar
  4. 4.
    Visscher TL, Seidell JC. The public health impact of obesity. Annu Rev Public Health. 2001;22:355–375.CrossRefPubMedGoogle Scholar
  5. 5.
    Ginde AA, Liu MC, Camargo CA, Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. Mar 23 2009;169(6):626–632.CrossRefGoogle Scholar
  6. 6.
    Lanham-New SA, Buttriss JL, Miles LM, et al. Proceedings of the Rank Forum on Vitamin D. Br J Nutr. Jan 2011;105(1):144–156.CrossRefGoogle Scholar
  7. 7.
    Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. Aug 2001;22(4):477–501.CrossRefGoogle Scholar
  8. 8.
    Mensink GB, Fletcher R, Gurinovic M, et al. Mapping low intake of micronutrients across Europe. Br J Nutr. Aug 2013;110(4):755–773.CrossRefGoogle Scholar
  9. 9.
    Patrini C, Griziotti A, Ricciardi L. Obese individuals as thiamin storers. Int J Obes Relat Metab Disord. Jul 2004;28(7):920–924.CrossRefGoogle Scholar
  10. 10.
    Snijder MB, van Dam RM, Visser M, et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab. Jul 2005;90(7):4119–4123.CrossRefGoogle Scholar
  11. 11.
    Vitezova A, Zillikens C, van Herpt T, et al. Vitamin D status and metabolic syndrome in the elderly: the Rotterdam Study. Eur J Endocrinol. Dec 2 2014.Google Scholar
  12. 12.
    Morley JE, Mooradian AD, Silver AJ, Heber D, Alfin-Slater RB. Nutrition in the elderly. Ann Intern Med. Dec 1 1988;109(11):890–904.CrossRefGoogle Scholar
  13. 13.
    Nguyen TV, Center JR, Eisman JA. Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index. J Bone Miner Res. Feb 2000;15(2):322–331.CrossRefGoogle Scholar
  14. 14.
    Saneei P, Salehi-Abargouei A, Esmaillzadeh A. Serum 25-hydroxy vitamin D levels in relation to body mass index: a systematic review and meta-analysis. Obes Rev. May 2013;14(5):393–404.CrossRefGoogle Scholar
  15. 15.
    Heim N, Snijder, M.B., Deeg, D.J.H., Seidell, J.C., Visser, M. Obesity in older adults is associated with an increased prevalence and incidence of pain. Obesity Journal. 2008;16(11):2510–2517.CrossRefGoogle Scholar
  16. 16.
    Kennedy RL, Chokkalingham K, Srinivasan R. Obesity in the elderly: who should we be treating, and why, and how? Curr Opin Clin Nutr Metab Care. Jan 2004;7(1):3–9.Google Scholar
  17. 17.
    Villareal DT, Apovian CM, Kushner RF, Klein S, American Society for N, Naaso TOS. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr. Nov 2005;82(5):923–934.Google Scholar
  18. 18.
    Zamboni M, Mazzali G, Zoico E, et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond). Sep 2005;29(9):1011–1029.CrossRefGoogle Scholar
  19. 19.
    Gallagher D, Visser M, de Meersman RE, et al. Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol (1985). Jul 1997;83(1):229–239.Google Scholar
  20. 20.
    Shah NR, Braverman ER. Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin. PLoS One. 2012;7(4):e33308.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    van Wijngaarden JP, Dhonukshe-Rutten RA, van Schoor NM, et al. Rationale and design of the B-PROOF study, a randomized controlled trial on the effect of supplemental intake of vitamin B12 and folic acid on fracture incidence. BMC Geriatr. 2011;11:80.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am J Clin Nutr. Apr 1991;53(4):839–846.Google Scholar
  23. 23.
    Garretsen H. Probleemdrinken: Prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden: Theoretische overwegingen en onderzoek in Rotterdam. (in Dutch). Lisse, Swets & Zeitlinger 1983.Google Scholar
  24. 24.
    Mulder PG, Garretsen HF. Are epidemiological and sociological surveys a proper instrument for detecting true problem drinkers? (The low sensitivity of an alcohol survey in Rotterdam). Int J Epidemiol. Dec 1983;12(4):442–444.CrossRefGoogle Scholar
  25. 25.
    Stel VS, Smit JH, Pluijm SM, Visser M, Deeg DJ, Lips P. Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. J Clin Epidemiol. Mar 2004;57(3):252–258.CrossRefGoogle Scholar
  26. 26.
    van Dijk SC, Sohl E, Oudshoorn C, et al. Non-linear associations between serum 25-OH vitamin D and indices of arterial stiffness and arteriosclerosis in an older population. Age Ageing. Jan 2015;44(1):136–142.CrossRefGoogle Scholar
  27. 27.
    Ross AC, Manson JE, Abrams SA, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. Jan 2011;96(1):53–58.CrossRefGoogle Scholar
  28. 28.
    Vimaleswaran KS, Berry DJ, Lu C, et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 2013;10(2):e1001383.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Brock K, Huang WY, Fraser DR, et al. Low vitamin D status is associated with physical inactivity, obesity and low vitamin D intake in a large US sample of healthy middle-aged men and women. J Steroid Biochem Mol Biol. Jul 2010;121(1-2):462–466.CrossRefGoogle Scholar
  30. 30.
    Power SE, Jeffery IB, Ross RP, et al. Food and nutrient intake of Irish communitydwelling elderly subjects: who is at nutritional risk? J Nutr Health Aging. 2014;18(6):561–572.CrossRefPubMedGoogle Scholar
  31. 31.
    Clemens TL, Zhou XY, Myles M, Endres D, Lindsay R. Serum vitamin D2 and vitamin D3 metabolite concentrations and absorption of vitamin D2 in elderly subjects. J Clin Endocrinol Metab. Sep 1986;63(3):656–660.CrossRefGoogle Scholar
  32. 32.
    Rosenstreich SJ, Rich C, Volwiler W. Deposition in and release of vitamin D3 from body fat: evidence for a storage site in the rat. J Clin Invest. Mar 1971;50(3):679–687.CrossRefGoogle Scholar
  33. 33.
    Blum M, Dolnikowski G, Seyoum E, et al. Vitamin D(3) in fat tissue. Endocrine. Feb 2008;33(1):90–94.CrossRefGoogle Scholar
  34. 34.
    Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. Sep 2000;72(3):690–693.Google Scholar
  35. 35.
    Rock CL, Emond JA, Flatt SW, et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity (Silver Spring). Nov 2012;20(11):2296–2301.CrossRefGoogle Scholar
  36. 36.
    Soares MJ, Murhadi LL, Kurpad AV, Chan She Ping-Delfos WL, Piers LS. Mechanistic roles for calcium and vitamin D in the regulation of body weight. Obes Rev. Jul 2012;13(7):592–605.CrossRefGoogle Scholar
  37. 37.
    Stokic E, Kupusinac A, Tomic-Naglic D, et al. Obesity and Vitamin D Deficiency: Trends to Promote a More Proatherogenic Cardiometabolic Risk Profile. Angiology. Mar 21 2014.Google Scholar
  38. 38.
    Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab. Jan 2003;88(1):157–161.CrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2015

Authors and Affiliations

  • S. Oliai Araghi
    • 1
  • S. C. van Dijk
    • 1
  • A. C. Ham
    • 1
  • E. M. Brouwer-Brolsma
    • 3
  • A. W. Enneman
    • 1
  • E. Sohl
    • 2
  • K. M. A. Swart
    • 2
  • N. L. van der Zwaluw
    • 3
  • J. P. van Wijngaarden
    • 3
  • R. A. M. Dhonukshe-Rutten
    • 3
  • N. M. van Schoor
    • 2
  • M. C. Zillikens
    • 1
  • P. Lips
    • 2
    • 4
  • L. de Groot
    • 3
  • A. G. Uitterlinden
    • 1
    • 5
  • Nathalie van der Velde
    • 1
    • 6
    Email author
  1. 1.Erasmus MC, Department of Internal Medicine, Section of GeriatricsUniversity Medical Centre RotterdamRotterdamthe Netherlands
  2. 2.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical CentreAmsterdamthe Netherlands
  3. 3.Division of Human NutritionWageningen UniversityWageningenthe Netherlands
  4. 4.Department of EndocrinologyVU University medical centreAmsterdamthe Netherlands
  5. 5.Department of Epidemiology, Erasmus MCUniversity Medical Centre RotterdamRotterdamthe Netherlands
  6. 6.Department of Internal Medicine, Section of Geriatric MedicineAcademic Medical CentreAmsterdamthe Netherlands

Personalised recommendations