Sun beds and cod liver oil as vitamin D sources

The objective of this study was to (1) to determine the contribution of moderate sun bed exposure to serum 25(OH)D(3) levels; (2) to estimate the decay time of a high 25(OH)D(3) level obtained by sun bed exposure; and (3) to evaluate if the recommended ingestion of vitamin D is sufficient to maintain the 25(OH)D(3) concentration obtained by sun bed exposure. Ten volunteers (20-35 y.o.), skin type I and II, living in Olso, Norway were whole body exposed twice per week to the radiation of a commercial and approved sun bed (Life Sun S 100 W, Wolff System), starting with 0.5 MED (minimal erythema dose) and escalating to up to 1 MED per exposure for 4 weeks. After that, half of the volunteers were given a daily supplement of 200 IU vitamin D in the form of cod liver oil capsules, while the other half of the persons received no supplements. Erythema did not occur at any time and a slight pigmentation was seen in most of the volunteers after the sun bed exposures. Serum level of 25(OH)D(3) increased by about 40% on the average. The initial serum 25(OH)D(3) level was different among the volunteers (40-100 nmol/L). Within eight weeks after the last exposure the 25(OH)D(3) level decreased to the initial value in all volunteers irrespective of vitamin D supplementation or not.     

Sunbed radiation provokes cutaneous vitamin D synthesis in humans--a randomized controlled trial

We wanted to investigate whether the use of sunbeds with sunlamps emitting mainly UVA and only 0.5% or 1.4% UVB will increase the level of serum 25-hydroxyvitamin D (25(OH)D). In a randomized, controlled, open study on healthy, Caucasian females (> 50 years) sunbed radiation was given as follows: four 6-min sunbed sessions (days 0, 2, 4 and 7) and four 12-min sunbed sessions (days 9, 11, 14 and 16 ) with sunlamps emitting 0.5% UVB (n = 20) or with sunlamps emitting 1.4% UVB (n = 15). The controls (n = 21) had no intervention. Serum levels of 25(OH)D were measured on days 0, 9 and 18 in all three groups. The average increase in serum 25(OH)D from day 0 to day 9 was 12 nmol L(-1) (SD 11 nmol L(-1), P = 0.0002) in the 0.5% UVB group and 27 nmol L(-1) (SD 9 nmol L(-1), P < 0.0001) in the 1.4% UVB group. From day 9 to day 18 a further but not significant increase in serum 25(OH)D of 3 nmol L(-1) (SD 9 nmol L(-1), P = 0.2) in the 0.5% UVB group and 0.6 nmol L(-1) (SD 18 nmol L(-1), P = 0.9) in the 1.4% UVB group was seen. No significant changes were found in the control group. Increasing with UVB dose and exposure time, 37-64% of the sunbed sessions resulted in side effects such as erythema or polymorphic light eruption. The results showed that sunbeds emitting 0.5% and 1.4% UVB increased 25(OH)D serum levels. The increases were dose dependent but reached a plateau after few sessions. Sunbed use as vitamin D source is, however, not generally recommendable due to the well-known carcinogenicity and high frequency of acute side effects.     

Serum vitamin D levels in office workers in a subtropical climate

Vitamin D is necessary to maintain healthy bones, and may prevent other chronic diseases. There is limited information regarding the vitamin D status of people living in climates with relatively high ambient ultraviolet radiation. We therefore aimed to determine serum 25(OH)D levels in a group of office-workers in subtropical Australia. We collected blood from 129 office workers in summer (n = 129) and 175 in winter (91 in both seasons). Serum 25(OH)D was estimated using a commercial chemiluminescent immunoassay and we asked participants to complete questionnaires about sun exposure and diet for the month prior to blood collection. Summer and winter mean serum 25(OH)D was 74 (95% CI 70-77) nmol L(-1) and 54 (95% CI 51-57) nmol L(-1), respectively. In summer, 14% of participants were classed as "insufficient," compared with 51% in winter. High 25(OH)D levels in summer were associated with time spent outdoors in nonpeak UV periods, while in winter high levels were associated with intake of vitamin D from food or supplements. The high prevalence of vitamin D insufficiency observed in this population highlights the need for further examination of the relation between sunlight and vitamin D production to enable more accurate sun exposure recommendations.     

Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia

Vitamin D status is influenced by sun exposure, geographic latitude, daily outdoor activities, body surface exposed to sunlight and dietary intakes. Malaysia, is sunny all year round. However, the vitamin D status of this population especially among the healthy and free living adults is not known. Therefore a study of vitamin D status and associated factors was initiated among an existing Malay cohort in Kuala Lumpur. A total of 380 subjects were sampled to have their vitamin D status assessed using 25-hydroxyvitamin D (25(OH)D). A short questionnaire enquiring socio-demographic characteristics, exposure to sunlight and clothing style was administered. Their mean age was 48.5±5.2years and the mean 25(OH)D for males and females were 56.2±18.9nmol/L and 36.2±13.4nmol/L respectively. There were significant positive correlation for sun exposure score (r=0.27, p<0.001) and negative correlation for sun protection score (r=-0.41, p<0.001) with 25(OH)D levels. In the logistic regression model, females (OR=2.93; 95% CI: 1.17, 7.31), BMI (1.1; 1.03, 1.20) and sun exposure score (0.998; 0.996, 0.999) were significantly associated with vitamin D status as represented by 25(OH)D levels. Our findings show that obesity, lifestyle behaviours and clothing style are directly associated with our participants especially females' low vitamin D status.     

Personal Sun Exposure and Serum 25‐hydroxy Vitamin D Concentrations

Solar ultraviolet‐B radiation (UVB) is essential for epidermal vitamin D production. We aimed to quantitate the relationship between personal solar UV exposure and serum 25hydroxy vitamin D (25[OH]D) concentration. Blood was collected for 25(OH)D analysis in 207 South Australian adults aged 27–61 years. At the time of blood collection, each participant completed a questionnaire, which included a calendar for recall of sun exposure in the preceding 16 weeks. We examined the association between solar UV exposure and serum 25(OH)D graphically from smoothed scatter plots, and modeled it using multiple linear regression, with age, sex and body mass index as covariates. Estimated erythemal solar UV exposure in the 6 weeks before blood collection best predicted serum 25(OH)D concentrations. Serum 25(OH)D rose with increasing personal solar UV exposure to a maximum of about 89 nmol L^?1 at an estimated mean weekly solar erythemal UV exposure of about 1230 mJ cm^?2. The maximum was the same after accounting for clothing coverage and was reached at an estimated whole body equivalent exposure to ambient UV of ca 700 mJ cm^?2. These results suggest that an average maximum serum 25(OH)D of ca 89 nmol L^?1 is achieved from sun exposure in a healthy Australian adult population.     

Identification and determination of 1 alpha,25-dihydroxyvitamin D3 in rat skin by high-performance liquid chromatography and radioreceptor assay

Endogenous 1 alpha,25-dihydroxyvitamin D3 [1,25-(OH)2D3] in normal rat skin was identified by using thermal isomerization to convert the metabolite into its pre-isomer, high-performance liquid chromatography (HPLC) and displacement potency with a chick intestinal cytosol receptor. When the metabolite in normal rat skin was determined by a radioreceptor assay after purification by Sep-Pak silica cartridge column chromatography and HPLC, the concentration was 71.0 +/- 6.6 pg/g of wet tissue (mean +/- S.D.). It is also shown that [3H]-1,25-(OH)2D3 and [3H]-25-hydroxyvitamin D3 administered intravenously in the mouse are located in the skin. These results suggest that the metabolite may play an important role in the skin.     

Does a high UV environment ensure adequate vitamin D status?

This study assesses the Vitamin D status of 126 healthy free-living adults aged 18-87 years, in southeast Queensland, Australia (27 degrees S) at the end of the 2006 winter. Participants provided blood samples for analysis of 25(OH)D (the measure of an individual's Vitamin D status), PTH, Calcium, Phosphate, and Albumin, completed a questionnaire on sun-protective/sun-exposure behaviours, and were assessed for phenotypic characteristics such as skin/hair/eye colour and BMI. We found that 10.2% of the participants had serum 25(OH)D levels below 25 nmol/l (considered deficient) and a further 32.3% had levels between 25 nmol/l and 50 nmol/l (considered insufficient). Our results show that low levels of 25(OH)D can occur in a substantial proportion of the population at the end of winter, even in a sunny climate. 25(OH)D levels were higher amongst those who spent more time in the sun and lower among obese participants (BMI>30) than those who were not obese (BMI<30). 25(OH)D levels were also lower in participants who had black hair, dark/olive skin, or brown eyes, when compared with participants who had brown or fair hair, fair skin, or blue/green eyes. No associations were found between 25(OH)D status and age, gender, smoking status, or the use of sunscreen.     

Vitamin D Level in Summer and Winter Related to Measured UVR Exposure and Behavior

The influence of the summer UVR exposure on serum-25-hydroxyvitamin D (25(OH)D) in late summer and winter was investigated in an open study on 25 healthy, adult volunteers. The UVR exposure dose in standard erythema dose (SED) was monitored continuously during a summer season with personal, electronic wristwatch UVR dosimeters and sun exposure diaries. Constitutive and facultative skin pigmentation was measured in September. 25(OH)D was measured in September and February and was in mean 82 nmol/L ± 25 (mean ± SD) in September and 56 nmol/L ± 19 (mean ± SD) in February. The received cumulative UVR dose measured during a mean of 121 days was 156 SED ± 159 (mean ± SD). The following UVR exposure parameters correlated with 25(OH)D in September and February, respectively: (1) The cumulative UVR dose ( r  = 0.53; P  < 0.01) and ( r  = 0.43; P  = 0.03); (2) Mean daily hours with UVR measurements monitored by the dosimeter ( r  = 0.64, P  = 0.001) and ( r  = 0.53; P  = 0.007); (3) Days "with sun-exposed upper body" ( r  = 0.58, P  = 0.003) and ( r  = 0.50; P  = 0.01); (4) Facultative pigmentation ( r  = 0.47; P  < 0.02) and ( r  = 0.7; P  < 0.001); (5) Constitutive pigmentation ( r  = 0.06, n.s.) and ( r  = 0.43, P  = 0.03). Neither days "sunbathing" nor days with "sunscreen applied" correlated with 25(OH)D. The fall in 25(OH)D during winter was dependent on the entry value.     

Validation of Brief Questionnaire Measures of Sun Exposure and Skin Pigmentation Against Detailed and Objective Measures Including Vitamin D Status

Self‐reported sun exposure is commonly used in research, but how well this represents actual sun exposure is poorly understood. From February to July 2011, a volunteer sample (n = 47) of older adults (≥45 years) in Canberra, Australia, answered brief questions on time outdoors (weekdays and weekends) and natural skin color. They subsequently maintained a sun diary and wore an ultraviolet radiation (UVR) digital dosimeter for 7 days. Melanin density was estimated using reflectance spectrophotometry; lifetime sun damage was assessed using silicone casts of the back of the hand; and serum 25‐hydroxyvitamin D (25(OH)D) concentration was assayed. Questionnaire‐reported time outdoors correlated significantly with diary‐recorded time outdoors (Spearman correlation r_s = 0.66; 95% CI 0.46, 0.80; P < 0.001) and UVR dosimeter dose (r_s = 0.46; 95% CI 0.18, 0.68; P = 0.003), but not 25(OH)D concentration (r_s = 0.24; 95% CI ?0.05, 0.50; P = 0.10). Questionnaire‐reported untanned skin color correlated significantly with measured melanin density at the inner upper arm (r_s = 0.49; 95% CI 0.24, 0.68; P < 0.001). In a multiple linear regression model, statistically significant predictors of 25(OH)D concentration were self‐reported frequency of physical activity, skin color and recent osteoporosis treatment (R² = 0.54). In this study, brief questionnaire items provided valid rankings of sun exposure and skin color, and enabled the development of a predictive model for 25(OH)D concentration.     

Constitutive and Relative Facultative Skin Pigmentation among Victorian Children Including Comparison of Two Visual Skin Charts for Determining Constitutive Melanin Density

Our aim was to examine the association between ethnicity, phenotype, sun behavior and other characteristics, and constitutive and relative facultative skin pigmentation. A total of 191 participants were recruited, with a mean age of 7.6 years (SD 3.4), during 2009–2011 from Maternal and Child Health Centres (MCHC) and schools in Melbourne, Australia. Parental questionnaire data were obtained on sun behavior and examination consisted of noting the child's natural skin, hair and eye color, ethnicity, nevi count and spectrophotometric melanin density (MD). Constitutive skin pigmentation was estimated from buttock MD. Relative facultative skin pigmentation was estimated by hand compared with buttock absorption. Ethnicity, hair color and skin color were associated with constitutive and facultative skin pigmentation on univariate analysis. Higher ambient ultraviolet radiation (UVR) in the past month, greater freckling, greater nevi and increased sun exposure over the past year were related to darker facultative skin pigmentation. Sun exposure over the life course was not. The two skin charts accounted for 39.7% and 21.4% of buttock MD, respectively. Relative facultative skin pigmentation is associated with recent UVR levels, not life‐course sun exposure. Relative facultative skin pigmentation may not be a useful measure of sun exposure over the early life course. Skin color charts can be used to assess constitutive skin pigmentation if spectrophotometry is not available.     

Vitamin D status of adults from tropical Australia determined using two different laboratory assays: implications for public health messages

We measured serum 25 hydroxyvitamin D [25(OH)D] levels of ambulatory adults in tropical Australia to determine whether it is appropriate to continue promoting sun‐safety in this population. In August 2006 (winter), self‐administered questionnaires were completed by 145 Meals‐on‐Wheels volunteers (49.3% male; mean age 57.8 ± 14.7 years; 76.6% response) from Townsville, Queensland (Latitude 19^oS). Serum 25(OH)D was analyzed using two common assays. Mean levels were 68.3 (SD ± 18.7; range 26–142) by DiaSorin Radioimmunoassay and 83.0 (SD ± 30.8; range 30–184) by DiaSorin Liaison^® one. No participants were 25(OH)D deficient (<25 nmol L⁻¹). Nine participants (6.2%) had 25(OH)D levels between 25 and 50 nmol L⁻¹ (insufficient), by both methods (seven with a BMI ≥ 25). Twenty‐eight participants (19.3%) had one result in the insufficient range and the other in the adequate range. Thus, almost all of these free‐living adults in tropical Australia had adequate vitamin D levels at the end of winter. There was poor agreement between the two 25(OH)D assays. These results suggest it is appropriate to continue promoting sun‐safe messages to the ambulatory Caucasian adult population of North Queensland, which has an extremely high incidence of skin cancer. The lack of agreement between the two assays is a concern. Few doctors are aware of this measurement issue.     

Sunshine is an Important Determinant of Vitamin D Status Even Among High‐dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients

Sunshine is considered to be the most important source of vitamin D. Due to an increased risk of skin cancer, sun avoidance is advised, but this directly contributes to the high prevalence of vitamin D deficiency. The simple solution is to advise vitamin D supplementation. The aim of this study was to examine the absolute and relative contribution of sunshine and supplementation to vitamin status. This study was a secondary analysis of an RCT of 92 Crohn's disease patients in remission (49% female, median age = 44). Participants were randomized to 2000 IU day^?1 of vitamin D3 or placebo for 1 year, with 25‐hydroxyvitamin D (25(OH)D) being measured at baseline and every 4 months. Based on participant's place of residence, daily ambient UVB dose at wavelengths that can induce vitamin D synthesis (D‐UVB) was obtained. Cumulative and weighted ambient D‐UVB (cw‐D‐UVB) exposure prior to each blood draw was calculated for each participant. Linear regression analysis and multilevel modeling were used to examine the association between UVB exposure, supplementation and 25(OH)D concentration. There was considerable annual variation in D‐UVB, cw‐D‐UVB and 25(OH)D. Both supplementation and cw‐D‐UVB were found to be strongly associated with 25(OH)D: in multilevel model, an increase of approximately 6 nmol L^?1 for every 100 kJ m^?2 in cw‐D‐UVB was found, among those receiving placebo and supplementation (P < 0.0001). Treatment was associated with increase of 23 nmol L^?1 (P < 0.0001). Sunshine is an important determinant of 25(OH)D concentration, even in those who are taking high‐dose vitamin D supplements and reside at a higher mid‐latitude location.     

液相色谱-串联质谱法检测干血点样本中25-羟基维生素D2和25-羟基维生素D3

建立了一种高通量液相色谱-串联质谱技术检测干血点(DBS)样本中25-羟基维生素D2[25(OH)D2]和25-羟基维生素D3[25(OH)D3]的方法.以DBS为样本,以4-苯基-1,2,4-三唑啉-3,5-二酮(PTAD)为试剂进行分析物衍生化,所需样本量仅约相当于6μL全血当量的DBS样本;使用甲醇直接超声提取分析物,避开了通常情况下DBS样本前处理中的全血复溶和蛋白质沉淀等繁琐步骤;整个前处理过程使用自动化液体处理平台实现自动化操作和高检测通量;以25(OH)D2-D6和25(OH)D3-D3为同位素内标,消除基质效应的影响.前处理后的样本进行LC-MS/MS分析,使用C18柱进行分离,流动相为甲醇(含5 mmol/L甲酸铵)-水(含5 mmol/L甲酸铵)(75:25,V/V),洗脱时间为4 min,使用多反应监测模式(MRM)定量.结果表明:25(OH)D2和25(OH)D3的检出限为0.12 ng/mL(S/N=3),定量限为0.94 ng/mL(S/N=10).25(OH)D2和25(OH)D3在0.94~120.00 ng/mL范围内线性关系良好,日内相对标准偏差(RSD)分别为1.4%~8.6%和3.7%~15.5%,日间RSD分别为4.0%~5.3%和3.8%~14.9%,平均回收率分别为91.7%±7.9%~108.5%±6.5%和94.8%±6.8%~101.3%±2.9%.DBS样本在不同温度(-20℃,22℃,37℃)下储存不同时间(0,1,2,3,5,7,14天)后的稳定性实验显示样本总体RSD°15%.以25(OH)D参考物质NIST SRM 972a中的Level 3制备标准DBS样本,25(OH)D2和25(OH)D3的回收率分别为110.3%和103.0%.     

2 alpha-(3-hydroxypropyl)- and 2 alpha-(3-hydroxypropoxy)-1 alpha,25-dihydroxyvitamin D3 accessible to vitamin D receptor mutant related to hereditary vitamin D-resistant rickets

Hereditary vitamin D-resistant rickets (HVDRR) is a genetic disorder caused by mutations in the vitamin D receptor, which lead to resistance to 1alpha,25-dihydroxyvitamin D(3) [1alpha,25(OH)(2)D(3)]. We found that the A ring-modified analogues, 2alpha-(3-hydroxypropyl)- and 2alpha-(3-hydroxypropoxy)-1alpha,25(OH)(2)D(3), (O1C3 and O2C3) can bind better than the natural hormone to the mutant VDR (R274A), which similar to the HVDRR mutant, R274L, had lost the hydrogen bond to the 1alpha-hydroxyl group of 1alpha,25(OH)(2)D(3).     

Gene mapping study for constitutive skin color in an isolated Mongolian population

To elucidate the genes responsible for constitutive human skin color, we measured the extent of skin pigmentation in the buttock, representative of lifelong non-sun-exposed skin, and conducted a gene mapping study on skin color in an isolated Mongolian population composed of 344 individuals from 59 families who lived in Dashbalbar, Mongolia. The heritability of constitutive skin color was 0.82, indicating significant genetic association on this trait. Through the linkage analysis using 1,039 short tandem repeat (STR) microsatellite markers, we identified a novel genomic region regulating constitutive skin color on 11q24.2 with an logarithm of odds (LOD) score of 3.39. In addition, we also found other candidate regions on 17q23.2, 6q25.1, and 13q33.2 (LOD ≥ 2). Family-based association tests on these regions with suggestive linkage peaks revealed ten and two significant single nucleotide polymorphisms (SNPs) on the linkage regions of chromosome 11 and 17, respectively. We were able to discover four possible candidate genes that would be implicated to regulate human skin color: ETS1, UBASH3B, ASAM, and CLTC.     

Effect on carbon lengthening at the side chain terminal of 1 alpha,25-dihydroxyvitamin D3 for calcium regulating activity

A series of analogs of 1 alpha,25-dihydroxyvitamin D3 [1,25-(OH)2D3 (1)] with alkyl substitutions in 26- and 27-positions have been tested for their activity 1) in competing with 1,25-(OH)2D3 for binding to chick intestinal cytosol receptor, 2) in ability for formation of multinucleated cells (MNC) with various osteoclastic cell characteristics from blast cells, and 3) in stimulating bone calcium mobilization in vitamin D-deficient rats. The relative potencies of 1,25-(OH)2D3, 1 alpha,25-dihydroxy-26,27-dimethylvitamin D3 (2), 1 alpha,25-dihydroxy-26,27-diethylvitamin D3 (3), and 1 alpha,25-dihydroxy-26,27-dipropylvitamin D3 (4) in competing for intestinal cytosolic binding were 1:1.1:0.25:0.05. The similar order of the abilities on formation of the multinucleated cells in the same series was observed. In a bone calcium mobilization test with vitamin D-deficient rats, 1 alpha,25-dihydroxy-26,27-dimethylvitamin D3 showed slightly less activity than 1,25-(OH)2D3 at 12 h after administration, but long lasting activity was observed during time course experiments. 1 alpha,25-Dihydroxy-26,27-diethylvitamin D3, and 1 alpha,25-dihydroxy-26,27-dipropylvitamin D3 were found to be much less active than 1,25-(OH)2D3 in a bone calcium mobilization test.     

Solar radiation, vitamin D and survival rate of colon cancer in Norway

Solar radiation contributes significantly to the status of serum calcidiol (25-hydroxyvitamin D3, 25-(OH)D3) in humans, even at the high latitudes of northern Norway. Thus, in late summer the serum concentration of calcidiol is roughly 50% larger than that in late winter, when the solar radiation in Norway contains too little ultraviolet radiation to induce any synthesis of vitamin D3 in human skin. This seems to influence the prognosis of colon cancer. We here report that the survival rate of colon cancer in men and women, assessed 18 months after diagnosis, is dependent on the season of diagnosis. A high serum concentration of calcidiol at the time of diagnosis, i.e. at the start of conventional therapy, seems to give an increased survival rate. This agrees with cell and animal experiments reported in the literature, as well as with epidemiological data from some countries relating colon cancer survival with latitude and vitamin D3 synthesis in skin. One possible interpretation of the present data is that, the level of calcidiol, or its derivative calcitriol (1alpha,25-dihydroxyvitamin D3, 1alpha,25-(OH)2D3), may act positively in concert with conventional therapies of colon cancer.     

Spore Film Dosimeters Are Feasible for UV Dose Monitoring During Heliotherapy

The objective of the study was to compare Bacillus subtilis spore film dosimeters with a Robertson Berger UV meter (RB meter) and diary records for assessing personal UV-B doses during a 13-day heliotherapy (HT) for atopic dermatitis (AD). In addition, the relationship between the personal UV-B dose and change in serum 25-hydroxyvitamin D (25(OH)D) was studied. Altogether 21 adult patients with AD completed the study arranged in the Canary Islands, either in January or March 2005. The spore film dosimeters were used throughout the day during the HT. Serum 25(OH)D was analyzed using radioimmunoassay. The mean personal UV-B dose measured with the dosimeters was 75 SED in January and 131 SED in March. The respective results gained from the RB meter combined with diary records were 63 SED and 119 SED showing a close correlation with the dosimeter results. Serum 25(OH)D concentration increased by 9.7 nmol L⁻¹ in January and by 26.0 7 nmol L⁻¹ in March. The increase in serum 25(OH)D correlated with the UV-B dose received. The patients complied well to use the dosimeters. We conclude spore films to be a feasible and reliable personal UV dosimeter in vivo in field conditions.     

Sun Exposure and Vitamin D Status as Northeast Asian Migrants Become Acculturated to Life in Australia

Vitamin D deficiency is more common in Northeast‐Asian immigrants to western countries than in the local population; prevalence equalizes as immigrants adopt the host country's culture. In a community‐based study of 100 Northeast‐Asian immigrants in Canberra, Australia, we examined predictors of vitamin D status, its association with indicators of acculturation (English language use; time since migration) and mediators of that association. Participants completed a sun and physical activity diary and wore an electronic ultraviolet radiation (UVR) dosimeter for 7 days. Skin colour was measured by reflectance spectrophotometry. Serum concentrations of 25‐hydroxyvitamin D (25(OH)D) and cardio‐metabolic biomarkers were measured on fasting blood. In a multiple linear regression model, predictors for 25(OH)D concentration were season of blood collection, vitamin D supplementation, UVR exposure, body mass index, physical activity and having private health insurance (R² = 0.57). Greater acculturation was associated with lower risk of vitamin D deficiency (de‐seasonalized 25(OH)D level <50 nmol L^?1) (Adjusted Odds Ratio (AOR): 0.22 [95%CI 0.04–0.96]); this association was statistically mediated by physical activity and time outdoors. Vitamin D deficiency was associated with higher total cholesterol levels (>5.0 mmol L^?1) (AOR: 7.48 [95%CI 1.51–37.0]). Targeted public health approaches are required to manage the high prevalence of vitamin D deficiency in migrants retaining a traditional lifestyle.     

Serum Levels of 25‐Hydroxy‐Vitamin D3 Among Sun‐protected Outdoor Workers in Israel

The objective of this study was to evaluate the effect of reduced sun exposure of outdoor workers on vitamin D status using different modalities of sun protection, for primary prevention of skin cancer. 25‐OH‐D3 measurements were performed in two successive winters, 8 (interim) and 20 months after initiation of the study, in three groups of male outdoor workers, enrolled in either a complete, partial or minimal sun protection program. Ambient solar UVB radiation was monitored simultaneously. No intragroup or intergroup differences were observed between the interim‐ and postintervention measurements of mean 25‐OH‐D3, which were close to 30 ng mL^?1. Significant risk factors for postintervention 25‐OH‐D3 levels >33.8 ng mL^?1 (a surrogate for reduced sun protection) were: previous sunburn episodes (OR 2.5; 95% CI 1.01–6.3; P = 0.05) and younger age (OR 0.92; 95 CI 0.86–0.98; P = 0.009). Outdoor workers of Western, compared with those of Eastern paternal origin had a borderline significant risk (OR 2.4; 95% CI 0.9–6.3; P = 0.07). A borderline significant effect (OR 2.9; 95% CI 0.97–10.1; P = 0.085) was also noted for those in the minimal intervention group. In conclusion, sun protection among outdoor workers following a successful intervention did not suppress mean winter 25‐OH‐D3.