Cardiorespiratory fitness in males, and upper limbs muscular strength in females, are positively related with 25-hydroxyvitamin D plasma concentrations in European adolescents: the HELENA study

QJM. 2013 Sep;106(9):809-21. doi: 10.1093/qjmed/hct089. Epub 2013 May 8.


Background: High prevalence of vitamin D insufficiency (<75 nmol/l) has been previously reported in European adolescents. Vitamin D deficiency has been related to physical fitness and adiposity but it is not clearly known whether this relationship applies to growing children and adolescents.

Aim: To determine how body composition and physical fitness are related to 25-hydroxyvitamin D [25(OH)D] concentrations in European adolescents.

Design: The HEalthy Lifestyle in Europe by Nutrition in Adolescence-CSS study was a multi-centre cross-sectional study.

Methods: Plasma 25(OH)D, body composition and physical fitness measures were obtained in 1006 European adolescents (470 males) aged 12.5-17.5 years. Stepwise regression and ANCOVA were performed by gender using 25(OH)D as dependent variable, with body composition, physical fitness as independent variables controlling for age, seasonality and latitude.

Results: For males, maximum oxygen consumption (VO2max) (B = 0.189) and body mass index (BMI) (B = -0.124) were independently associated with 25(OH)D concentrations (both P < 0.05). For females, handgrip strength (B = 0.168; P < 0.01) was independently associated with 25(OH)D concentrations. Those adolescents at lower BMI and high fitness score presented significant higher 25(OH)D concentrations than those at lower fitness score in the other BMI groups (P < 0.05).

Conclusion: Cardiorespiratory fitness and upper limbs muscular strength are positively associated with 25(OH)D concentrations in male and female adolescents, respectively. Adiposity in males and low fat free mass in females are related to hypovitaminosis D. The interaction between fitness and BMI has a positive effect on 25(OH)D concentrations. Therapeutic interventions to correct the high rates of vitamin D deficiency in adolescents should consider physical fitness.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Adolescent
  • Body Composition / physiology*
  • Cardiovascular Diseases / etiology
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Exercise Test
  • Female
  • Humans
  • Male
  • Muscle Strength / physiology*
  • Physical Fitness / physiology*
  • Upper Extremity
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology
  • Whites


  • Vitamin D
  • 25-hydroxyvitamin D