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Longitudinal associations between lifestyle and vitamin D: A general population study with repeated vitamin D measurements

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Abstract

Several lifestyle factors have been found to be associated with vitamin D status in cross-sectional studies, but it is not clear whether a change in these factors can actually affect the vitamin D level. We investigated the association between repeated measurements of physical activity, body mass index (BMI), diet, alcohol consumption, and smoking habits, and corresponding levels of vitamin D during 5 years of follow-up of a large general population sample. We included 4185 persons who participated and had vitamin D (serum-25-hydroxyvitamin D, 25-OH-D) measurements in the Inter99 study at baseline (1999–2001) and 5-year follow-up. In a subsample, 25-OH-D was also measured at 1- and 3-year follow-ups. We used mixed models to examine the association between repeated measurements of lifestyle factors and 25-OH-D levels. In multivariable analyses of repeated measurements, the difference in 25-OH-D was −0.32 ng/ml (95 % CI −0.37, −0.28) per 1 kg/m2 increase in BMI; 4.50 ng/ml (95 % CI 3.84, 5.15) for persons moderately/vigorously physically active versus sedentary; 1.82 ng/ml (95 % CI 1.09, 2.56) for persons with healthy versus unhealthy dietary habits; 0.05 ng/ml (95 % CI 0.03, 0.07) per 1 standard drink/weak increase in alcohol consumption; and 0.86 ng/ml (95 % CI 0.36, 1.35) for never smokers versus daily smokers. Our study shows that lower BMI, a higher level of physical activity, a healthier diet and possibly a higher alcohol intake, and not smoking, are associated with higher 25-OH-D levels.

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References

  1. J. Hilger, A. Friedel, R. Herr, T. Rausch, F. Roos, D.A. Wahl et al., A systematic review of vitamin D status in populations worldwide. Br. J. Nutr. 111, 23–45 (2013)

    Article  PubMed  Google Scholar 

  2. M.F. Holick, Vitamin D deficiency. N. Engl. J. Med. 357, 266–281 (2007)

    Article  CAS  PubMed  Google Scholar 

  3. T. Skaaby, L.L. Husemoen, C. Pisinger, T. Jorgensen, B.H. Thuesen, M. Fenger et al., Vitamin D status and cause-specific mortality: a general population study. PLoS ONE 7, e52423 (2012)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. T. Skaaby, L.L. Husemoen, B.H. Thuesen, C. Pisinger, T. Jorgensen, N. Roswall et al., Prospective population-based study of the association between serum 25-hydroxyvitamin-D levels and the incidence of specific types of cancer. Cancer Epidemiol. Biomarkers Prev. 23, 1220–1229 (2014)

    Article  CAS  PubMed  Google Scholar 

  5. T. Skaaby, The relationship of vitamin D status to risk of cardiovascular disease and mortality. Dan. Med. J. 61, 2 (2015)

    Google Scholar 

  6. T. Skaaby, L. Husemoen, B. Thuesen, A. Linneberg, Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease. Endocrine (2015). doi:10.1007/s12020-015-0547-4

    Google Scholar 

  7. E. Theodoratou, I. Tzoulaki, L. Zgaga, J.P. Ioannidis, Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 348, g2035 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  8. L.L. Husemoen, T. Skaaby, B.H. Thuesen, T. Jorgensen, R.V. Fenger, A. Linneberg, Serum 25(OH)D and incident type 2 diabetes: a cohort study. Eur. J. Clin. Nutr. 66, 1309–1314 (2012)

    Article  CAS  PubMed  Google Scholar 

  9. T. Skaaby, L.L. Husemoen, C. Pisinger, T. Jorgensen, B.H. Thuesen, M. Fenger et al., Vitamin D status and changes in cardiovascular risk factors: a prospective study of a general population. Cardiology. 123, 62–70 (2012)

    Article  CAS  PubMed  Google Scholar 

  10. T. Skaaby, L.L. Husemoen, T. Martinussen, J.P. Thyssen, M. Melgaard, B.H. Thuesen et al., Vitamin D status, filaggrin genotype, and cardiovascular risk factors: a Mendelian randomization approach. PLoS ONE 8, e57647 (2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. T. Skaaby, L.L. Husemoen, C. Pisinger, T. Jorgensen, B.H. Thuesen, K. Rasmussen et al., Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population. Endocrine 44, 473–480 (2013)

    Article  CAS  PubMed  Google Scholar 

  12. T. Skaaby, L.L. Husemoen, C. Pisinger, T. Jorgensen, B.H. Thuesen, M. Fenger et al., Vitamin D status and incident cardiovascular disease and all-cause mortality: a general population study. Endocrine 43, 618–625 (2013)

    Article  CAS  PubMed  Google Scholar 

  13. T. Skaaby, L.L. Husemoen, B.H. Thuesen, C. Pisinger, T. Jorgensen, R.V. Fenger et al., Vitamin D status and chronic obstructive pulmonary disease: a prospective general population study. PLoS ONE 9, e90654 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  14. L. Yin, J.M. Ordonez-Mena, T. Chen, B. Schottker, V. Arndt, H. Brenner, Circulating 25-hydroxyvitamin D serum concentration and total cancer incidence and mortality: a systematic review and meta-analysis. Prev. Med. 57, 753–764 (2013)

    Article  PubMed  Google Scholar 

  15. E. Klingberg, G. Olerod, J. Konar, M. Petzold, O. Hammarsten, Seasonal variations in serum 25-hydroxy vitamin D levels in a Swedish cohort. Endocrine (2015). doi:10.1007/s12020-015-0548-3

    PubMed  PubMed Central  Google Scholar 

  16. K. Brock, W.Y. Huang, D.R. Fraser, L. Ke, M. Tseng, R. Stolzenberg-Solomon 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. 121, 462–466 (2010)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. L.S. Greene-Finestone, C. Berger, M. de Groh, D.A. Hanley, N. Hidiroglou, K. Sarafin et al., 25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos. Int. 22, 1389–1399 (2011)

    Article  CAS  PubMed  Google Scholar 

  18. B. Hintzpeter, G.B. Mensink, W. Thierfelder, M.J. Muller, C. Scheidt-Nave, Vitamin D status and health correlates among German adults. Eur. J. Clin. Nutr. 62, 1079–1089 (2008)

    Article  CAS  PubMed  Google Scholar 

  19. V. Hirani, A. Mosdol, G. Mishra, Predictors of 25-hydroxyvitamin D status among adults in two British national surveys. Br. J. Nutr. 101, 760–764 (2009)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. M.A. Levy, T. McKinnon, T. Barker, A. Dern, T. Helland, J. Robertson et al., Predictors of vitamin D status in subjects that consume a vitamin D supplement. Eur. J. Clin. Nutr. 69, 84–89 (2015)

    Article  CAS  PubMed  Google Scholar 

  21. J.A. Pasco, M.J. Henry, G.C. Nicholson, S.L. Brennan, M.A. Kotowicz, Behavioural and physical characteristics associated with vitamin D status in women. Bone 44, 1085–1091 (2009)

    Article  CAS  PubMed  Google Scholar 

  22. B.H. Thuesen, T. Skaaby, L.L. Husemoen, M. Fenger, T. Jorgensen, A. Linneberg, The association of serum 25-OH vitamin D with atopy, asthma, and lung function in a prospective study of Danish adults. Clin. Exp. Allergy 45, 265–272 (2015)

    Article  CAS  PubMed  Google Scholar 

  23. B. Thuesen, L. Husemoen, M. Fenger, J. Jakobsen, P. Schwarz, U. Toft et al., Determinants of vitamin D status in a general population of Danish adults. Bone 50, 605–610 (2012)

    Article  CAS  PubMed  Google Scholar 

  24. T. Jorgensen, K. Borch-Johnsen, T.F. Thomsen, H. Ibsen, C. Glumer, C. Pisinger, A randomized non-pharmacological intervention study for prevention of ischaemic heart disease: baseline results Inter99. Eur. J. Cardiovasc. Prev. Rehabil. 10, 377–386 (2003)

    Article  PubMed  Google Scholar 

  25. U. Toft, L. Kristoffersen, S. Ladelund, A. Bysted, J. Jakobsen, C. Lau et al., Relative validity of a food frequency questionnaire used in the Inter99 study. Eur. J. Clin. Nutr. 62, 1038–1046 (2008)

    Article  CAS  PubMed  Google Scholar 

  26. A. Ramnemark, M. Norberg, U. Pettersson-Kymmer, M. Eliasson, Adequate vitamin D levels in a Swedish population living above latitude 63 degrees N: The 2009 Northern Sweden MONICA study. Int. J. Circumpolar. Health. 74, 27963 (2015)

    Article  PubMed  Google Scholar 

  27. A.J. Voipio, K.A. Pahkala, J.S. Viikari, V. Mikkila, C G. Magnussen, N. Hutri-Kahonen et al., Determinants of serum 25(OH)D concentration in young and middle-aged adults. The Cardiovascular Risk in Young Finns Study. Ann Med. 1–10 (2015). doi:10.3109/07853890.2015.1020860

  28. K.S. Vimaleswaran, D.J. Berry, C. Lu, E. Tikkanen, S. Pilz, L.T. Hiraki et al., Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 10, e1001383 (2013)

    Article  PubMed  PubMed Central  Google Scholar 

  29. A. Supervia, X. Nogues, A. Enjuanes, J. Vila, L. Mellibovsky, S. Serrano et al., Effect of smoking and smoking cessation on bone mass, bone remodeling, vitamin D, PTH and sex hormones. J. Musculoskelet. Neuronal. Interact. 6, 234–241 (2006)

    CAS  PubMed  Google Scholar 

  30. E. Cutillas-Marco, A. Fuertes-Prosper, W.B. Grant, M. Morales-Suarez-Varela, Vitamin D deficiency in South Europe: effect of smoking and aging. Photodermatol. Photoimmunol. Photomed. 28, 159–161 (2012)

    Article  CAS  PubMed  Google Scholar 

  31. K. Lee, Sex-specific relationships between alcohol consumption and vitamin D levels: The Korea National Health and Nutrition Examination Survey 2009. Nutr. Res. Pract. 6, 86–90 (2012)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. T. Skaaby, L.L. Husemoen, A. Borglykke, T. Jorgensen, B.H. Thuesen, C. Pisinger et al., Vitamin D status, liver enzymes, and incident liver disease and mortality: a general population study. Endocrine 47, 213–220 (2013)

    Article  PubMed  Google Scholar 

  33. T. Skaaby, L.L. Husemoen, A. Linneberg, Does liver damage explain the inverse association between vitamin D status and mortality? Ann. Epidemiol. 23, 812–814 (2013)

    Article  PubMed  Google Scholar 

  34. M. Gascon-Barre, Interrelationships between vitamin D3 and 25-hydroxyvitamin D3 during chronic ethanol administration in the rat. Metabolism. 31, 67–72 (1982)

    Article  CAS  PubMed  Google Scholar 

  35. R.T. Turner, R.C. Aloia, L.D. Segel, K.S. Hannon, N.H. Bell, Chronic alcohol treatment results in disturbed vitamin D metabolism and skeletal abnormalities in rats. Alcohol. Clin. Exp. Res. 12, 159–162 (1988)

    Article  CAS  PubMed  Google Scholar 

  36. J.P. McClung, E. Gaffney-Stomberg, J.J. Lee, Female athletes: a population at risk of vitamin and mineral deficiencies affecting health and performance. J. Trace Elem. Med Biol. 28, 388–392 (2014)

    Article  CAS  PubMed  Google Scholar 

  37. A.C. Ellis, J.A. Alvarez, B.A. Gower, G.R. Hunter, Cardiorespiratory fitness in older adult women: relationships with serum 25-hydroxyvitamin D. Endocrine 47, 839–844 (2014)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. M. Jenab, S. Salvini, C.H. van Gils, M. Brustad, S. Shakya-Shrestha, B. Buijsse et al., Dietary intakes of retinol, beta-carotene, vitamin D and vitamin E in the European Prospective Investigation into Cancer and Nutrition cohort. Eur. J. Clin. Nutr. 63(Suppl 4), S150–S178 (2009)

    Article  CAS  PubMed  Google Scholar 

  39. M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney et al., Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 96, 1911–1930 (2011)

    Article  CAS  PubMed  Google Scholar 

  40. Z. Lagunova, A.C. Porojnicu, L. Aksnes, M.F. Holick, V. Iani, O.S. Bruland et al., Effect of vitamin D supplementation and ultraviolet B exposure on serum 25-hydroxyvitamin D concentrations in healthy volunteers: a randomized, crossover clinical trial. Br. J. Dermatol. 169, 434–440 (2013)

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The present study was financially supported by the Health Insurance Foundation (Grant No. 2010 B 131). We would like to thank the participants and all members of the Inter99 staff at Research Centre for Prevention and Health. The Inter99 study was initiated by Torben Jørgensen, DMSci (principal investigator); Knut Borch-Johnsen, DMSci, (co-principal investigator); Troels Thomsen, PhD; and Hans Ibsen, DMSci. The Steering Committee comprises Torben Jørgensen and Charlotta Pisinger, PhD, MPH.

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The authors declare that they have no conflict of interest

Ethical standards

The study was approved by the local Ethics Committees and the Danish Data Protection Agency, participants gave their informed written consent, and the recommendations of the Declaration of Helsinki were followed.

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Correspondence to Tea Skaaby.

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Skaaby, T., Husemoen, L.L.N., Thuesen, B.H. et al. Longitudinal associations between lifestyle and vitamin D: A general population study with repeated vitamin D measurements. Endocrine 51, 342–350 (2016). https://doi.org/10.1007/s12020-015-0641-7

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