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Vitamin D status in mothers with pre-eclampsia and their infants: a case–control study from Serbia, a country without a vitamin D fortification policy
- Marija Djekic-Ivankovic, Hope Weiler, Glenville Jones, Martin Kaufmann, Jovana Kaludjerovic, Vesna Aleksic-Velickovic, Ljuba M Mandić, Maria Glibetic
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- Journal:
- Public Health Nutrition / Volume 20 / Issue 10 / July 2017
- Published online by Cambridge University Press:
- 18 April 2016, pp. 1825-1835
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Objective
The objective of the present study was to determine if vitamin D intake and status are associated with pre-eclampsia in a country without a vitamin D fortification policy.
DesignA case–control study of pregnancies with (case) and without (control) pre-eclampsia was conducted from January to April when UVB is minimal. Maternal and cord blood obtained at delivery were measured for plasma 25-hydroxycholecalciferol (25-OH-D3), 3-epimer of 25-OH-D3 (3-epi-25-OH-D3) and 24,25-dihydroxycholecalciferol (24,25-(OH)2D3) by LC–MS/MS and maternal 1,25-dihydroxyvitamin D (1,25-(OH)2D). Differences between groups were tested with ANOVA and Bonferroni post hoc tests (P<0·05).
SettingClinical Center of Serbia.
SubjectsPregnant women with and without pre-eclampsia (n 60) and their infants.
ResultsExogenous vitamin D intake (0·95–16·25 µg/d (38–650 IU/d)) was not significantly different between groups. Women with pre-eclampsia delivered infants at an earlier gestational age and had significantly lower mean total plasma 25-hydroxyvitamin D (25-OH-D; case: 11·2 (sd 5·1); control: 16·1 (sd 5·7) ng/ml; P=0·0006), 25-OH-D3 (case: 10·0 (sd 4·9); control: 14·2 (sd 5·8) ng/ml; P=0·002), 3-epi-25-OH-D3 (case: 0·5 (sd 0·2); control: 0·7 (sd 0·2) ng/ml; P=0·0007) and 1,25-(OH)2D (case: 56·5 (sd 26·6); control: 81·0 (sd 25·7) pg/ml; P=0·018), while 24,25-(OH)2D3 was not different between groups. Infants did not differ in total plasma 25-OH-D, 25-OH-D3, 3-epi-25-OH-D3 and 24,25-(OH)2D3, but the mean proportion of 3-epi-25-OH-D3 was higher in the infant case group (case: 7·9 (sd 1·1); control: 7·0 (sd 1·4) % of total 25-OH-D3; P=0·005).
ConclusionsA high prevalence of vitamin D deficiency, as defined by plasma 25-OH-D<12 ng/ml, was observed in 47 % of all mothers and 77 % of all infants. These data underscore the need for prenatal vitamin D supplementation and a food fortification policy in Serbia.
UV and dietary predictors of serum 25-hydroxyvitamin D concentrations among young shift-working nurses and implications for bone density and skin cancer
- Sarah C Wallingford, Glenville Jones, Lindsay C Kobayashi, Anne Grundy, Qun Miao, Joan Tranmer, Kristan J Aronson
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- Journal:
- Public Health Nutrition / Volume 17 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 09 July 2013, pp. 772-779
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Objective
In 2011, the US Institute of Medicine updated the definition of vitamin D inadequacy to serum 25-hydroxyvitamin D (25(OH)D) concentration of 30–<50 nmol/l and of deficiency to serum 25(OH)D < 30 nmol/l. We describe the prevalence of these conditions according to these definitions, seasonal variation in 25(OH)D and predictors of serum 25(OH)D concentrations among working, white women.
DesignParticipants recorded lifestyle factors and dietary intake and provided fasting blood samples for measurement of serum 25(OH)D in both summer and winter. Predictors of serum 25(OH)D variation were analysed using linear regression and generalized linear mixed models.
SettingKingston General Hospital in Kingston, Ontario, Canada, from April 2008 to July 2009.
SubjectsFemale premenopausal nurses (n 83) working full-time rotating shifts.
ResultsDeficient or inadequate vitamin D status was observed in 9 % of participants following summer/autumn and in 13 % following winter/spring. Predictors of serum 25(OH)D concentration were vitamin D supplement use, tanning bed use and season. Tanning bed use increased serum 25(OH)D by 23·24 nmol/l (95 % CI 8·78, 37·69 nmol/l, P = 0·002) on average.
ConclusionsAccording to the 2011 Institute of Medicine bone health guidelines, over 10 % of nurses had deficient or inadequate vitamin D status following winter. Higher serum concentrations were associated with use of tanning beds and vitamin D supplements. As health promotion campaigns and legal restrictions are successful in reducing tanning bed use among women, our data suggest that increased prevalence of vitamin D inadequacy and deficiency may be a consequence, and that low vitamin D status will need to be countered with supplementation.
IV.A.5 - Vitamin E
- from IV.A - Vitamins
- Edited by Kenneth F. Kiple, Bowling Green State University, Ohio, Kriemhild Coneè Ornelas
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- The Cambridge World History of Food
- Published online:
- 28 March 2008
- Print publication:
- 07 December 2000, pp 769-774
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Summary
As any nutritional text dated prior to 1970 will indicate, vitamin E has not received much respect from nutritionists. In such texts it is often placed after vitamin K, in the miscellaneous category. This is because it took a good 40 years from its discovery in 1923 (Evans and Bishop 1923) to demonstrate a clear-cut human deficiency disease for vitamin E. Though numerous studies had shown vitamin E to be an essential component of animal diets, deficiency symptoms varied from one species to the next, from reproductive disorders in rats to vascular abnormalities in chickens. Thus, it was not clear that humans had an obligatory requirement for vitamin E. Recent research, however, has shown that this is indeed the case and that vitamin E is just as important to human nutrition as the other vitamins. It is, therefore, pleasing to see that vitamin E is now placed in its proper place in the alphabet of vitamins.
Vitamin E is the nutritional term used to describe two families of four naturally occurring compounds each, the tocopherols and the tocotrienols (Pennock, Hemming, and Kerr 1964). Tocopherols and tocotrienols both contain a chroman ring, which is essential for biological activity, but differ in the degree of saturation of their fatty side chains. They are otherwise interchangeable in their biological role. Each family comprises alpha, beta, gamma, and delta forms, which differ significantly in their potency. Thus, alpha-tocopherol represents the principal source of vitamin E found in the human diet with a small contribution also coming from gamma-tocopherol (Bieri and Evarts 1973). Many texts, including this one, use the terms alpha-tocopherol and vitamin E interchangeably.
IV.A.4 - Vitamin D
- from IV.A - Vitamins
- Edited by Kenneth F. Kiple, Bowling Green State University, Ohio, Kriemhild Coneè Ornelas
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- Book:
- The Cambridge World History of Food
- Published online:
- 28 March 2008
- Print publication:
- 07 December 2000, pp 763-768
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Summary
Definitions and Nomenclature
Vitamin D is a fat-soluble substance required by most vertebrates, including humans, to keep blood calcium and phosphate levels within a narrow normal range and thereby maintain a normal skeleton and optimal cellular function. The term, vitamin D, is a misnomer. Vitamin D is not a vitamin. It is synthesized in the skin, and so, unlike other vitamins, which are essential dietary components, it does not satisfy the criteria for classification as a vitamin. Nor is it a hormone because it is biologically inactive and must be metabolized by the body into a multihydroxylated version, known as calcitriol, which is biologically active and the true hormonal form. Thus vitamin D is more accurately described as a prohormone. The natural form of the vitamin, known as vitamin D3, is a cholesterollike substance produced in the skin by a nonenzymatic process involving ultraviolet light and heat. An artificial form of the vitamin, with an altered side chain, known as vitamin D2, is derived from the plant sterol ergosterol and is often used instead of vitamin D3 as a dietary supplement.
Most of the complexity associated with the nomenclature in the vitamin D field stems from confusion surrounding its discovery during the period 1919 to 1922. Early research showed that the deficiency associated with lack of vitamin D (rickets in children or osteomalacia in adults) was cured by seemingly unrelated treatments: exposure to sunlight or ingestion of a fat-soluble substance. The early nutritional pioneers of that period, including Sir Edward Mellanby and Elmer V. McCollum, realized that several related factors would cure rickets and that one of these substances, vitamin D3, could be made in the skin. Students often ponder the fate of vitamin D1. It was a short-lived research entity comprising a mixture of vitamins D2 and D3, and the term has no value today. Vitamin D3 is sometimes referred to as cholecalciferol or, more recently, calciol; vitamin D2 is known as ergocalciferol or ercalciol. The discovery of the hydroxylated versions of vitamin D by Hector F. DeLuca and Egon Kodicek in the 1967 to 1971 period led to a major expansion of our knowledge of a number of biologically active compounds, but calcitriol is the singularly most important version of these. For purposes of discussing the history of foodstuffs, we shall use the term vitamin D to describe all substances that can be activated to produce biological effects on calcium and phosphate metabolism in humans.