@article{2987624,
    title = "Association of serum vitamin D status with dietary intake and sun exposure in adults",
    author = "Dimakopoulos, I. and Magriplis, E. and Mitsopoulou, A.-V. and Karageorgou, D. and Bakogianni, I. and Micha, R. and Michas, G. and Chourdakis, M. and Ntouroupi, T. and Tsaniklidou, S.-M. and Argyri, K. and Panagiotakos, D.B. and Zampelas, A. and Fappa, E. and Theodoraki, E.-M. and Trichia, E. and Sialvera, T.-E. and Varytimiadi, A. and Spyreli, E. and Koutelidakis, A. and Karlis, G. and Zacharia, S. and Papageorgiou, A. and Chrousos, G.P. and Dedoussis, G. and Dimitriadis, G. and Manios, Y. and Roma, E. and HNNHS Contributors and HNNHS Advisory Committee",
    journal = "Clinical Nutrition ESPEN",
    year = "2019",
    volume = "34",
    pages = "23-31",
    publisher = "Elsevier Ireland Ltd",
    issn = "2405-4577",
    doi = "10.1016/j.clnesp.2019.09.008",
    keywords = "vitamin D;  vitamin D, adult;  anthropometry;  Article;  blood sampling;  demography;  dietary intake;  evaluation study;  female;  Greece;  health survey;  human;  male;  multivariate logistic regression analysis;  nutritional assessment;  obesity;  risk factor;  sex difference;  skin color;  sun exposure;  vitamin blood level;  vitamin supplementation;  blood;  complication;  cross-sectional study;  dietary supplement;  middle aged;  nutrition;  nutritional status;  public health;  season;  sunlight;  vitamin D deficiency, Adult;  Cross-Sectional Studies;  Dietary Supplements;  Female;  Greece;  Humans;  Male;  Middle Aged;  Nutrition Surveys;  Nutritional Status;  Obesity;  Public Health;  Seasons;  Sunlight;  Vitamin D;  Vitamin D Deficiency",
    abstract = "Background & aims: Serum 25(OH)D deficiency is becoming an epidemic. The aim was to assess vitamin D status of the adult Greek population in relation to intake, sun exposure and other factors, using data from the Hellenic National Nutrition and Health Survey (HNNHS). Methods: Data from 1084 adult participants (37.8% males) were analyzed. Vitamin D intake was assessed using 24-h recalls. Serum 25(OH)D concentration was evaluated and related to anthropometric measurements and other covariates including supplements used, by sex. Variables significantly associated with 25(OH)D < 20 ng/ml were assessed using simple and multiple logistic regression. Results: Median vitamin D intake from food was 1.23 mcg/day (0.60, 2.44), with 9.1% consuming supplements. Median serum 25(OH)D was 16.72 ng/ml, with no sex differences (P = 0.923). The odds of having 25(OH)D < 20 ng/ml significantly decreased with being very active (OR 0.55, 95% CI 0.35, 0.98), increasing length of sun exposure [1–3 h/day (OR 0.59, 95% CI 0.44, 0.80), >3 h/day (OR 0.36, 95% CI 0.24, 0.55)], and skin colour [light to medium skin (OR 0.47, 95% CI 0.24, 0.91), fairly dark skin colour (OR 0.34, 95% CI 0.17, 0.67) and dark or very dark skin colour (OR 0.34, 95% CI 0.15, 0.75)], compared to respective baseline levels. The odds significantly increased with obesity (OR 1.95, 95% CI 1.24, 3.08), and spring season of blood sample collection (OR 1.75, 95% CI 1.22, 2.50). Conclusions: Vitamin D deficiency is highly prevalent in Greek adults. Relevant public health policies are highly recommended, which could include vitamin D fortification. and suggestion for increased but safe sun exposure. © 2019 European Society for Clinical Nutrition and Metabolism"
}