Vitamin D status in the United States, 2011-2014

Am J Clin Nutr. 2019 Jul 1;110(1):150-157. doi: 10.1093/ajcn/nqz037.

Abstract

Background: Vitamin D is important for bone health; in 2014 it was the fifth most commonly ordered laboratory test among Medicare Part B payments.

Objectives: The aim of this study was to describe vitamin D status in the US population in 2011-2014 and trends from 2003 to 2014.

Methods: We used serum 25-hydroxyvitamin D data from NHANES 2011-2014 (n = 16,180), and estimated the prevalence at risk of deficiency (<30 nmol/L) or prevalence at risk of inadequacy (30-49 nmol/L) by age, sex, race and Hispanic origin, and dietary intake of vitamin D. We also present trends between 2003 and 2014.

Results: In 2011-2014, the percentage aged ≥1 y at risk of vitamin D deficiency or inadequacy was 5.0% (95% CI: 4.1%, 6.2%) and 18.3% (95% CI: 16.2%, 20.6%). The prevalence of at risk of deficiency was lowest among children aged 1-5 y (0.5%; 95% CI: 0.3%, 1.1%), peaked among adults aged 20-39 y (7.6%; 95% CI: 6.0%, 9.6%), and fell to 2.9% (95% CI: 2.0%, 4.0%) among adults aged ≥60 y; the prevalence of at risk of inadequacy was similar. The prevalence of at risk of deficiency was higher among non-Hispanic black (17.5%; 95% CI: 15.2%, 20.0%) than among non-Hispanic Asian (7.6%; 95% CI: 5.9%, 9.9%), non-Hispanic white (2.1%; 95% CI: 1.5%, 2.7%), and Hispanic (5.9%; 95% CI: 4.4%, 7.8%) persons; the prevalence of at risk of inadequacy was similar. Persons with higher vitamin D dietary intake or who used supplements had lower prevalences of at risk of deficiency or inadequacy. From 2003 to 2014 there was no change in the risk of vitamin D deficiency; the risk of inadequacy declined from 21.0% (95% CI: 17.9%, 24.5%) to 17.7% (95% CI: 16.0%, 19.7%).

Conclusion: The prevalence of at risk of vitamin D deficiency in the United States remained stable from 2003 to 2014; at risk of inadequacy declined. Differences in vitamin D status by race and Hispanic origin warrant additional investigation.

Keywords: 25(OH)D; NHANES; diet; supplements; survey; trend; vitamin D status.

MeSH terms

  • Adolescent
  • Adult
  • African Americans
  • Asian Continental Ancestry Group
  • Child
  • Child, Preschool
  • Diet
  • Dietary Supplements
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Nutritional Status*
  • Risk Factors
  • United States / epidemiology
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / epidemiology*
  • Young Adult

Substances

  • Vitamin D
  • 25-hydroxyvitamin D