Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001-2018.
Level 4 - case-series / case-control
Repeated cross-sectional survey analysis (NHANES 2001-2018)
PubMed 36263304 · doi:10.3389/fnut.2022.965376
What was done
The authors analyzed NHANES cross-sectional data from 2001 to 2018 to evaluate prevalence, secular trends, and predictors of vitamin D deficiency (VDD) in the US population. Serum 25(OH)D concentrations were classified as severe VDD (<25 nmol/L), moderate VDD (25-50 nmol/L), insufficiency (50-75 nmol/L), and sufficiency (>75 nmol/L). Weighted multivariate linear regression models were used to identify predictors, adjusting for the complex survey design using Mobile Examination Center (MEC) weights.
What was found
Among 71,685 participants, weighted prevalence was 2.6% for severe VDD, 22.0% for moderate VDD, 40.9% for insufficiency, and 34.5% for sufficiency. Severe and moderate VDD were higher among women, non-Hispanic Black Americans, individuals aged 20-29 years, and during winter. From 2001 to 2018, slight linear decreases occurred in moderate VDD (coefficient = -0.847; P = 0.009) and insufficiency (coefficient = -0.810; P = 0.014), while sufficiency increased (coefficient = 1.693; P = 0.004). Severe VDD showed no trend change (coefficient = -0.037; P = 0.698). Age, sex, ethnicity, season, sun-protective behaviors, lower BMI, lower socioeconomic status, alcohol use, and lower milk intake predicted severe VDD.
Why it matters
This study provides updated national prevalence estimates through 2018, demonstrating slight population-wide improvements in sufficiency alongside persistent disparities and stagnant rates of severe deficiency among high-risk demographic groups.
Limits
The repeated cross-sectional design cannot establish causality or individual longitudinal trajectories. Serum 25(OH)D was measured at single timepoints, and the abstract does not provide exact effect sizes or confidence intervals for the identified predictors.
Cited by
- supports NHANES data show that approximately 70% of the US population is vitamin D insufficient and 30% is vitamin D deficient.