6 billion people have less than 75 nmol (30 ng) of Vitamin D – March 2023

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Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants

Front. Nutr., 17 March 2023 Sec. Nutritional Epidemiology Volume 10 - 2023 https://doi.org/10.3389/fnut.2023.1070808
Aiyong Cui1†, Tiansong Zhang2†, Peilong Xiao3†, Zhiqiang Fan4, Hu Wang4* and Yan Zhuang4*
1 Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
2 Jing'an District Hospital of Traditional Chinese Medicine, Shanghai, China
3 Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
4 Department of Pelvic and Acetabular Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China

< 50 nmol

Background: Vitamin D deficiency causes the bone hypomineralization disorder osteomalacia in humans and is associated with many non-skeletal disorders. We aim to estimate the global and regional prevalence of vitamin D deficiency in people aged 1 year or older from 2000 to 2022.

Methods: We systematically searched Web of Science, PubMed (MEDLINE), Embase, Scopus, and Google databases on December 31, 2021, and updated them on August 20, 2022, without language and time restrictions. Meanwhile, we identified references of relevant system reviews and eligible articles and included the latest and unpublished data from the National Health and Nutrition Examination Survey (NHANES, 2015–2016 and 2017–2018) database. The studies investigating the prevalence of vitamin D deficiency in population-based studies were included. A standardized data extraction form was used to collect information from eligible studies. We used a random-effects meta-analysis to estimate the global and regional prevalence of vitamin D deficiency. We stratified meta-analyses by latitude, season, six WHO regions, the World Bank income groups, gender, and age groups. This study was registered with PROSPERO (CRD42021292586).

Findings: Out of 67,340 records searched, 308 studies with 7,947,359 participants from 81 countries were eligible for this study, 202 (7,634,261 participants), 284 (1,475,339 participants), and 165 (561,978 participants) studies for the prevalence of serum 25(OH)D <30, <50, and <75 nmol/L, respectively. We found that globally, 15.7% (95% CrI 13.7–17.8), 47.9% (95% CrI 44.9–50.9), and 76·6% (95% CrI 74.0–79.1) of participants had serum 25-hydroxyvitamin D levels less than 30, 50, and 75 nmol/l, respectively; the prevalence slightly decreased from 2000–2010 to 2011–2022, but it was still at a high level; people living in high latitude areas had a higher prevalence; the prevalence in winter-spring was 1.7 (95% CrI 1.4–2.0) times that in summer-autumn; the Eastern Mediterranean region and Lower-middle-income countries had a higher prevalence; females were vulnerable to vitamin D deficiency; gender, sampling frame, detection assays, sampling region, time of data collection, season, and other factors contributed to heterogeneity between the included studies.

Interpretation: Globally, vitamin D deficiency remained prevalent from 2000 to 2022. The high prevalence of vitamin D deficiency would increase the global burden of disease. Therefore, governments, policymakers, health workers, and individuals should attach importance to the high prevalence of vitamin D deficiency and take its prevention as a public health priority.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021292586, PROSPERO CRD42021292586.

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VitaminDWiki – Is 50 ng of vitamin D too high, just right, or not enough

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VitaminDWiki – Deficiency of Vitamin D category contains

462 items   Some Highlights:

• Overview Deficiency of vitamin D
• Many reasons why vitamin D deficiency has become epidemic
  •   23 of the 40 reasons are recent
• Many doctors continue to believe 2,000 IU of vitamin D is max (Hungary in this case)– Dec 2021
• 73 percent of US infants still do not even get 400 IU of Vitamin D - June 2020
• Vitamin D levels are dropping rapidly – what you need to do
• 4 Reasons why Vitamin D levels are crashing
  • Update Reasons for Low Vitamin D and what to do with a concise table
• Air Pollution reduces Vitamin D production - many studies
• Vitamin D levels in 56 countries (many have less than 20 ng) – 2021
• Trends in vitamin D status around the world – Nov 2021
• Vitamin deficiency in US military – Vitamin D is the most prevalent and is growing rapidly – June 2021
• Smoking reduces vitamin D - many studies 77 studies as of Feb 2024
• Low Vitamin D is worse for your health than smoking
• Many categories of people are at High Risk of low vitamin D - 67 studies
• 26 health factors increase the risk of COVID-19 – all are proxies for low vitamin D
• Diseases arising from depletion are cured by repletion - Hippocrates 400 BC

VitaminDWiki – Vitamin D Deficiency contains

Incidence of 22 health problems related to vitamin D have doubled in a decade
Criteria to associate a health problem with low vitamin D
Many reasons why vitamin D deficiency has become epidemic 20 of the 35 are new in past few decades
Diseases that may be related via low vitamin D

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VitaminDWiki –Maps of deficiency in 2014 (<75 nmol = grey)

Children

Adults

Seniors

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VitaminDWiki – Optimum category contains

The RDA is barely enough for the bones to survive.
   Need an optimal level for the body to thrive

99 items in Optimum Vitamin D category

Example pages

• Is 50 ng of vitamin D too high, just right, or not enough
• More than 30 ng of vitamin D is needed for many diseases - Feb 2022 has

• Saudi study defines normal Vitamin D level to be 50 to 70 ng (diabetes, etc.) - June 2020
• Need 40 to 60 ng of Vitamin D – 48 scientists call for action – 2015
• Vitamin D RDA of 600 IU is not enough - global RCT meta-analysis March 2019
• Vitamin D sufficiency 10 to 30 ng, optimal 40 to 80 ng (no consensus)– May 2018
• 4 X fewer visits to Dr. after getting high level of vitamin D (Interview with transcript) - Jan 3, 2022
• Vitamin D sufficiency 10 to 30 ng, optimal 40 to 80 ng (no consensus)– May 2018
• Sports benefits from up to 50 ng of Vitamin – meta-analysis - Nov 2012
• Vitamin D of 32 to 60 ng is needed before, during, and after pregnancy – Dec 2012
• Hypothesis by VitaminDWiki – Vitamin D levels are no longer limited by evolution
• VitaminDWiki pages with HIGH-DOSE in title 57 as of Feb 2022

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VitaminDWiki – Consenus category contains:

69 Vitamin D consensus publications

• French pediatric consensus: 30 – 60 ng of Vitamin D – Feb 2022
• 15 Clinical guidelines now recommend vitamin D – Nov 2021
• 34 clinical practice Vitamin D guidelines, huge diversity – Nov 2021
• Minimum National Vitamin D recommendations range from 200 to 4,000 IU – July 2021
• Controversies and consensus in Vitamin D – 3rd Conference Sept 2019
• Vitamin D Consensus 4,000 to 10,000 IU, upper limit 100 ng – Italy 2018
• 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018 six say 10,000 IU is OK
• 17 reasons why are doctors reluctant to accept vitamin D
  • Doctors and medical communities appear to be poor audiences to convince that vitamin D is good