Associations among 25-hydroxyvitamin D, diet quality, and metabolic disturbance differ by adiposity in adults in the United States

J Clin Endocrinol Metab. 2010 Aug;95(8):3814-27. doi: 10.1210/jc.2010-0410. Epub 2010 May 12.


Context: Recent evidence indicates that a higher plasma level of 25-hydroxyvitamin D [25(OH)D] is associated with lower adiposity and a reduced number of metabolic disturbances (MetD).

Objectives: We examined associations among dietary quality, 25(OH)D, percent body fat (%BF), and MetD, and a pathway linking them, across central obesity.

Design: This cross-sectional nationally representative study used extensive data from the National Health and Nutrition Examination Surveys of 2001-2004.

Participants: U.S. adults aged at least 20 yr were stratified by central obesity (CO) status. Sample sizes ranged from 1943 (all MetD combined) to 7796 (each component).

Main outcome measures: %BF was measured using dual-energy x-ray absorptiometry, and MetD was measured with individual continuous nonadiposity outcomes (e.g. fasting plasma glucose) and with a composite count index of binary MetD with prespecified cutoff points (Index I).

Results: A higher 25(OH)D was associated with better dietary quality, lower %BF, and lower number of MetD. These inverse 25(OH)D-%BF and 25(OH)D-MetD associations (i.e. fasting blood glucose, homeostatic model assessment of insulin resistance, C-reactive protein, and Index I) were significantly stronger among the CO+ group. Finally, the pathway linking the dairy component of the Healthy Eating Index (HEIdairy) to Index I through 25(OH)D and %BF indicated complete mediation among the CO- group, but HEIdairy and 25(OH)D had direct inverse associations with Index I among the CO+ group.

Conclusions: Due to potential genetic differences between CO- and CO+ groups, empowering U.S. adults with central obesity to make related behavioral changes may be especially effective in improving their vitamin D status and metabolic profile.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Absorptiometry, Photon
  • Adiposity / physiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Blood Glucose
  • Cross-Sectional Studies
  • Diet
  • Female
  • Health Surveys
  • Humans
  • Hyperuricemia / blood*
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Obesity / blood*
  • United States
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood


  • Blood Glucose
  • Vitamin D
  • 25-hydroxyvitamin D