Livija Wells

Research Article Summary

NTR 403
March 23, 2016

In United Kingdom during November 2010, The International Osteoporosis

Foundation and National Osteoporosis Foundation published the article titled Sunlight
and dietary contributions to the seasonal vitamin D status of cohorts of healthy
postmenopausal women living at northerly latitudes: a major cause for concern? This
article discusses how vitamin D deficiency is common in countries at higher latitude,
which is a concern due to vitamin Ds contribution to reducing risks of illnesses. Vitamin
D is a fat-soluble vitamin that is present in foods, supplementation, and also ultraviolet
rays from sunlight. Vitamin D is significant because combined with calcium; the dynamic
duo creates strong healthy bones. Parathyroid hormone is responsible for causing bones
to become thin and brittle. Vitamin D is needed to combat parathyroid hormone to
prevent disintegration of bones. The study in this article mainly focuses on sunlight and
dietary influences on vitamin D status in British postmenopausal women living in
northern areas.
The purpose of this study is to assess vitamin D intake of women at higher
latitudes because there is insufficient data to define vitamin D status is areas such as the
UK. This information is crucial when considering revisions of vitamin D intake for
healthy individuals. The main goal of the study is to compare between the north (57oN)
and the south (51oN) the vitamin D status of healthy postmenopausal women less than 65
years of age during each season while considering their exposure and dietary intake of
vitamin D.
The subjects that made this study possible include women from Aberdeen,
Scotland, and the UK below the age of 65. Women using diuretics and thyroid medication
were included if their lab values were stable. Women excluded from the study include
women with osteoporosis, past bisphosphonate treatment, liver disease, stroke, severe
heart disease, rheumatoid arthritis, Pagets disease, osteomalacia, malabsorption, <5 years
postmenopausal, hormone replacement therapy, and active treatment for breast cancer
and oral corticosteroids. The study for vitamin D status in Europe also included
Caucasian and Asian women. Caucasian women were sampled through local GP surgeries
in Surrey and Asian women were found through local Asian networks by SL-N.

In order to make a study possible, organization is key. The methods and materials
are a significant attribute to a study, together testing the hypothesis by gathering and
analyzing data collected. The methods in this study include a sample size of 518
postmenopausal women between the ages 5570 years. As we learned in class, vitamin D
is assessed by serum 25-(OH)D which is what took place in this study. The participants
vitamin D intake was assessed by fasted serum 25-(OH)D collected at 3 month intervals
during summer 2006 for measurement of vitamin D and parathyroid hormone. Materials
used to analyze the data included log-transformed data and SPSS for Windows version
17. The author used chi-square to test for differences in the data. The study was
successful and therefore not repeated. Factors that may affect the outcome include
women consuming excess vitamin D, which can skew the lab values for the assessment
of vitamin D. Other factors include the software not functioning, and also the distribution
of 25-(OH)D.
The results of the study were as predicted by the author, proving that at a higher
altitude there was a lower absorption of vitamin D. Also, dietary vitamin D intakes
resulted in much lower values than the RDA value of 600 IU. Caucasian women
consumed 80100 IU, and Asian women consumed 5065. Based on latitude and
absorption of vitamin D, Caucasian women had lower 25-(OH)D (p < 0.001) at 57 N in
comparison to 51 N. For summer (JuneAugust) at 57 N was 43.0 (20.9) nanomoles per
liter compared to 62.5 (26.6) at 51 N. For winter (DecemberFebruary) at 57 N was
28.3 (18.9) compared to 39.9 (24.0) at 51 N. For Asian women, their vitamin D status
seemed to be lower than Caucasian women at northern latitudes. At 51 N, 25-(OH)D
was 24.0 (15.8) nanomoles per liter in summer and 16.9 (15.9) nanomoles per liter in
winter. In the summer, the majority of the participants werent deficient in vitamin D,
providing >80% of the population; Ultraviolet rays from the sun being the main source of
25-(OH)D. The study provided both geographical and ethnical differences in vitamin D
exposure and absorption from sunlight.
Based on what we learned in class about vitamin D, the fat-soluble vitamin is
made in the skin from 7-dehydrocholesterol with presence of ultra violet rays from
sunlight, this version of vitamin D is vitamin D3 (cholecalciferol). Vitamin D2, is known
as ergocalciferol and is found in plants. As vitamin D3 travels through the bloodstream to

the liver, it is initially metabolized to 25-(OH)D. As cholecalciferol travels to the kidneys,

it becomes the hormonal form 1,25-dihydroxyvitamin D. The enzyme involved is 1alpha-hydroxylase. The vitamin D receptor (VDR), is a transcription factor and is
responsible for binding to specific sites called vitamin D response elements (VDREs) in
which the ligand, 1,25-dihydroxyvitamin is needed. This process is dependent on
comodulators. There are thousands of binding sites located on the cell. These cell specific
binding sites are responsible for regulating genes. Vitamin D3 is the active vitamin D
hormone and its responsible for regulating how the body uses calcium and phosphorus in
the bloodstream, which is significant in human metabolism.
What surprised me about this article was the fact that within each cohort, a
prevalence of vitamin D deficiency between winter and spring was similar. I would
assume that after a harsh winter, sunlight rays would be popular demand within the
population causing an increase in absorption of ultraviolet rays. Another surprise to me
was the fact that the author didnt include much about calcium. Since the article was
based solely upon women, I anticipated more studies on calcium absorption.
Vitamin D is a key vitamin used for calcium absorption, and to block parathyroid
hormone secretion. Vitamin D in conjunction with calcium creates healthy bones and
teeth. Secretion of parathyroid hormone causes bones to become brittle, hence the
significance of Vitamin D especially in women who are prone to disorders such as
osteomalacia. Other benefits of vitamin D include reducing the risk of illnesses such as
diabetes, rheumatoid arthritis, and heart disease. As the article illustrates, a deficiency of
vitamin D is prevalent in northern areas; therefore supplementation may be beneficial in
reducing the risk of chronic illnesses.

Citations:
Macdonald, H. M., Mavroeidi, A., Fraser, W. D., Darling, A. L., Black, A. J., Aucott,
L., . . . Reid, D. M. (2010). Sunlight and dietary contributions to the seasonal
vitamin D status of cohorts of healthy postmenopausal women living at northerly
latitudes: A major cause for concern? Osteoporosis International Osteoporos Int,
22(9), 2461-2472.
Gropper, S. A., Smith, J. L., & Groff, J. L. (2009). Advanced nutrition and human
metabolism. Australia: Wadsworth/Cengage Learning.