Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis


Low levels of vitamin D nutrition (i.e., vitamin D insufficiency), which potentially cause osteoporosis, have been recognized as a common health problem for elderly people in European and North American countries, but there have been no studies on the prevalence of vitamin D insufficiency in Japan until recently. The aim of this article was to review descriptive features of serum 25-hydroxyvitamin D [25(OH)D] levels and vitamin D insufficiency in Japanese subjects. Reviewing 15 studies pertaining to vitamin D nutritional status recently published for various Japanese populations revealed that: (1) the prevalence of vitamin D insufficiency in active elderly people was as low as 5% or less; (2) the prevalence of vitamin D insufficiency was much higher (up to about 50%) in inactive elderly people than in active elderly people, depending on activities of daily living (ADL); (3) frequent fish consumption helps increase serum 25(OH)D concentrations, especially in winter; and (4) vitamin D nutrition in young women was poorer than people in middle and advanced ages, which may adversely affect bone metabolism. Future studies should focus on the effects of low vitamin D status on bone mass and fractures in Japanese subjects.

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  1. 1

    O Sahota (2000) ArticleTitleOsteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency Age Ageing 29 301–304 Occurrence Handle10985437 Occurrence Handle10.1093/ageing/29.4.301 Occurrence Handle1:STN:280:DC%2BD3M%2Fpsl2gsg%3D%3D

    PubMed  Article  CAS  Google Scholar 

  2. 2

    MC Chapuy P Preziosi M Maamer S Arnaud P Galan S Hercberg PJ Meunier (1997) ArticleTitlePrevalence of vitamin D insufficiency in an adult normal population Osteoporos Int 7 439–443 Occurrence Handle9425501 Occurrence Handle10.1007/s001980050030 Occurrence Handle1:STN:280:DyaK1c%2Fos1Kgug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  3. 3

    ME Ooms P Lips JC Roos WJ van der Vijgh C Popp-Snijders PD Bezemer LM Bouter (1995) ArticleTitleVitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women J Bone Miner Res 10 1177–1184 Occurrence Handle8585420 Occurrence Handle1:CAS:528:DyaK2MXntlSgtLw%3D

    PubMed  CAS  Google Scholar 

  4. 4

    RPJ Van der Wielen MRH Löwik H van der Berg LC de Groot J Haller O Moreiras WA van Staveren (1995) ArticleTitleSerum vitamin D concentrations among elderly people in Europe Lancet 346 207–210 Occurrence Handle7616799 Occurrence Handle1:CAS:528:DyaK2MXnt1ynsrs%3D

    PubMed  CAS  Google Scholar 

  5. 5

    MC Chapuy AM Schott P Garnero D Hans PD Delmas PJ Meunier (1996) ArticleTitleHealthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter J Clin Endocrinol Metab 81 1129–1133 Occurrence Handle8772587 Occurrence Handle10.1210/jc.81.3.1129 Occurrence Handle1:CAS:528:DyaK28Xhs1agsbY%3D

    PubMed  Article  CAS  Google Scholar 

  6. 6

    T Kobayashi T Okano S Shida K Okada T Suginohara H Nakao E Kuroda S Kodama T Matsuo (1983) ArticleTitleVariation of 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 levels in human plasma obtained from 758 Japanese healthy subjects J Nutr Sci Vitaminol 29 271–281 Occurrence Handle6604797 Occurrence Handle1:CAS:528:DyaL3sXkvVOjs7Y%3D

    PubMed  CAS  Google Scholar 

  7. 7

    Y Morita N Endo T Iga K Tokunaga Y Ohkawa (2002) ArticleTitleThe incidence of cervical and trochanteric fractures of the proximal femur in 1999 in Niigata Prefecture, Japan J Bone Miner Metab 20 311–318 Occurrence Handle12203038 Occurrence Handle10.1007/s007740200045

    PubMed  Article  Google Scholar 

  8. 8

    MK Thomas DM Lloyd-Jones RI Thadhani AC Shaw DJ Deraska BT Kitch EC Vamvakas IM Dick RL Prince JS Finkelstein (1998) ArticleTitleHypovitaminosis D in medical inpatients N Engl J Med 338 777–783 Occurrence Handle9504937 Occurrence Handle10.1056/NEJM199803193381201 Occurrence Handle1:STN:280:DyaK1c7lvVSgsw%3D%3D

    PubMed  Article  CAS  Google Scholar 

  9. 9

    A Malabanan IE Veronikis MF Holick (1998) ArticleTitleRedefining vitamin D insufficiency Lancet 351 805–806 Occurrence Handle9519960 Occurrence Handle10.1016/S0140-6736(05)78933-9 Occurrence Handle1:STN:280:DyaK1c7nvVOrsA%3D%3D

    PubMed  Article  CAS  Google Scholar 

  10. 10

    K Nakamura M Nashimoto Y Hori K Muto M Yamamoto (1999) ArticleTitleSerum 25-hydroxyvitamin D levels in active women of middle and advanced age in a rural community in Japan Nutrition 15 870–873 Occurrence Handle10575663 Occurrence Handle1:CAS:528:DyaK1MXntVCns74%3D

    PubMed  CAS  Google Scholar 

  11. 11

    K Nakamura M Nashimoto Y Hori M Yamamoto (2000) ArticleTitleSerum parathyroid hormone in healthy female Japanese in relation to serum 25-hydroxyvitamin D Int J Vitam Nutr Res 70 287–292 Occurrence Handle11214353 Occurrence Handle1:CAS:528:DC%2BD3MXktFWkt7o%3D

    PubMed  CAS  Google Scholar 

  12. 12

    K Nakamura M Nashimoto Y Hori M Yamamoto (2000) ArticleTitleSerum 25-hydroxyvitamin D concentrations and related dietary factors in peri- and postmenopausal Japanese women Am J Clin Nutr 71 1161–1165 Occurrence Handle10799378 Occurrence Handle1:CAS:528:DC%2BD3cXivFymsLc%3D

    PubMed  CAS  Google Scholar 

  13. 13

    K Nakamura M Nashimoto K Endoh M Yamamoto (2000) ArticleTitleVitamin D nutritional status of women living on a solitary island in Japan: a population-based study Environ Health Prev Med 5 49–52 Occurrence Handle10.1265/ehpm.2000.49 Occurrence Handle1:CAS:528:DC%2BD3cXmtl2qs78%3D

    Article  CAS  Google Scholar 

  14. 14

    PF Jacques DT Felson KL Tucker B Mahnken PW Wilson IH Rosenberg D Rush (1997) ArticleTitlePlasma 25-hydroxyvitamin D and its determinants in an elderly population sample Am J Clin Nutr 66 929–936 Occurrence Handle9322570 Occurrence Handle1:STN:280:DyaK2svmtlyluw%3D%3D

    PubMed  CAS  Google Scholar 

  15. 15

    C Lamberg-Allardt (1984) ArticleTitleThe relationship between serum 25-hydroxy-vitamin D levels and other variables related to calcium and phosphorus metabolism in the elderly Acta Endocrinol (Copenh) 105 139–144 Occurrence Handle1:CAS:528:DyaL2cXmslSluw%3D%3D

    CAS  Google Scholar 

  16. 16

    S Levis A Gomez C Jimenez L Veras F Ma S Lai B Hollis BA Roos (2005) ArticleTitleVitamin D deficiency and seasonal variation in an adult South Florida population J Clin Endocrinol Metab 90 1557–1562 Occurrence Handle15634725 Occurrence Handle1:CAS:528:DC%2BD2MXisVOhtr0%3D

    PubMed  CAS  Google Scholar 

  17. 17

    B Burnand D Sloutskis F Gianoli J Cornuz M Rickenbach F Paccaud P Burckhardt (1992) ArticleTitleSerum 25-hydroxyvitamin D: distribution and determinants in the Swiss population Am J Clin Nutr 56 537–542 Occurrence Handle1503066 Occurrence Handle1:CAS:528:DyaK3sXjsl2ltQ%3D%3D

    PubMed  CAS  Google Scholar 

  18. 18

    JL Omdahl PJ Garry LA Hunsaker WC Hunt JS Goodwin (1982) ArticleTitleNutritional status in a healthy elderly population: vitamin D Am J Clin Nutr 36 1225–1233 Occurrence Handle7148741 Occurrence Handle1:CAS:528:DyaL3sXjtlGktQ%3D%3D

    PubMed  CAS  Google Scholar 

  19. 19

    ME Ooms P Lips JC Roos WJ van der Vijgh C Popp-Snijders PD Bezemer LM Bouter (1995) ArticleTitleVitamin D status and sex hormone binding globulin: determinants of bone turnover and bone mineral density in elderly women J Bone Miner Res 10 1177–1184 Occurrence Handle8585420 Occurrence Handle1:CAS:528:DyaK2MXntlSgtLw%3D Occurrence Handle10.1002/jbmr.5650100806

    PubMed  CAS  Article  Google Scholar 

  20. 20

    K Nakamura M Nashimoto M Yamamoto (2000) ArticleTitleSummer/winter difference in the serum 25-hydroxyvitamin D3 and parathyroid hormone levels of Japanese women Int J Biometeorol 44 186–189 Occurrence Handle11131290 Occurrence Handle10.1007/s004840000067 Occurrence Handle1:STN:280:DC%2BD3M%2FosFCktg%3D%3D

    PubMed  Article  CAS  Google Scholar 

  21. 21

    FM Gloth SuffixIII CM Gundberg BW Hollis JG Haddad SuffixJr JD Tobin (1995) ArticleTitleVitamin D deficiency in homebound elderly persons JAMA 274 1683–1686 Occurrence Handle7474272 Occurrence Handle10.1001/jama.274.21.1683

    PubMed  Article  Google Scholar 

  22. 22

    M Nashimoto K Nakamura S Matsuyama M Hatakeyama M Yamamoto (2002) ArticleTitleHypovitaminosis D and hyperparathyroidism in physically inactive elderly Japanese living in nursing homes: relationship with age, sunlight exposure, and activities of daily living Aging Clin Exp Res 14 5–12 Occurrence Handle12027153 Occurrence Handle1:STN:280:DC%2BD383os1Smug%3D%3D

    PubMed  CAS  Google Scholar 

  23. 23

    K Nakamura T Nishiwaki K Ueno M Yamamoto (2005) ArticleTitleSerum 25-hydoroxyvitamin D and parathyroid hormone levels of non-institutionalized elderly Japanese requiring care J Bone Miner Metab 23 488–494 Occurrence Handle16261457 Occurrence Handle1:CAS:528:DC%2BD2MXhtFKktrzJ

    PubMed  CAS  Google Scholar 

  24. 24

    K Nakamura M Nashimoto Y Okuda T Ota M Yamamoto (2002) ArticleTitleFish as a major source of vitamin D in the Japanese diet Nutrition 18 415–416 Occurrence Handle11985947 Occurrence Handle10.1016/S0899-9007(02)00751-7 Occurrence Handle1:CAS:528:DC%2BD38Xjt1Witrs%3D

    PubMed  Article  CAS  Google Scholar 

  25. 25

    K Nakamura Y Hori M Nashimoto Y Okuda H Miyazaki Y Kasai M Yamamoto (2003) ArticleTitleNutritional covariates of dietary calcium in elderly Japanese women: results of a study using the duplicate portion sampling method Nutrition 19 922–925 Occurrence Handle14624939 Occurrence Handle10.1016/S0899-9007(03)00181-3 Occurrence Handle1:CAS:528:DC%2BD3sXptVWmu7w%3D

    PubMed  Article  CAS  Google Scholar 

  26. 26

    InstitutionalAuthorNameSociety for Information on Health and Nutrition (1999) Recommended Dietary Allowance. Dietary Reference Intakes EditionNumber6th ed. Dai-ichi Shuppan Tokyo

    Google Scholar 

  27. 27

    MF Holick (1995) Evolution, biologic functions, and recommended dietary allowances for vitamin D MF Holick (Eds) Vitamin D: Physiology, Molecular Biology, and Clinical Applications Humana Press Totowa, NJ, (USA) 1–16

    Google Scholar 

  28. 28

    InstitutionalAuthorNameResources Council, Science and Technology Agency, Japan (2000) Standard Tables of Food Composition in Japan EditionNumber5th ed. Printing Bureau, Ministry of Finance Tokyo

    Google Scholar 

  29. 29

    T Okano N Tsugawa Y Suhara K Tanaka H Ishida K Uenishi E Kubota M Fukunaga T Hosoi M Shiraki (2004) ArticleTitleVitamin D status and bone metabolic markers of adult, especially elderly women in Japan Osteoporos Jpn 12 76–79

    Google Scholar 

  30. 30

    JY Reginster I Frederick R Deroisy W Dewe AN Taquet A Albert J Collette H Pirenne SX Zheng C Gosset (1998) ArticleTitleParathyroid hormone plasma concentrations in response to low 25-OH vitamin D circulating levels increases with age in elderly women Osteoporos Int 8 390–392 Occurrence Handle10024911 Occurrence Handle1:STN:280:DyaK1M7kvFSmsg%3D%3D

    PubMed  CAS  Google Scholar 

  31. 31

    K Stone DC Bauer DM Black P Sklarin KE Ensrud SR Cummings InstitutionalAuthorNameThe Study of Osteoporotic Fractures Research Group (1998) ArticleTitleHormonal predictors of bone loss in elderly women: a prospective study J Bone Miner Res 13 1167–1174 Occurrence Handle9661081 Occurrence Handle1:CAS:528:DyaK1cXks1arsrs%3D

    PubMed  CAS  Google Scholar 

  32. 32

    EE Fradinger JR Zanchetta (2001) ArticleTitleVitamin D and bone mineral density in ambulatory women living in Buenos Aires, Argentina Osteoporos Int 12 24–27 Occurrence Handle11305079 Occurrence Handle10.1007/s001980170153 Occurrence Handle1:CAS:528:DC%2BD3MXjsFeqs78%3D

    PubMed  Article  CAS  Google Scholar 

  33. 33

    A Del Puente A Esposito S Savastano A Carpinelli L Postiglione P Oriente (2002) ArticleTitleDietary calcium intake and serum vitamin D are major determinants of bone mass variations in women: a longitudinal study Aging Clin Exp Res 14 382–388 Occurrence Handle12602573 Occurrence Handle1:CAS:528:DC%2BD3sXivFKksrg%3D

    PubMed  CAS  Google Scholar 

  34. 34

    HA Bischoff-Ferrari T Dietrich EJ Orav B Dawson-Hughes (2004) ArticleTitlePositive association between 25-hydroxyvitamin D levels and bone mineral density: a population-based study of younger and older adults Am J Med 116 634–639 Occurrence Handle15093761 Occurrence Handle10.1016/j.amjmed.2003.12.029 Occurrence Handle1:CAS:528:DC%2BD2cXjt1SisrY%3D

    PubMed  Article  CAS  Google Scholar 

  35. 35

    K Nakamura M Nashimoto M Yamamoto (2001) ArticleTitleAre the serum 25-hydroxyvitamin D concentrations associated with the forearm bone mineral density in healthy Japanese elderly women? Int J Vitam Nutr Res 71 25–29 Occurrence Handle11276918 Occurrence Handle1:CAS:528:DC%2BD3MXntFWju70%3D

    PubMed  CAS  Google Scholar 

  36. 36

    TA Outila MUM Kärkkäinen CJE Lamberg-Allardt (2001) ArticleTitleVitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density Am J Clin Nutr 74 206–210 Occurrence Handle11470722 Occurrence Handle1:CAS:528:DC%2BD3MXlslKns7k%3D

    PubMed  CAS  Google Scholar 

  37. 37

    K Nakamura M Nashimoto Y Tsuchiya A Obata K Miyanishi M Yamamoto (2001) ArticleTitleVitamin D insufficiency in Japanese female college students: a preliminary report Int J Vitam Nutr Res 71 302–305 Occurrence Handle11725695 Occurrence Handle1:CAS:528:DC%2BD3MXptFKrsL8%3D

    PubMed  CAS  Google Scholar 

  38. 38

    K Nakamura M Nashimoto S Matsuyama M Yamamoto (2001) ArticleTitleLow concentrations of the serum 25-hydroxyvitamin D in young Japanese women: a cross sectional study Nutrition 17 921–925 Occurrence Handle11744341 Occurrence Handle10.1016/S0899-9007(01)00662-1 Occurrence Handle1:CAS:528:DC%2BD3MXptVSksb8%3D

    PubMed  Article  CAS  Google Scholar 

  39. 39

    K Nakamura Y Tanaka K Saitou M Nashimoto M Yamamoto (2000) ArticleTitleAge and sex differences in the bone mineral density of the distal forearm based on health check-up data of 6343 Japanese Osteoporos Int 11 772–777 Occurrence Handle11148805 Occurrence Handle10.1007/s001980070056 Occurrence Handle1:STN:280:DC%2BD3M7hs1aqtA%3D%3D

    PubMed  Article  CAS  Google Scholar 

  40. 40

    AG Uitterlinden JPTM van Leeuwen HAP Pols (2001) Genetics and genomics of osteoporosis R Marcus D Feldman J Kelsey (Eds) Osteoporosis EditionNumber2nd ed, Vol 1 Academic San Diego 639–667

    Google Scholar 

  41. 41

    M Pfeifer B Begerow HW Minne C Abrams D Nachtigall C Hansen (2000) ArticleTitleEffects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women J Bone Miner Res 15 1113–1118 Occurrence Handle10841179 Occurrence Handle1:CAS:528:DC%2BD3cXktFKhurs%3D

    PubMed  CAS  Google Scholar 

  42. 42

    M Pfeifer B Begerow HW Minne T Schlotthauer M Pospeschill M Scholz AD Lazarescu W Pollahne (2001) ArticleTitleVitamin D status, trunk muscle strength, body sway, falls, and fractures among 237 postmenopausal women with osteoporosis Exp Clin Endocrinol Diabetes 109 87–92 Occurrence Handle11341304 Occurrence Handle10.1055/s-2001-14831 Occurrence Handle1:CAS:528:DC%2BD3MXltlarsLs%3D

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Kazutoshi Nakamura.

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Nakamura, K. Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis. J Bone Miner Metab 24, 1–6 (2006).

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Key words

  • bone metabolism
  • 25-hydroxyvitamin D
  • Japanese
  • osteoporosis
  • parathyroid hormone
  • vitamin D