Serum 25(OH)D concentrations in sunny Israel.

Osteoporos Int. 2012 Feb;23(2):687-94. Epub 2011 Mar 17.
Saliba W, Rennert HS, Kershenbaum A, Rennert G.
Department of Community Medicine and Epidemiology, Carmel Medical Center, Clalit Health Services, and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 7 Michal St., Haifa 34362, Israel. saliba_wa@clalit.org.il

SUMMARY:
This study assesses vitamin D status in Israel. Serum 25(OH)D levels <25 and <50 nmol/L are common in Israel with noted differences between Arabs and Jews, Arab females were particularly at high risk.
These findings may require public health intervention at the population level.

INTRODUCTION:
Small studies from Israel have suggested a high prevalence of hypovitaminosis D.
The objective of this study was to evaluate the extent of hypovitaminosis D among demographic subgroups in Israel.

METHODS:
The data of this study are from the Clalit Health Services (CHS) which is a non-for-profit health maintenance organization (HMO) covering more than half of the Israeli population.
We included all CHS members for whom a 25(OH)D test result in 2009 was available and who were not taking vitamin D supplements in 2008-2009 before that 25(OH)D result.
Complete data were available for 198,834 members.

RESULTS:
The mean level of 25(OH)D was 51.9?±?24.5 nmol/L and was higher in summer compared to winter (P?<?0.0001).
Level <25, <37.5, and <50 nmol/L were detected in 14.4%, 30.7%, and 49.9% of tests; 16.4% had levels >75 nmol/L.

Females had higher prevalence of 25(OH)D levels?<?50 nmol/L which were found in 51.8% of females versus 45.0% in males (P?<?0.0001);
76.7% of the Arabs had levels <50 nmol/L versus 46.5% in Jews (P?<?0.0001).

Arabs females were particularly at high risk for 25(OH)D <50 nmol/L;
84.8% of them had levels <50 nmol/L versus 48.1% of Jewish females (P?<?0.0001).

The relation of 25(OH)D levels with age had a

• sinusoidal shape among Jews, a
• U-shape in Arab females, and
• inverse linear pattern in Arab males.

CONCLUSIONS:
25(OH)D levels <25 and <50 nmol/L are common in Israel.
Public health measures are needed for values lesser than about 30 nmol/L and further monitoring of concentrations between about 30 and 50 nmol/L to determine if there are adverse health effects.

PMID: 21416123
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Summary 21 ng mean (not average)

• 14% < 10 ng
• 50% < 20 ng
• 15% > 30 ng

Less than 20 ng

• 52% females
• 45% males
• 77% Arabs
• 47% Jews

Females less than 20 ng

• 85% Arab
• 48% Jews

Interesting to wonder about the sub-sampling 3.9 million ==> 198,000

• 7.8 million people in Israel
• Apparently more than half covered by CHS
• Some of those got a vitamin D test: wonder how many because of a suspected deficiency?
• Excluded those taking vitamin D supplements: wonder how many were excluded: 10%, 40%?

See also VitaminDWiki

• Parkinson disease increased in Israel by 50 percent in 7 years – June 2011
• All items in Middle East and Vitamin D 154 items
• Air Conditioning probably has decreased vitamin D from a book
• After 245,000 free vitamin D tests, 121,000 supplemented, but only 5,400 had 2nd test – Oct 2011 perhaps from the same dataset
  Notice: about 50% of those who found that they were deficient then supplemented with vitamin D
• 23 ng of vitamin D in sunny Israel – Dec 2010 this was average for 195 people, not mean
• Percent of population with < 20 ng of vitamin D has the following graph

See also web

• Demographics in Israel Wikipedia which had the following graphic Aug 2012