Skip to main content

Advertisement

SpringerLink
Log in

A systematic review of vitamin D status in southern European countries

  • Review
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Despite an acknowledged dearth of data on serum 25-hydroxyvitamin D (25(OH)D) concentrations from Southern European countries, inter-country comparison is hampered by inconsistent data reporting. The purpose of the current study was to conduct a systematic literature review of available data on serum 25(OH)D concentrations and estimate vitamin D status in Southern European and Eastern Mediterranean countries, both at a population level and within key population subgroups, stratified by age, sex, season and country.

Methods

A systematic review of the literature was conducted to identify and retrieve scientific articles reporting data on serum 25(OH)D concentration and/or vitamin D status following standard procedures.

Results

Data were extracted from 107 studies, stratified by sex and age group, representing 630,093 individuals. More than one-third of the studies reported mean 25(OH)D concentrations below 50 nmol/L and ~ 10% reported mean serum 25(OH)D concentrations below 25 nmol/L. Overall, females, neonates/ infants and adolescents had the higher prevalence of poor vitamin D status. As expected, there was considerable variability between studies. Specifically, mean 25(OH)D ranged from 6.0 (in Italian centenarians) to 158 nmol/L (in elderly Turkish men); the prevalence of serum 25(OH)D < 50 nmol/L ranged from 6.8 to 97.9% (in Italian neonates).

Conclusions

Contrary to expectations, there was a high prevalence of low vitamin D status in the Southern Europe and the Eastern Mediterranean regions, despite abundant sunshine. These data further emphasize the need for strategies, such as fortification of foods with vitamin D and/or vitamin D supplementation, which will be tailored to the needs of specific population groups with higher risk of insufficiency or deficiency, to efficiently tackle the pandemic of hypovitaminosis D in Europe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Cashman KD, Kiely M (2014) Recommended dietary intakes for vitamin D: where do they come from, what do they achieve and how can we meet them?. J Hum Nutr Diet 27(5), 434 – 42

  2. German Nutrition Society (2012) New reference values for vitamin D. Ann Nutr Metab 60(4), 241–246

    Article  CAS  Google Scholar 

  3. Health Council of the Netherlands (2012) Evaluation of dietary reference values for vitamin D. vol 2012/15E, Health Council of the Netherlands, The Hague

    Google Scholar 

  4. Lamberg-Allardt C, Brustad M, Meyer HE, Steingrimsdottir L (2013) Vitamin D—a systematic literature review for the 5th edition of the nordic nutrition recommendations. Food Nutr Res 57

  5. Scientific Advisory Committee on Nutrition (SACN) (2015) Draft Vitamin D and Health report

  6. European Food Safety Authority (EFSA) Panel on Dietetic Products Nutrition and Allergies (2016) Dietary reference values for vitamin D. EFSA J 14(10), e04547-1000

    Google Scholar 

  7. Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, The National Academies Collection: Reports funded by National Institutes of Health, Dietary Reference Intakes for Calcium and Vitamin D, Ross AC et al, (eds) 2011, National Academies Press (US) National Academy of Sciences.: Washington (DC)

  8. European Food Safety Authority (EFSA) Panel on Dietetic Products Nutrition and Allergies (2010) Scientific opinion on principles for deriving and applying dietary reference values. EFSA J 8(3), 1458

    Google Scholar 

  9. Cashman KD, Kiely M (2011) Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. Br J Nutr 106(11):1617–1627

    Article  CAS  PubMed  Google Scholar 

  10. Lips P (2010) Worldwide status of vitamin D nutrition. J Steroid Biochem Mol Biol 121(1–2):297–300

    Article  CAS  PubMed  Google Scholar 

  11. van Schoor NM, Lips P (2011) Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 25(4), 671 – 80

  12. O’Neill C, Barber N, Ryan M, Jorde R, Kiely M, Kazantzidis A, Webb A, and KD C (2016) 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

  13. Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, Pierroz DD, Weber P, Hoffmann K (2014) A systematic review of vitamin D status in populations worldwide. Br J Nutr 111(1):23–45

    Article  CAS  PubMed  Google Scholar 

  14. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  PubMed Central  Google Scholar 

  15. Loney PL, Chambers LW, Bennett KJ, Roberts JG, Stratford PW (1998) Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can 19(4):170–176

    CAS  PubMed  Google Scholar 

  16. Adami S, Bertoldo F, Braga V, Fracassi E, Gatti D, Gandolini G, Minisola S, Rini Battista G (2009) 25-hydroxy vitamin D levels in healthy premenopausal women: association with bone turnover markers and bone mineral density. Bone 45(3):423–426

    Article  CAS  PubMed  Google Scholar 

  17. Adami S, Viapiana O, Gatti D, Idolazzi L, Rossini M (2008) Relationship between serum parathyroid hormone, vitamin D sufficiency, age, and calcium intake. Bone 42(2):267–270

    Article  CAS  PubMed  Google Scholar 

  18. Akcakus M, Koklu E, Budak N, Kula M, Kurtoglu S, Koklu S (2006) The relationship between birthweight, 25-hydroxyvitamin D concentrations and bone mineral status in neonates. Ann Trop Paediatr 26(4):267–275

    Article  PubMed  Google Scholar 

  19. Akman AO, Tumer L, Hasanoglu A, Ilhan M, Cayci B (2011) Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int 53(6):968–973

    Article  CAS  PubMed  Google Scholar 

  20. Almirall J, Vaqueiro M, Bare ML, Anton E (2010) Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Nephrol Dial Transplant 25(2):503–509

    Article  CAS  PubMed  Google Scholar 

  21. Alonso MA, Pallavicini ZF, Rodriguez J, Avello N, Martinez-Camblor P, Santos F (2015) Can vitamin D status be assessed by serum 25OHD in children? Pediatr Nephrol 30(2):327–332

    Article  PubMed  Google Scholar 

  22. Andiran N, Celik N, Akca H, Dogan G (2012) Vitamin D deficiency in children and adolescents. J Clin Res Pediatr Endocrinol 4(1):25–29

    Article  PubMed  PubMed Central  Google Scholar 

  23. Andiran N, Yordam N, Ozon A (2002) Risk factors for vitamin D deficiency in breast-fed newborns and their mothers. Nutrition 18(1):47–50

    Article  CAS  PubMed  Google Scholar 

  24. Annweiler C, Beauchet O, Berrut G, Fantino B, Bonnefoy M, Herrmann FR, Schott AM (2009) Is there an association between serum 25-hydroxyvitamin D concentration and muscle strength among older women? Results from baseline assessment of the EPIDOS study. J Nutr Health Aging 13(2):90–95

    Article  CAS  PubMed  Google Scholar 

  25. Assmann KE, Touvier M, Andreeva VA, Deschasaux M, Constans T, Hercberg S, Galan P, Kesse-Guyot E (2015) Midlife plasma vitamin D concentrations and performance in different cognitive domains assessed 13 years later. Br J Nutr 113(10):1628–1637

    Article  CAS  PubMed  Google Scholar 

  26. Atli T, Gullu S, Uysal AR, Erdogan G (2005) The prevalence of Vitamin D deficiency and effects of ultraviolet light on Vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr 40(1):53–60

    Article  CAS  PubMed  Google Scholar 

  27. Aypak C, Turedi O, Yuce A (2014) The association of vitamin D status with cardiometabolic risk factors, obesity and puberty in children. Eur J Pediatr 173(3):367–373

    Article  CAS  PubMed  Google Scholar 

  28. Barchetta I, Baroni MG, Leonetti F, De Bernardinis M, Bertoccini L, Fontana M, Mazzei E, Fraioli A, Cavallo MG (2014) TSH levels are associated with vitamin D status and seasonality in an adult population of euthyroid adults. Clin Exp Med

  29. Barchetta I, Baroni MG, Leonetti F, De Bernardinis M, Bertoccini L, Fontana M, Mazzei E, Fraioli A, Cavallo MG (2015) TSH levels are associated with vitamin D status and seasonality in an adult population of euthyroid adults. Clin Exp Med 15(3):389–396

    Article  CAS  PubMed  Google Scholar 

  30. Bellone S, Esposito S, Giglione E, Genoni G, Fiorito C, Petri A, Bona G, Prodam F (2014) Vitamin D levels in a paediatric population of normal weight and obese subjects. J Endocrinol Invest 37(9):805–809

    Article  CAS  PubMed  Google Scholar 

  31. Bettica P, Bevilacqua M, Vago T, Norbiato G (1999) High prevalence of hypovitaminosis D among free-living postmenopausal women referred to an osteoporosis outpatient clinic in northern Italy for initial screening. Osteoporos Int 9(3):226–229

    Article  CAS  PubMed  Google Scholar 

  32. Bruyere O, Malaise O, Neuprez A, Collette J, Reginster JY (2007) Prevalence of vitamin D inadequacy in European postmenopausal women. Curr Med Res Opin 23(8):1939–1944

    Article  CAS  PubMed  Google Scholar 

  33. Cabral M, Araujo J, Teixeira J, Barros H, Martins S, Guimaraes JT, Lopes C, Ramos E (2016) Vitamin D levels and cardiometabolic risk factors in Portuguese adolescents. Int J Cardiol 220:501–507

    Article  PubMed  Google Scholar 

  34. Cadario F, Savastio S, Magnani C, Cena T, Pagliardini V, Bellomo G, Bagnati M, Vidali M, Pozzi E, Pamparana S, Zaffaroni M, Genoni G, Bona G (2015) High prevalence of vitamin D deficiency in native versus migrant mothers and newborns in the North of Italy: a call to act with a stronger prevention program. PLoS One 10(6):e0129586

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Cals MJ, Bories PN, Devanlay M, Desveaux N, Luciani L, Succari M, Duche JC, de Jaeger C, Blonde-Cynober F, Coudray-Lucas C (1994) Extensive laboratory assessment of nutritional status in fit, health-conscious, elderly people living in the Paris area. Research Group on Aging. J Am Coll Nutr 13(6):646–657

    Article  CAS  PubMed  Google Scholar 

  36. Celikbilek A, Gocmen AY, Tanik N, Borekci E, Adam M, Celikbilek M, Suher M, Delibas N (2015) Decreased serum vitamin D levels are associated with diabetic peripheral neuropathy in a rural area of Turkey. Acta Neurol Belg 115(1):47–52

    Article  PubMed  Google Scholar 

  37. Cesareo R, Di Stasio E, Vescini F, Campagna G, Cianni R, Pasqualini V, Romitelli F, Grimaldi F, Manfrini S, Palermo A (2015) Effects of alendronate and vitamin D in patients with normocalcemic primary hyperparathyroidism. Osteoporos Int 26(4), 1295 – 302

  38. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7(5):439–443

    Article  CAS  PubMed  Google Scholar 

  39. Cougnard-Gregoire A, Merle BM, Korobelnik JF, Rougier MB, Delyfer MN, Feart C, Le Goff M, Dartigues JF, Barberger-Gateau P, Delcourt C (2015) Vitamin D deficiency in community-dwelling elderly is not associated with age-related Macular degeneration. J Nutr 145(8):1865–1872

    Article  CAS  PubMed  Google Scholar 

  40. De Rui M, Toffanello ED, Veronese N, Zambon S, Bolzetta F, Sartori L, Musacchio E, Corti MC, Baggio G, Crepaldi G, Perissinotto E, Manzato E, Sergi G (2014) Vitamin D deficiency and leisure time activities in the elderly: are all pastimes the same?. PLoS One 9(4):e94805

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. De Vita F, Lauretani F, Bauer J, Bautmans I, Shardell M, Cherubini A, Bondi G, Zuliani G, Bandinelli S, Pedrazzoni M, Dall’Aglio E, Ceda GP, Maggio M (2014) Relationship between vitamin D and inflammatory markers in older individuals. Age (Dordr) 36(4):9694

    Article  CAS  Google Scholar 

  42. Di Nisio A, De Toni L, D’Addato E, Pizzo MR, Sabatino P, Foresta C (2015) 25-Hydroxyvitamin D insufficiency discriminates cardiovascular risk factors accumulation in peri-pubertal boys undergoing overweight screening. Endocrine

  43. Dura-Trave T, Gallinas-Victoriano F (2016) Seasonal variations in calcidiol and parathyroid hormone levels in healthy children and adolescents in Navarre, Spain: a cross-sectional study. JRSM Open 7(4):2054270416632704

    Article  PubMed  PubMed Central  Google Scholar 

  44. Erdonmez D, Hatun S, Cizmecioglu FM, Keser A (2011) No relationship between vitamin D status and insulin resistance in a group of high school students. J Clin Res Pediatr Endocrinol 3(4):198–201

    Article  PubMed  PubMed Central  Google Scholar 

  45. Erol M, Yigit O, Kucuk SH, Bostan Gayret O (2015) Vitamin D deficiency in children and adolescents in Bagcilar, Istanbul. J Clin Res Pediatr Endocrinol 7(2):134–139

    Article  PubMed  PubMed Central  Google Scholar 

  46. Esterle L, Nguyen M, Walrant-Debray O, Sabatier JP, Garabedian M (2010) Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls. J Bone Miner Res 25(11):2392–2398

    Article  CAS  PubMed  Google Scholar 

  47. Formiga F, Ferrer A, Megido MJ, Boix L, Contra A, Pujol R (2014) Low serum vitamin D is not associated with an increase in mortality in oldest old subjects: the Octabaix three-year follow-up study. Gerontology 60(1):10–15

    Article  CAS  PubMed  Google Scholar 

  48. Franchi B, Piazza M, Sandri M, Tenero L, Comberiati P, Boner AL, Capristo C (2015) 25-hydroxyvitamin D serum level in children of different ethnicity living in Italy. Eur J Pediatr 174(6):749–757

    Article  CAS  PubMed  Google Scholar 

  49. Golan S, Shalev V, Treister G, Chodick G, Loewenstein A (2011) Reconsidering the connection between vitamin D levels and age-related macular degeneration. Eye (Lond) 25(9):1122–1129

    Article  CAS  Google Scholar 

  50. Gomez JM, Maravall FJ, Gomez N, Navarro MA, Casamitjana R, Soler J (2004) Relationship between 25-(OH) D3, the IGF-I system, leptin, anthropometric and body composition variables in a healthy, randomly selected population. Horm Metab Res 36(1):48–53

    Article  CAS  PubMed  Google Scholar 

  51. Gomez-Alonso C, Naves-Diaz ML, Fernandez-Martin JL, Diaz-Lopez JB, Fernandez-Coto MT, Cannata-Andia JB (2003) Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels. Kidney Int Suppl (85):S44-8

  52. Goncalves A, Milea D, Gohier P, Jallet G, Leruez S, Baskaran M, Aung T, Annweiler C (2015) Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma. Maturitas 81(4):470–474

    Article  CAS  PubMed  Google Scholar 

  53. Gonnelli S, Caffarelli C, Cappelli S, Rossi S, Giordano N, Nuti R (2014) Gender-specific associations of appendicular muscle mass with BMD in elderly Italian subjects. Calcif Tissue Int 95(4):340–348

    Article  CAS  PubMed  Google Scholar 

  54. Gonnelli S, Caffarelli C, Tanzilli L, Alessi C, Tomai Pitinca MD, Rossi S, Campagna MS, Nuti R (2013) The associations of body composition and fat distribution with bone mineral density in elderly Italian men and women. J Clin Densitom 16(2):168–177

    Article  PubMed  Google Scholar 

  55. Gonzalez-Gross M, Valtuena J, Breidenassel C, Moreno LA, Ferrari M, Kersting M, De Henauw S, Gottrand F, Azzini E, Widhalm K, Kafatos A, Manios Y, Stehle P (2012) Vitamin D status among adolescents in Europe: the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Br J Nutr 107(5):755–764

    Article  CAS  PubMed  Google Scholar 

  56. Gonzalez-Molero I, Rojo-Martinez G, Morcillo S, Gutierrez C, Rubio E, Perez-Valero V, Esteva I, Ruiz de Adana MS, Almaraz MC, Colomo N, Olveira G, Soriguer F (2013) Hypovitaminosis D and incidence of obesity: a prospective study. Eur J Clin Nutr 67(6):680–682

    Article  CAS  PubMed  Google Scholar 

  57. Gonzalez-Molero I, Rojo-Martinez G, Morcillo S, Gutierrez-Repiso C, Rubio-Martin E, Almaraz MC, Olveira G, Soriguer F (2012) Vitamin D and incidence of diabetes: a prospective cohort study. Clin Nutr 31(4):571–573

    Article  CAS  PubMed  Google Scholar 

  58. Guasch A, Bullo M, Rabassa A, Bonada A, Del Castillo D, Sabench F, Salas-Salvado J (2012) Plasma vitamin D and parathormone are associated with obesity and atherogenic dyslipidemia: a cross-sectional study. Cardiovasc Diabetol 11:149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Halicioglu O, Aksit S, Koc F, Akman SA, Albudak E, Yaprak I, Coker I, Colak A, Ozturk C, Gulec ES (2012) Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey. Paediatr Perinat Epidemiol 26(1):53–60

    Article  PubMed  Google Scholar 

  60. Hekimsoy Z, Dinc G, Kafesciler S, Onur E, Guvenc Y, Pala T, Guclu F, Ozmen B (2010) Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health 10:782

    Article  PubMed  PubMed Central  Google Scholar 

  61. Hernandez JL, Olmos JM, Pariente E, Martinez J, Valero C, Garcia-Velasco P, Nan D, Llorca J, Gonzalez-Macias J (2010) Metabolic syndrome and bone metabolism: the Camargo Cohort study. Menopause 17(5):955–961

    Article  PubMed  Google Scholar 

  62. Hicks GE, Shardell M, Miller RR, Bandinelli S, Guralnik J, Cherubini A, Lauretani F, Ferrucci L (2008) Associations between vitamin D status and pain in older adults: the Invecchiare in Chianti study. J Am Geriatr Soc 56(5):785–791

    Article  PubMed  PubMed Central  Google Scholar 

  63. Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S (2003) Prevalence of hypovitaminosis D in elderly women in Italy: clinical consequences and risk factors. Osteoporos Int 14(7):577–582

    Article  CAS  PubMed  Google Scholar 

  64. Karaguzel G, Dilber B, Can G, Okten A, Deger O, Holick MF (2014) Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr 58(5):654–660

    Article  CAS  PubMed  Google Scholar 

  65. Karras SN, Shah I, Petroczi A, Goulis DG, Bili H, Papadopoulou F, Harizopoulou V, Tarlatzis BC, Naughton DP (2013) An observational study reveals that neonatal vitamin D is primarily determined by maternal contributions: implications of a new assay on the roles of vitamin D forms. Nutr J 12:77

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Kassi EN, Stavropoulos S, Kokkoris P, Galanos A, Moutsatsou P, Dimas C, Papatheodorou A, Zafeiris C, Lyritis G (2015) Smoking is a significant determinant of low serum vitamin D in young and middle-aged healthy males. Hormones (Athens) 14(2):245–250

    Google Scholar 

  67. Kavadar G, Demircioglu DT, Ozgonenel L, Emre TY (2015) The relationship between vitamin D status, physical activity and insulin resistance in overweight and obese subjects. Bosn J Basic Med Sci 15(2):62–66

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Kolokotroni O, Papadopoulou A, Yiallouros PK, Raftopoulos V, Kouta C, Lamnisos D, Nicolaidou P, Middleton N (2014) Association of vitamin D with adiposity measures and other determinants in a cross-sectional study of Cypriot adolescents. Public Health Nutr, pp 1–10

  69. Kolokotroni O, Papadopoulou A, Yiallouros PK, Raftopoulos V, Kouta C, Lamnisos D, Nicolaidou P, Middleton N (2015) Association of vitamin D with adiposity measures and other determinants in a cross-sectional study of Cypriot adolescents. Public Health Nutr 18(1):112–121

    Article  PubMed  Google Scholar 

  70. Korchia G, Amitai Y, Moshe G, Korchia L, Tenenbaum A, Rosenblum J, Schechter A (2013) Vitamin D deficiency in children in Jerusalem: the need for updating the recommendation for supplementation. Isr Med Assoc J 15(7):333–338

    PubMed  Google Scholar 

  71. Kristal-Boneh E, Froom P, Harari G, Ribak J (1999) Seasonal changes in calcitropic hormones in Israeli men. Eur J Epidemiol 15(3):237–244

    Article  CAS  PubMed  Google Scholar 

  72. Lauretani F, Bandinelli S, Russo CR, Maggio M, Di Iorio A, Cherubini A, Maggio D, Ceda GP, Valenti G, Guralnik JM, Ferrucci L (2006) Correlates of bone quality in older persons. Bone 39(4):915–921

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Lippi G, Bonelli P, Buonocore R, Aloe R (2015) Birth season and vitamin D concentration in adulthood. Ann Transl Med 3(16):231

    PubMed  PubMed Central  Google Scholar 

  74. Maggio D, Cherubini A, Lauretani F, Russo RC, Bartali B, Pierandrei M, Ruggiero C, Macchiarulo MC, Giorgino R, Minisola S, Ferrucci L (2005) 25(OH)D Serum levels decline with age earlier in women than in men and less efficiently prevent compensatory hyperparathyroidism in older adults. J Gerontol A Biol Sci Med Sci 60(11):1414–1419

    Article  PubMed  Google Scholar 

  75. Malavolta N, Pratelli L, Frigato M, Mule R, Mascia ML, Gnudi S (2005) The relationship of vitamin D status to bone mineral density in an Italian population of postmenopausal women. Osteoporos Int 16(12):1691–1697

    Article  CAS  PubMed  Google Scholar 

  76. Mata-Granados JM, Luque de Castro MD, Quesada Gomez JM (2008) Inappropriate serum levels of retinol, alpha-tocopherol, 25 hydroxyvitamin D3 and 24,25 dihydroxyvitamin D3 levels in healthy Spanish adults: simultaneous assessment by HPLC. Clin Biochem 41(9):676–680

    Article  CAS  PubMed  Google Scholar 

  77. Mezquita-Raya P, Munoz-Torres M, Alonso G, de Luna JD, Quesada JM, Dorado G, Luque-Recio F, Ruiz-Requena ME, Lopez-Rodriguez F, Escobar-Jimenez F (2004) Susceptibility for postmenopausal osteoporosis: interaction between genetic, hormonal and lifestyle factors. Calcif Tissue Int 75(5):373–379

    Article  CAS  PubMed  Google Scholar 

  78. Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jimenez F (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16(8):1408–1415

    Article  CAS  PubMed  Google Scholar 

  79. Moore A, Hochner H, Sitlani CM, Williams MA, Hoofnagle AN, de Boer IH, Kestenbaum B, Siscovick DS, Friedlander Y, Enquobahrie DA (2015) Plasma vitamin D is associated with fasting insulin and homeostatic model assessment of insulin resistance in young adult males, but not females, of the Jerusalem Perinatal Study. Public Health Nutr 18(7):1324–1331

    Article  PubMed  Google Scholar 

  80. Moschonis G, Tanagra S, Koutsikas K, Nikolaidou A, Androutsos O, Manios Y (2009) Association between serum 25-hydroxyvitamin D levels and body composition in postmenopausal women: the postmenopausal Health Study. Menopause 16(4):701–707

    Article  PubMed  Google Scholar 

  81. Mosele M, Coin A, Manzato E, Sarti S, Berton L, Bolzetta F, Imoscopi A, Rinaldi G, Perissinotto E, Sergi G (2013) Association between serum 25-hydroxyvitamin d levels, bone geometry, and bone mineral density in healthy older adults. J Gerontol A Biol Sci Med Sci 68(8):992–998

    Article  CAS  PubMed  Google Scholar 

  82. Mouratidou T, Vicente-Rodriguez G, Gracia-Marco L, Huybrechts I, Sioen I, Widhalm K, Valtuena J, Gonzalez-Gross M, Moreno LA (2013) Associations of dietary calcium, vitamin D, milk intakes, and 25-hydroxyvitamin D with bone mass in Spanish adolescents: the HELENA study. J Clin Densitom 16(1):110–117

    Article  PubMed  Google Scholar 

  83. Nicolaidou P, Hatzistamatiou Z, Papadopoulou A, Kaleyias J, Floropoulou E, Lagona E, Tsagris V, Costalos C, Antsaklis A (2006) Low vitamin D status in mother-newborn pairs in Greece. Calcif Tissue Int 78(6):337–342

    Article  CAS  PubMed  Google Scholar 

  84. Olmos JM, Hernandez JL, Garcia-Velasco P, Martinez J, Llorca J, Gonzalez-Macias J (2016) Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults. Osteoporos Int 27(1):105–113

    Article  CAS  PubMed  Google Scholar 

  85. Olmos JM, Hernandez JL, Martinez J, Pariente E, Llorca J, Gonzalez-Macias J (2010) Bone turnover markers in Spanish adult men the Camargo cohort study. Clin Chim Acta 411(19–20):1511–1515

    Article  CAS  PubMed  Google Scholar 

  86. Pagliardini L, Vigano’ P, Molgora M, Persico P, Salonia A, Vailati SH, Paffoni A, Somigliana E, Papaleo E, Candiani M (2015) High prevalence of vitamin D deficiency in infertile women referring for assisted reproduction. Nutrients 7(12):9972–9984

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Parlak M, Kalay S, Kalay Z, Kirecci A, Guney O, Koklu E (2014) Severe vitamin D deficiency among pregnant women and their newborns in Turkey. J Matern Fetal Neonatal Med 1–4

  88. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M, Franceschi C (2003) Low vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin Endocrinol Metab 88(11):5109–5115

    Article  CAS  PubMed  Google Scholar 

  89. Rodriguez A, Garcia-Esteban R, Basterretxea M, Lertxundi A, Rodriguez-Bernal C, Iniguez C, Rodriguez-Dehli C, Tardon A, Espada M, Sunyer J, Morales E (2015) Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. Bjog 122(12):1695–1704

    Article  CAS  PubMed  Google Scholar 

  90. Rodriguez A, Santa Marina L, Jimenez AM, Esplugues A, Ballester F, Espada M, Sunyer J, Morales E (2016) Vitamin D status in pregnancy and determinants in a Southern European cohort study. Paediatr Perinat Epidemiol 30(3):217–228

    Article  PubMed  Google Scholar 

  91. Rodriguez-Rodriguez E, Ortega RM, Gonzalez-Rodriguez LG, Lopez-Sobaler AM (2011) Vitamin D deficiency is an independent predictor of elevated triglycerides in Spanish school children. Eur J Nutr 50(5):373–378

    Article  CAS  PubMed  Google Scholar 

  92. Saliba W, Barnett O, Rennert HS, Lavi I, Rennert G (2011) The relationship between serum 25(OH)D and parathyroid hormone levels. Am J Med 124(12):1165–1170

    Article  CAS  PubMed  Google Scholar 

  93. Saliba W, Barnett O, Stein N, Kershenbaum A, Rennert G (2012) The longitudinal variability of serum 25(OH)D levels. Eur J Intern Med 23(4):e106-11

    Article  CAS  PubMed  Google Scholar 

  94. Saliba W, Barnett-Griness O, Rennert G (2014) Obesity and association of serum 25(OH)D levels with all-cause mortality. Calcif Tissue Int 95(3):222–228

    Article  CAS  PubMed  Google Scholar 

  95. Saliba W, Rennert HS, Kershenbaum A, Rennert G (2012) Serum 25(OH)D concentrations in sunny Israel. Osteoporos Int 23(2):687–694

    Article  CAS  PubMed  Google Scholar 

  96. Sarre ME, Annweiler C, Legrand E, Martin L, Beauchet O (2016) Association between bullous pemphigoid and hypovitaminosis D in older inpatients: Results from a case-control study. Eur J Intern Med 31:25–28

    Article  CAS  PubMed  Google Scholar 

  97. Sergi G, Sarti S, Mosele M, Ruggiero E, Imoscopi A, Miotto F, Bolzetta F, Inelmen EM, Manzato E, Coin A (2011) Changes in healthy elderly women’s physical performance: a 3-year follow-up. Exp Gerontol 46(11):929–933

    Article  CAS  PubMed  Google Scholar 

  98. Shardell M, Hicks GE, Miller RR, Kritchevsky S, Andersen D, Bandinelli S, Cherubini A, Ferrucci L (2009) Association of low vitamin D levels with the frailty syndrome in men and women. J Gerontol A Biol Sci Med Sci 64(1):69–75

    Article  CAS  PubMed  Google Scholar 

  99. Singhellakis PN, Malandrinou F, Psarrou CJ, Danelli AM, Tsalavoutas SD, Constandellou ES (2011) Vitamin D deficiency in white, apparently healthy, free-living adults in a temperate region. Hormones (Athens) 10(2):131–143

    Article  Google Scholar 

  100. Sonmez FM, Donmez A, Namuslu M, Canbal M, Orun E (2015) Vitamin D deficiency in children with newly diagnosed idiopathic epilepsy. J Child Neurol 30(11):1428–1432

    Article  PubMed  Google Scholar 

  101. Souberbielle JC, Cavalier E, Delanaye P, Massart C, Brailly-Tabard S, Cormier C, Borderie D, Benachi A, Chanson P (2015) Serum calcitriol concentrations measured with a new direct automated assay in a large population of adult healthy subjects and in various clinical situations. Clin Chim Acta 451(Pt B):149–153

    Article  CAS  PubMed  Google Scholar 

  102. Stagi S, Pelosi P, Strano M, Poggi G, Manoni C, de Martino M, Seminara S (2014) Determinants of vitamin D levels in Italian children and adolescents: a longitudinal evaluation of cholecalciferol supplementation versus the improvement of factors influencing 25(OH)D status. Int J Endocrinol 583039

  103. Steinvil A, Leshem-Rubinow E, Berliner S, Justo D, Finn T, Ish-shalom M, Birati EY, Shalev V, Sheinberg B, Rogowski O (2011) Vitamin D deficiency prevalence and cardiovascular risk in Israel. Eur J Clin Invest 41(3):263–268

    Article  PubMed  Google Scholar 

  104. Szulc P, Munoz F, Marchand F, Chapuy MC, Delmas PD (2003) Role of vitamin D and parathyroid hormone in the regulation of bone turnover and bone mass in men: the MINOS study. Calcif Tissue Int 73(6):520–530

    Article  CAS  PubMed  Google Scholar 

  105. Szulc P, Schoppet M, Goettsch C, Rauner M, Dschietzig T, Chapurlat R, Hofbauer LC (2012) Endocrine and clinical correlates of myostatin serum concentration in men—the STRAMBO study. J Clin Endocrinol Metab 97(10):3700–3708

    Article  CAS  PubMed  Google Scholar 

  106. Tekin M, Konca C, Celik V, Almis H, Kahramaner Z, Erdemir A, Gulyuz A, Uckardes F, Turgut M (2015) The association between vitamin D levels and urinary tract infection in children. Horm Res Paediatr 83(3):198–203

    Article  CAS  PubMed  Google Scholar 

  107. Tepper S, Shahar DR, Geva D, Ish-Shalom S. Pt A (2014) Predictors of serum 25(Oh)D increase following bimonthly supplementation with 100,000 IU vitamin D in healthy, men aged 25–65 years. J Steroid Biochem Mol Biol 144:163–166

    Article  CAS  PubMed  Google Scholar 

  108. Toffanello ED, Sergi G, Veronese N, Perissinotto E, Zambon S, Coin A, Sartori L, Musacchio E, Corti MC, Baggio G, Crepaldi G, Manzato E (2014) Serum 25-hydroxyvitamin d and the onset of late-life depressive mood in older men and women: the Pro.V.A. study. J Gerontol A Biol Sci Med Sci 69(12):1554–1561

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Toffanello ED, Perissinotto E, Sergi G, Zambon S, Musacchio E, Maggi S, Coin A, Sartori L, Corti MC, Baggio G, Crepaldi G, Manzato E (2012) Vitamin D and physical performance in elderly subjects: the Pro.V.A study. PLoS One 7(4):e34950

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Torun E, Gonullu E, Ozgen IT, Cindemir E, Oktem F (2013) Vitamin d deficiency and insufficiency in obese children and adolescents and its relationship with insulin resistance. Int J Endocrinol 631845

  111. Touvier M, Deschasaux M, Montourcy M, Sutton A, Charnaux N, Kesse-Guyot E, Assmann KE, Fezeu L, Latino-Martel P, Druesne-Pecollo N, Guinot C, Latreille J, Malvy D, Galan P, Hercberg S et al (2015) Determinants of vitamin D status in Caucasian adults: influence of sun exposure, dietary intake, sociodemographic, lifestyle, anthropometric, and genetic factors. J Invest Dermatol 135(2):378–388

    Article  CAS  PubMed  Google Scholar 

  112. Turkeli A, Ayaz O, Uncu A, Ozhan B, Bas VN, Tufan AK, Yilmaz O, Yuksel H (2016) Effects of vitamin D levels on asthma control and severity in pre-school children. Eur Rev Med Pharmacol Sci 20(1):26–36

    CAS  PubMed  Google Scholar 

  113. Usluogullari CA, Balkan F, Caner S, Ucler R, Kaya C, Ersoy R, Cakir B (2015) The relationship between microvascular complications and vitamin D deficiency in type 2 diabetes mellitus. BMC Endocr Disord 15:33

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. Valtuena J, Gracia-Marco L, Vicente-Rodriguez G, Gonzalez-Gross M, Huybrechts I, Rey-Lopez JP, Mouratidou T, Sioen I, Mesana MI, Martinez AE, Widhalm K, Moreno LA (2012) Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study. Osteoporos Int 23(8):2227–2237

    Article  CAS  PubMed  Google Scholar 

  115. Veronese N, Sergi G, De Rui M, Bolzetta F, Toffanello ED, Zambon S, Corti MC, Sartori L, Musacchio E, Baggio G, Crepaldi G, Perissinotto E, Manzato E (2014) Serum 25-hydroxyvitamin D and incidence of diabetes in elderly people: the PRO.V.A. study. J Clin Endocrinol Metab 99(7):2351–2358

    Article  CAS  PubMed  Google Scholar 

  116. Vierucci F, Del Pistoia M, Fanos M, Erba P, Saggese G (2014) Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents. Ital J Pediatr 40:54

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  117. Vierucci F, Del Pistoia M, Fanos M, Gori M, Carlone G, Erba P, Massimetti G, Federico G, Saggese G (2013) Vitamin D status and predictors of hypovitaminosis D in Italian children and adolescents: a cross-sectional study. Eur J Pediatr 172(12):1607–1617

    Article  CAS  PubMed  Google Scholar 

  118. Zamboni M, Zoico E, Tosoni P, Zivelonghi A, Bortolani A, Maggi S, Di Francesco V, Bosello O (2002) Relation between vitamin D, physical performance, and disability in elderly persons. J Gerontol A Biol Sci Med Sci 57(1):M7-11

    Article  PubMed  Google Scholar 

  119. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J, Group IOFCoSANW (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20(11):1807–1820

    Article  CAS  PubMed  Google Scholar 

  120. Ovesen L, Andersen R, Jakobsen J (2003) Geographical differences in vitamin D status, with particular reference to European countries. Proc Nutr Soc 62(4):813–821

    Article  CAS  PubMed  Google Scholar 

  121. Binkley N, Krueger D, Cowgill CS, Plum L, Lake E, Hansen KE, DeLuca HF, Drezner MK (2004) Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. J Clin Endocrinol Metab 89(7):3152–3157

    Article  CAS  PubMed  Google Scholar 

  122. Carter GD, Carter R, Jones J, Berry J (2004) How accurate are assays for 25-hydroxyvitamin D? Data from the international vitamin D external quality assessment scheme. Clin Chem 50(11):2195–2197

    Article  CAS  PubMed  Google Scholar 

  123. Lai JK, Lucas RM, Banks E, Ponsonby AL (2012) Variability in vitamin D assays impairs clinical assessment of vitamin D status. Intern Med J 42(1):43–50

    Article  CAS  PubMed  Google Scholar 

  124. Arabi A, El Rassi R, El-Hajj Fuleihan G (2010) Hypovitaminosis D in developing countries-prevalence, risk factors and outcomes. Nat Rev Endocrinol 6(10):550–561

    Article  CAS  PubMed  Google Scholar 

  125. Hagenau T, Vest R, Gissel TN, Poulsen CS, Erlandsen M, Mosekilde L, Vestergaard P (2009) Global vitamin D levels in relation to age, gender, skin pigmentation and latitude: an ecologic meta-regression analysis. Osteoporos Int 20(1):133–140

    Article  CAS  PubMed  Google Scholar 

  126. Challa A, Ntourntoufi A, Cholevas V, Bitsori M, Galanakis E, Andronikou S (2005) Breastfeeding and vitamin D status in Greece during the first 6 months of life. Eur J Pediatr 164(12):724–729

    Article  CAS  PubMed  Google Scholar 

  127. Ostergard M, Arnberg K, Michaelsen KF, Madsen AL, Krarup H, Trolle E, Molgaard C (2011) Vitamin D status in infants: relation to nutrition and season. Eur J Clin Nutr 65(5):657–660

    Article  CAS  PubMed  Google Scholar 

  128. Dawodu A, Zalla L, Woo JG, Herbers PM, Davidson BS, Heubi JE, Morrow AL (2014) Heightened attention to supplementation is needed to improve the vitamin D status of breastfeeding mothers and infants when sunshine exposure is restricted. Matern Child Nutr 10(3):383–397

    Article  PubMed  Google Scholar 

  129. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rossello J, Cox JE (2008) Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 162(6), 505 – 12

  130. Cashman KD (2007) Vitamin D in childhood and adolescence. Postgrad Med J 83(978):230–235

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  131. Smith TJ, Tripkovic L (2016) Estimation of the dietary requirement for vitamin D in adolescents aged 14–18 y: a dose-response, double-blind, randomized placebo-controlled trial. 104(5):1301–1309

  132. Lips P (2007) Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103(3–5):620–625

    Article  CAS  PubMed  Google Scholar 

  133. Batieha A, Khader Y, Jaddou H, Hyassat D, Batieha Z, Khateeb M, Belbisi A, Ajlouni K (2011) Vitamin D status in Jordan: dress style and gender discrepancies. Ann Nutr Metab 58(1), 10 – 8

  134. Spiro A, Buttriss JL (2014) Vitamin D: an overview of vitamin D status and intake in Europe. Nutr Bull 39(4):322–350

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  135. Lips P, van Schoor NM, de Jongh RT (2014) Diet, sun, and lifestyle as determinants of vitamin D status. Ann N Y Acad Sci 1317:92–98

    Article  CAS  PubMed  Google Scholar 

  136. El-Hajj Fuleihan G, Nabulsi M, Choucair M, Salamoun M, Hajj Shahine C, Kizirian A, Tannous R (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107(4):E53

    Article  CAS  PubMed  Google Scholar 

  137. Gannage-Yared MH, Chemali R, Yaacoub N, Halaby G (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15(9):1856–1862

    Article  CAS  PubMed  Google Scholar 

  138. Weisman Y (2003) Vitamin D deficiency rickets and osteomalacia in Israel. Isr Med Assoc J 5(4):289–290

    PubMed  Google Scholar 

  139. van der Wielen RP, Lowik MR, van den Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346(8969):207–210

    Article  PubMed  Google Scholar 

  140. Puri S, Marwaha RK, Agarwal N, Tandon N, Agarwal R, Grewal K, Reddy DH, Singh S (2008) Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle. Br J Nutr 99(4):876–882

    Article  CAS  PubMed  Google Scholar 

  141. Chaplin G, Jablonski NG (2013) The human environment and the vitamin D compromise: Scotland as a case study in human biocultural adaptation and disease susceptibility. Hum Biol 85(4):529–552

    Article  PubMed  Google Scholar 

  142. Hosseinpanah F, Pour SH, Heibatollahi M, Moghbel N, Asefzade S, Azizi F (2010) The effects of air pollution on vitamin D status in healthy women: a cross sectional study. BMC Public Health 10:519

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  143. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281

    Article  CAS  PubMed  Google Scholar 

  144. Tavera-Mendoza LE, White JH (2007) Cell defenses and the sunshine vitamin. Sci Am 297(5):62–75

    Article  CAS  PubMed  Google Scholar 

  145. Roman Vinas B, Ribas Barba L, Ngo J, Gurinovic M, Novakovic R, Cavelaars A, de Groot LC, van’t Veer P, Matthys C, Majem Serra L (2011) Projected prevalence of inadequate nutrient intakes in Europe. Ann Nutr Metab 59(2–4):84–95

    Article  CAS  PubMed  Google Scholar 

  146. Hayes A, Cashman KD (2017) Food-based solutions for vitamin D deficiency: putting policy into practice and the key role for research. Proc Nutr Soc 76(1):54–63

    Article  PubMed  Google Scholar 

  147. Kiely M, Black LJ (2012) Dietary strategies to maintain adequacy of circulating 25-hydroxyvitamin D concentrations. Scand J Clin Lab Invest Suppl 243:14–23

    PubMed  Google Scholar 

  148. Cashman KD (2015) Vitamin D: dietary requirements and food fortification as a means of helping achieve adequate vitamin D status. J Steroid Biochem Mol Biol 148:19–26

    Article  CAS  PubMed  Google Scholar 

  149. Carter GD, Berry JL, Gunter E, Jones G, Jones JC, Makin HL, Sufi S, Wheeler MJ (2010) Proficiency testing of 25-hydroxyvitamin D (25-OHD) assays. J Steroid Biochem Mol Biol 121(1–2):176–179

    Article  CAS  PubMed  Google Scholar 

  150. Cashman KD, Kiely M, Kinsella M, Durazo-Arvizu RA, Tian L, Zhang Y, Lucey A, Flynn A, Gibney MJ, Vesper HW, Phinney KW, Coates PM, Picciano MF, Sempos CT (2013) Evaluation of Vitamin D Standardization Program protocols for standardizing serum 25-hydroxyvitamin D data: a case study of the program’s potential for national nutrition and health surveys. Am J Clin Nutr 97(6):1235–1242

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  151. Toffanello ED, Coin A, Perissinotto E, Zambon S, Sarti S, Veronese N, De Rui M, Bolzetta F, Corti MC, Crepaldi G, Manzato E, Sergi G (2014) Vitamin D deficiency predicts cognitive decline in older men and women: the Pro.V.A. Study. Neurology 83(24):2292–2298

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

YM, GM, CPL, KT, PB, AK, CB and MGG contributed to the systematic review of the literature. All authors contributed to the writing, critical review and approval of the final version of the manuscript for publication. The present review was supported by funding received from the European Commission under its Seventh Framework Programme (FP7) ODIN (grant agreement no. 613977). The authors would like to thank Dr. Colette O’Neill, University College Cork, for her help in preparation of the vitamin D status maps.

Author information

Authors and Affiliations

  1. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece

    Yannis Manios, Christina-Paulina Lambrinou, Konstantina Tsoutsoulopoulou, Panagiota Binou & Alexandra Karachaliou

  2. Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, 3086, Melbourne, Australia

    George Moschonis

  3. ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain

    Christina Breidenassel & Marcela Gonzalez-Gross

  4. Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland

    Mairead Kiely & Kevin D. Cashman

  5. The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland

    Mairead Kiely

  6. Department of Medicine, University College Cork, Cork, Ireland

    Kevin D. Cashman

Authors
  1. Yannis Manios
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George Moschonis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina-Paulina Lambrinou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Konstantina Tsoutsoulopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Panagiota Binou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alexandra Karachaliou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christina Breidenassel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marcela Gonzalez-Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mairead Kiely
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kevin D. Cashman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yannis Manios.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

The current review includes anonymized data from epidemiological and clinical studies on vitamin D status.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 83 KB)

Supplementary material 2 (DOC 77 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Manios, Y., Moschonis, G., Lambrinou, CP. et al. A systematic review of vitamin D status in southern European countries. Eur J Nutr 57, 2001–2036 (2018). https://doi.org/10.1007/s00394-017-1564-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-017-1564-2

Keywords

Search

Navigation