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Vitamin D status of the African-Caribbean population globally: A Systematic Review and Meta-Analysis

Published online by Cambridge University Press:  19 October 2020

R.M. Vearing ,
A.L. Darling ,
K.H. Hart ,
Y. Probst ,
A.S. Olayinka ,
H. Ribeiro ,
S. Thakur ,
M. Mendes ,
K. Charlton  and
S.A. Lanham-New
R.M. Vearing
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia, 2522
A.L. Darling
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH
K.H. Hart
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH
Y. Probst
Affiliation:
School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia, 2522 Illawarra Health and Medical Research Institute, Wollongong, Australia, NSW 2522
A.S. Olayinka
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH
H. Ribeiro
Affiliation:
School of Public Health, University of São Paulo, São Paulo, 01246-904
S. Thakur
Affiliation:
College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA, 27695
M. Mendes
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH School of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia, 70910-900
K. Charlton
Affiliation:
School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia, 2522 Illawarra Health and Medical Research Institute, Wollongong, Australia, NSW 2522
S.A. Lanham-New
Affiliation:
School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK, GU27XH
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Abstract

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Vitamin D is unlike any other nutrient, with the majority of the vitamin derived from sunlight rather than food(Reference Chen, Chimeh and Lu1,Reference Jones2) . There is a lack of research looking into the vitamin D status of the African-Caribbean population worldwide. This population may be at high risk of vitamin D deficiency because of their darkly pigmented skin that hinders ability to synthesise vitamin D cutaneously, especially in those living at higher latitudes(Reference Chen, Chimeh and Lu1). The aim of this study was to investigate the vitamin D status (as measured by 25(OH)D and dietary intake) of the African-Caribbean population globally.

A systematic review was conducted by searching key scientific databases (PUBMED, Web of Science, Scopus) from inception until October 2019. Search terms included ‘Vitamin D status’ and ‘African-Caribbean’. Random and fixed effects meta-analyses were performed by combining means and standard error of the mean. Sub group analysis were performed to assess vitamin D status at high and low latitudes. A sensitivity analysis was conducted, whilst a Pearson's correlation test was run to show the extent that latitude and 25(OH)D were related.

The search yielded 19 papers that included n = 5,270 African-Caribbean individuals from six countries. The meta-analysis found this population to have sufficient (>50nmol/L) 25(OH)D levels at 71.4nmol/L (95% CI 62.8,80) but poor dietary intake of vitamin D at only 3.0μg/day (95% CI 1.67,4.31). For those living at low latitudes ‘insufficient’ (as defined by the original study authors), 25(OH)D levels were found only in participants with type 2 diabetes and in those undergoing haemodialysis. However, when using our cut-offs (deficiency <25nmol/L, insufficiency >25–50nmol/L and sufficiency >50nmol/L) these participants were considered vitamin D sufficient. In contrast, African Caribbean populations living at high latitudes were found to be vitamin D ‘insufficient’ to ‘deficient’ according to original study authors, and insufficient according to our cut-offs. A strong inverse association (Pearson correlation) was found between 25(OH)D status and distance from the equator (r = −.894, p < 0.0001). Suboptimal dietary vitamin D intake was reported in all studies at high latitudes (intakes < UK recommended nutrient intake of 10μg/day). At lower latitudes, where there are lower recommended dietary intakes (Caribbean recommended dietary intake: 2.5μg/day), two out of three studies reported ‘sufficient’ intakes.

In African-Caribbean populations, 25(OH)D insufficiency and low dietary vitamin D intake are more prevalent at higher latitudes.

References

Chen, TC, Chimeh, F, Lu, Z et al. (2007) Arch Biochem Biophys 460, 2, 213–710.1016/j.abb.2006.12.017CrossRefGoogle Scholar
Jones, G (2008) Am J Clin Nutr 88, 2, 582–60010.1093/ajcn/88.2.582SCrossRefGoogle Scholar