Vitamin D deficiency is rife in Southern Europe and the Eastern Mediterranean populations despite having plentiful sunshine

A comprehensive, systematic literature review has been conducted regarding serum 25(OH) vitamin D plasma levels in Southern Europe and Eastern Mediterranean populations with data extracted from 107 studies, covering 630,093 individuals (1). In more than a third of studies, mean serum 25(OH)D levels were <50 nmol/L (i.e. usually defined as the level of insufficiency”) and in ca. 10% of studies the mean were serum levels <25 nmol/L (usually defined as “deficiency”). As perhaps could be expected, there was considerable heterogeneity in the studies, however the populations with poorest vitamin D status were found to be infants, adolescents and females.

This study was necessary because the recent European Union-funded ODIN project predominantly looked at plasma 25(OH)D levels in Northern Europe (2). It would be logical to expect the populations in Southern European Countries with much higher levels of ultraviolet B (UVB) sunshine, and hence, potential for synthesis in exposed skin, to have higher levels of plasma 25(OH)D than levels in Northern Europe (3). Actually, the new study shows the opposite is true. At present, it is not clear why this contradiction exists. It is possible that young people and women tend to cover up more in Southern Europe and generally avoid the sun.  The government policies toward dietary supplementation in these countries could provide another explanation.

It seems that Southern Europeans, like their northern cousins, are afflicted with a pandemic of hypovitaminosis D. The solutions likely lie with government led schemes to encourage food fortification and widespread use of vitamin D supplements, particularly for “at risk” groups, including the elderly, females and adolescents.

REFERENCES

1. Manios Y, Moschonis G, Lambrinou C-|P et al.; “A systematic review of Vitamin D status in southern European countries”; Eur J Nutr 2017 DOI: 10.1007/s00394-017-1564-2.
2. Cashman KD & Kiely M; “Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in Vitamon D nutrition and public health”; Br J Nutr 106 (11): 1617-1627.
3. O’Neill C, Barber N, Ryan M et al.; “The availability of Ultraviolet B radiation throughout the year in several European countries from South to North: implications for population vitamin D status”; Int J AOAC 2016.