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. 2016 Aug;104(2):454-61.
doi: 10.3945/ajcn.115.127985. Epub 2016 Jul 6.

The vitamin D status of the US population from 1988 to 2010 using standardized serum concentrations of 25-hydroxyvitamin D shows recent modest increases

Rosemary L Schleicher  1 , Maya R Sternberg  1 , David A Lacher  2 , Christopher T Sempos  3 , Anne C Looker  2 , Ramon A Durazo-Arvizu  3 , Elizabeth A Yetley  3 , Madhulika Chaudhary-Webb  1 , Khin L Maw  1 , Christine M Pfeiffer  4 , Clifford L Johnson  2
Affiliations

The vitamin D status of the US population from 1988 to 2010 using standardized serum concentrations of 25-hydroxyvitamin D shows recent modest increases

Rosemary L Schleicher et al. Am J Clin Nutr. 2016 Aug.

Abstract

Background: Temporal trends in the US population's vitamin D status have been uncertain because of nonstandardized serum 25-hydroxyvitamin D [25(OH)D] measurements.

Objective: To accurately assess vitamin D status trends among those aged ≥12 y, we used data from the cross-sectional NHANESs.

Design: A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for measuring 25(OH)D (sum of 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3), calibrated to standard reference materials, was used to predict LC-MS/MS-equivalent concentrations from radioimmunoassay data (1988-2006 surveys; n = 38,700) and to measure LC-MS/MS concentrations (2007-2010 surveys; n = 12,446). Weighted arithmetic means and the prevalence of 25(OH)D above or below cutoff concentrations were calculated to evaluate long-term trends.

Results: Overall, mean predicted 25(OH)D showed no time trend from 1988 to 2006, but during 2007-2010 the mean measured 25(OH)D was 5-6 nmol/L higher. Those groups who showed the largest 25(OH)D increases (7-11 nmol/L) were older, female, non-Hispanic white, and vitamin D supplement users. During 1988-2010, the proportions of persons with 25(OH)D <40 nmol/L were 14-18% (overall), 46-60% (non-Hispanic blacks), 21-28% (Mexican Americans), and 6-10% (non-Hispanic whites).

Conclusions: An accurate method for measuring 25(OH)D showed stable mean concentrations in the US population (1988-2006) and recent modest increases (2007-2010). Although it is unclear to what extent supplement usage compared with different laboratory methods explain the increases in 25(OH)D, the use of higher vitamin D supplement dosages coincided with the increase. Marked race-ethnic differences in 25(OH)D concentrations were apparent. These data provide the first standardized information about temporal trends in the vitamin D status of the US population.

Keywords: NHANES; standardization; supplements; survey; trend; vitamin D.

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Figures

FIGURE 1
FIGURE 1
Trends in age-adjusted mean concentrations of serum 25-hydroxyvitamin D, stratified by vitamin D supplement usage, for persons aged ≥12 y: NHANESs 1988–2010. Values are weighted arithmetic means (95% CIs). Data were age-standardized by using the 2000 US Census as the standard population. NHANES 1988–2006 data represent predicted LC-MS/MS–equivalent concentrations; NHANES 2007–2010 data represent measured LC-MS/MS concentrations. The use of any vitamin D–containing supplements during the 30 d preceding the household interview was assessed and used to categorize participants as users or nonusers. Linear trend based on Wald F test: user, P < 0.0001; overall, P < 0.0001; and nonuser, P = 0.5615. LC-MS/MS, liquid chromatography–tandem mass spectrometry.
FIGURE 2
FIGURE 2
Trends in age-adjusted proportions of the population either using or not using vitamin D supplements, stratified by daily dose, for persons aged ≥12 y: NHANESs 1988–2010. Values are weighted proportions (95% CIs). Data were age-standardized by using the 2000 US Census as the standard population. The use of any vitamin D–containing supplements during the 30 d preceding the household interview was used to categorize participants on the basis of mean daily dose.
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