Factors associated with vitamin D deficiency in European adolescents: the HELENA study

J Nutr Sci Vitaminol (Tokyo). 2013;59(3):161-71. doi: 10.3177/jnsv.59.161.


Evidence indicates low 25-hydroxyvitamin D [(25(OH)D] concentrations in European adolescents. Identification of potential determinants is therefore essential to guide public health initiatives aiming at optimizing vitamin D status across Europe. The aim of the study was to identify potential influencing factors of 25(OH)D concentrations in European adolescents aged 12.5 to 17.5 y, participating in the multi-centre cross-sectional Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. A subset of 1,006 participants (46.8% males) was drawn from the main study. Measures of body composition, biochemical markers, socioeconomic status, dietary intake, physical activity, fitness, sleep time and vitamin D genetic polymorphism (rs1544410) were assessed. Stepwise multivariate linear regression analysis was conducted stratified by gender. In males, linear regression of 25(OH)D, suggested that (1) winter season (β=-0.364; p<0.01), (2) higher latitudes (β=-0.246; p<0.01), (3) BMI z-score (β=-0.198; p<0.05) and (4) retinol concentration (β=0.171; p<0.05) independently influenced 25(OH)D concentrations. In females, (1) winter season (β=-0.370; p<0.01), (2) sleep time (β=-0.231; p<0.01), (3) supplement intake (β=0.221; p<0.05), (4) flexibility (β=0.184; p<0.05), (5) body fat % (β=0.201; p<0.05) (6), BMI z-score (β=-0.272; p<0.05), (7) higher latitudes (β=-0.219; p<0.01) and (8) handgrip strength (β=0.206; p<0.05) independently influenced 25(OH)D concentrations. Season, latitude, fitness, adiposity, sleep time and micronutrient supplementation were highly related to 25(OH)D concentrations found in European adolescents.

Publication types

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

MeSH terms

  • Adipose Tissue
  • Adolescent
  • Body Composition*
  • Body Mass Index
  • Cross-Sectional Studies
  • Dietary Supplements*
  • Europe
  • Female
  • Hand Strength
  • Health Behavior
  • Humans
  • Life Style*
  • Linear Models
  • Male
  • Micronutrients / administration & dosage
  • Multivariate Analysis
  • Physical Fitness*
  • Range of Motion, Articular
  • Seasons*
  • Sex Factors
  • Sleep*
  • Vitamin A / blood
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency* / blood


  • Micronutrients
  • Vitamin A
  • Vitamin D
  • 25-hydroxyvitamin D