Abstract
Objectives
The purpose of this study was to examine the relative impact of seasonal differences and age on dietary vitamin D intakes, outdoor activity time and serum vitamin D status among Korean postmenopausal women.
Methods
A cross-sectional study was conducted with 164 free-living postmenopausal women (mean age=55.4 years) in Daegu, Korea. Dietary intake, daily physical activity patterns and fasting blood samples were collected during summer and winter. We compared the results from 75 women during summer and 89 women during winter. Dietary intake of vitamin D was assessed by 24-hour recall method. Daily outdoor activity time was derived from physical activity diary.
Results
The average dietary intake of vitamin D of the participants was 3.7 µg during summer, 3.3 µg during winter, showing no significant difference between the two seasons. The average time spent on outdoor activities was not significantly different between summer (=35.1 ± 75.0 min/d) and winter (=48.5 ± 76.8 min/d). The average serum 25-(OH) vitamin D concentrations of participants was 17.5 ± 7.5 ng/mL in the summer and 13.4 ± 4.3 ng/mL in the winter, showing no significant differences by season. Dietary intake of vitamin D was not related to age. When total subjects were divided into two groups by age, the average serum 25-(OH) vitamin D concentration was significantly higher in older group (p=0.047) and time spent on outdoor activities was also (p=0.018) significantly higher in the older group.
Acknowledgments
This work was supported by Basic Science Research Program through the National Reserch Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (MEST 2010-0241)
References
1. Adams JS, Clemens TL, Parrish JA, Holick MF. Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects. N Engl J Med. 1982; 306(12):722–725.
2. Baker MR, Peacock M, Nordin BE. The decline in vitamin D status with age. Age Ageing. 1980; 9(4):249–252.
3. Binkley N, Krueger D, Drezner MK. Low vitamin D status: time to recognize and correct a Wisconsin epidemic. WMJ. 2007; 106(8):466–472.
4. Buchanan JR, Santen R, Cauffman S, Cavaliere A, Greer RB, Demers LM. The effect of endogenous estrogen fluctuation on metabolism of 25-hydroxyvitamin D. Calcif Tissue Int. 1986; 39(3):139–144.
5. Cinar N, Harmanci A, Yildiz BO, Bayraktar M. Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. Eur J Intern Med. 2014; 25(2):197–201.
6. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int. 1997; 7(5):439–443.
7. Choi EY. 25(OH)D status and demographic and lifestyle determinants of 25(OH)D among Korean adults. Asia Pac J Clin Nutr. 2012; 21(4):526–535.
8. Choi SH, Lee DJ, Kim KM, Kim BT. Association between seasonal changes in vitamin D and Bone mineral density. J Korean Soc Menopause. 2011; 17(2):88–93.
9. Darling AL, Hart KH, Gibbs MA, Gossiel F, Kantermann T, Horton K, Johnsen S, Berry JL, Skene DJ, Eastell R, Vieth R, Lanham-New SA. Greater seasonal cycling of 25-hydroxyvitamin D is associated with increased parathyroid hormone and bone resorption. Osteoporos Int. 2014; 25(3):933–941.
10. Dattani JT, Exton-Smith AN, Stephen JM. Vitamin D status of the elderly in relation to age and exposure to sunlight. Hum Nutr Clin Nutr. 1984; 38(2):131–137.
11. Dawson-Hughes B. Racial/ethnic considerations in making recommendations for vitamin D for adult and elderly men and women. Am J Clin Nutr. 2004; 80(6):1763S–1766S.
12. Devgun MS, Paterson CR, Johnson BE, Cohen C. Vitamin D nutrition in relation to season and occupation. Am J Clin Nutr. 1981; 34(8):1501–1504.
13. Holick MF. Mccollum award lecture, 1994: vitamin D-new horizons for the 21st century. Am J Clin Nutr. 1994; 60(4):619–630.
14. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357(3):266–281.
15. Kim HB, Park JG. A study on the solar UVA and UVB doses at Kongju. Korean J Dermatol. 1987; 25(1):16–24.
16. Kluczynski MA, Lamonte MJ, Mares JA, Wactawski-Wende J, Smith AW, Engelman CD, Andrews CA, Snetselaar LG, Sarto GE, Millen AE. Duration of physical activity and serum 25-hydroxyvitamin D status of postmenopausal women. Ann Epidemiol. 2011; 21(6):440–449.
17. Korean Nutrition Society. Dietary reference intakes for
Koreans. Seoul, Korea: 2010. p. 590–592.
18. Lamberg-Allardt C. Vitamin D intake, sunlight exposure and 25-hydroxyvitamin D levels in the elderly during one year. Ann Nutr Metab. 1984; 28(3):144–150.
19. Lee MK, Yoon BK, Chung HY, Park HM. The serum vitamin D nutritional status and its relationship with skeletal status in Korean postmenopausal women. Korean J Obstet Gynecol. 2011; 54(5):241–246.
20. Lim HJ, Kim JI. Serum 25-hydroxyvitamin D status in wintertime in premenopausal working women. Korean J Nutr. 2006; 39(7):649–660.
21. Lim HJ. Serum 25-hydroxyvitamin D status and associated factors in premenopausal working women. Korean J Community Nutr. 2005; 10(1):79–90.
22. Lips P, Chapuy MC, Dawson-Hughes B, Pols HAP, Holick MF. An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int. 1999; 9(5):394–397.
23. Lund B, Sørensen OH. Measurement of 25-hydroxyvitamin D in serum and its relation to sunshine, age and vitamin D intake in the Danish population. Scand J Clin Lab Invest. 1979; 39(1):23–30.
24. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985; 76(4):1536–1538.
25. Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF. Clothing prevents ultraviolet-B radiationdependent photosynthesis of vitamin D3. J Clin Endocrinol Metab. 1992; 75(4):1099–1103.
26. Matsuoka LY, Wortsman J, Hollis BW. Use of topical sunscreen for the evaluation of regional synthesis of vitamin D3. J Am Acad Dermatol. 1990; 22(5 Pt 1):772–775.
27. Ministy of Health and Welfare & Korea Center for Disease Control and Prevention. Korea health statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1). Seoul: Korea Center for Disease Control and Prevention;2012. p. 341–434.
28. Moon SJ, Kim JH. The effects of vitamin D status on bone mineral density of Korean adults. Korean J Nutr. 1998; 31(1):46–61.
29. Park HM, Kim JG, Choi WH, Lim SK, Kim GS. The vitamin D nutritional status of postmenopausal women in Korea. Korean J Bone Metab. 2003; 10(1):47–55.
30. Park SY, Yim CH, Kim SH, Han KO, Yoon HK. Changes of serum parathyroid hormone and bone turnover status according to serum vitamin D levels in Korean postmenopausal women. Korean J Bone Metab. 2008; 15(1):17–24.
31. Scragg R, Camargo CA. Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2008; 168(6):577–586.
32. Thuesen B, Husemoen L, Fenger M, Jakobsen J, Schwarz P, Toft U, Ovesen L, Jørgensen T, Linneberg A. Determinants of vitamin D status in a general population of Danish adults. Bone. 2012; 50(3):605–610.
33. Van Dam RM, Snijder MB, Dekker JM, Stehouwer CD, Bouter LM, Heine RJ, Lips P. Potentially modifiable determinants of vitamin D status in an older population in the Netherlands: the Hoorn Study. Am J Clin Nutr. 2007; 85(3):755–761.
34. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988; 67(2):373–378.
35. Webb AR, Pilbeam C, Hanafin N, Holick MF. An evaluation of the relative contributions of exposure to sunlight and of diet to the circulating concentrations of 25-hydroxyvitamin D in an elderly nursing home population in Boston. Am J Clin Nutr. 1990; 51(6):1075–1081.
36. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis (WHO Technical Report Series 843). Geneva, Switzerland: 1994. p. 5–6.
37. Yoon JS, Song MK. Seasonal differences in outdoor activity time and serum 25-(OH) vitamin D status of Korean young women. Korean J Community Nutr. 2014; 19(3):231–240.