Vitamin D status has been found to be inversely associated with risk of respiratory tract infections (RTIs)(1). It varies by ethnicity, with several ethnic minority groups in the United Kingdom (UK) reported to be at a higher risk of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentrations <25 nmol/L) compared to their white counterparts(2, 3). However, the relationship between serum 25(OH)D concentrations and incidence of RTIs by ethnicity in the UK remains unclear. This study aimed to investigate the association between serum 25(OH)D concentrations and likelihood of hospitalisation for RTI in UK ethnic groups. A nested, case-control study was conducted using data from UK Biobank, which has data for 500k adults for serum 25(OH)D and hospital episodes from linked records. Binary logistic regression models were used to explore the association between serum 25(OH)D concentrations and likelihood of RTIs overall, and by ethnicity. Of the 36,772 participants included in the analysis, 12,638 (34%) were white Caucasian, 10,311 (28%) Asian, 7,138 (19%) black, 4,034 (11%) other, and 2,651 (7%) of mixed ethnicity. In fully adjusted models, compared to participants with a serum 25(OH)D concentration <15 nmol/L (severe deficiency), those with 25-49 nmol/L, 50-74 nmol/L, and ≥75 nmol/L were found to have statistically significantly lower odds of RTI hospitalisation, with odds ratios (ORs) of 0.53 (95% CI: 0.37, 0.75), 0.61 (95% CI: 0.40, 0.92) and 0.54 (95% CI: 0.30, 0.97), respectively. In the subgroup analysis, ethnic minorities and white individuals with vitamin D deficiency (<25 nmol/L) were more likely to be hospitalised with RTI compared to those that were not deficient, with ORs of 1.36 (95% CI: 1.02, 1.81) and 2.03 (95% CI: 1.30, 3.17), respectively. This association was not statistically significant within ethnic minority subgroups when analysed separately. Serum 25(OH)D concentrations above 25 nmol/L are associated with lower likelihood of RTI hospitalisation among UK adults. This finding was noted across white and ethnic minority groups, although ethnic minorities with vitamin D deficiency had a lower likelihood of RTIs compared to white individuals. Further studies are warranted to validate these findings and explore the mechanisms underlying the association between vitamin D status and RTIs in different ethnic groups. Acknowledgements This project was conducted using the UK Biobank resource under project 15168.

There are known differences in biological functionality between vitamin D2 and D3. It is suspected from randomised control trial (RCT) data that vitamin D2 supplementation causes a reduction in serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations (1), but the size of the effect has yet to be fully assessed across multiple studies. The aim of this study was to undertake a systematic review and meta-analysis of the effect of vitamin D2 supplementation on serum 25(OH)D3 concentrations.PUBMED was searched for publications from 1st January 1975 to 1st February 2023. Of the 182 papers retrieved, 29 were included in the systematic review, and of those, 18 were suitable for meta-analysis.The meta-analysis found significant reductions in serum D3 after vitamin D2 supplementation compared with control, for both end of trial between groups data (weighted mean difference (WMD) (random) = −13.51 nmol/L; 95% CI: −20.14, −6.89; P < 0.0001) and absolute change over the trial (WMD (random) = −9.25 nmol/L; 95% CI: −14.40, −4.10; P = 0.0004). Similar results were found when D2 supplementation was compared to D3 supplementation, although as expected, the magnitude of the difference was larger, with WMD (random) = −46.20 nmol/L (95% CI: −60.80, −31.60; P < 0.00001) for end of trial data, and WMD (random) = −56.23 nmol/L (95% CI: -69.17, −43.28; P < 0.00001) for absolute change.Overall, we found that vitamin D2 supplementation produces significant reductions in serum 25(OH)D3 concentrations, when compared to either control or vitamin D3 supplementation. An inverse relationship between vitamin D2 and D3 concentrations has been proposed in the literature (2). A regulatory mechanism that disposes of 25(OH)D after an increase in vitamin D concentrations could explain our results (3). Moreover, supplementation with vitamins D2 and D3 has differential effects on gene expression (4). However, longer-term research is needed to establish whether clinical advice should recommend vitamin D3 supplements over vitamin D2 supplements, where appropriate.

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the 'Save PDF' action button.

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the 'Save PDF' action button.

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Numerous studies show a high prevalence of vitamin D de fi ciency in the UK (1) but similar data have been found in Greece and Cyprus, despite an abundance of UV light and skin vitamin D production being possible for almost the whole the year. (2) Moreover, there is no data on vitamin D status in Greek and Cypriot populations living in higher latitude countries, such as the UK. The aim of this study was to assess differences in vitamin D status and vitamin D intake between Greek/Cypriot UK residents (born in Greece or Cyprus) and a British/Irish comparison group. A cross sectional study of n = 140 Greeks, n = 185 Cypriots and a randomly sampled group of n = 4158 British/Irish participants (self-reported ethnicity, 40 – 69 years old), all of whom were part of the UK Biobank cohort (baseline). Serum 25-hydroxyvitaminD (25 (OH)D) levels were measured using DiaSorin Liaison XL assay and vitamin D intake was estimated using the Oxford WebQ (24 h food frequency questionnaire). The Greek/Cypriot group had a median 25(OH)D of 40.3 nmol/L, which was statistically signi fi cantly lower than the British/Irish group (47.6nmol/L) (P < 0.001). A total of 11% of British/Irish and 22.8% of Greek/Cypriot participants did not meet the 25nmol/L cut-off (so were deemed de fi cient). The 50 nmol/l cut-off point (adequate) was not met by 53.1% of British/Irish and 62.3% of Greek/ Cypriot participants. Vitamin D intake was similar in the Greek/Cypriot (1.41 μ g/d) and British/Irish group (1.77 μ g/d)

Little published data has assessed the association between socio-economic deprivation and 25hydroxyvitamin D (25(OH)D) concentration. One study found low socio-economic status predicted vitamin D deficiency, but another did not. Our objective was to assess the relationship between 25(OH)D and Townsend Deprivation Index (TDI) in a large sample, using data from the UK Biobank Cohort, which has data on 502,000 individuals (baseline 2006–2010, aged 40 years or over). Blood draws, for measurement of serum 25(OH)D by the DiaSorin Liaison XL assay, were spread across the year with each participant sampled once. The UK Biobank holds ethical approval from UK North West Multi-Centre Research Ethics Committee (11/NW/ 0382). We had 447,766 participants with data for both 25(OH)D and TDI. Median (interquartile range; IQR) TDI score for quartile 1 (least deprived) was −4.4 (1) and for quartile 4 (most deprived) was 2.8 (3). Median (IQR) for 25(OH)D concentration for quartile 1 vs quartile 4 was as follows: spring (42.0 (27.4) vs 35.1 (26.7) nmol/L, P < 0.001); summer (58.8 (24.8) vs 49.9 (28.3) nmol/L, P < 0.001); autumn (55.4 (26.8) vs 45.6 (29.9) nmol/L, P < 0.001) and winter (40.4 (26.9) vs. 32.7 (25.4) nmol/L, P < 0.001). Therefore, quartile 4 was lower by 7–10 nmol/L depending on season. Results for quartiles 2 and 3 were intermediate to those of 1 and 4. P values were from Kruskal Wallis tests across four quartiles. Logistic regression assessed whether TDI quartile predicted vitamin D deficiency (<25 nmol/L), including 414,017 participants with sufficient data. All model variables (TDI, gender, ethnicity, age, self-reported health, vegetarianism, season, Body Mass Index (BMI), summer sunlight exposure, vitamin D containing supplement use, oily fish consumption, region) were predictors of 25(OH)D <25 nmol/L (P < 0.001). Compared to quartile 1 (OR= 1), quartiles 2 to 4 had increased odds of deficiency as follows: quartile 2 (OR= 1.05; 1.01,1.08); quartile 3 (OR= 1.29: 1.25, 1.33); quartile 4 (OR= 1.77; 1.72, 1.82). Overall, we found higher deprivation scores were associated with lower 25(OH)D by 7 to 10 nmol/L. After adjustment for confounders, those with the highest deprivation still had 77% increased odds of being <25nmol/L compared with the lowest deprivation. For perspective, 10 nmol/L is the winter 25(OH)D difference between Southern England and Northern Scotland. The most deprived UK subpopulations need targeting with interventions to increase vitamin D concentration. As participants in the Biobank are likely to be less deprived than the UK average, the 25(OH)D differences we report may be an underestimate.

Vitamin D concentration, body mass index, ethnicity and SARS-CoV-2/COVID-19: initial analysis of the first- reported UK Biobank Cohort positive cases (n 1474) compared with negative controls (n 4643) - Volume 80 Issue OCE1

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Personalised nutrition is a novel public health strategy aiming to promote positive diet and lifestyle changes. Tailored dietary and physical activity advice may be more appropriate than a generalised 'one-size-fits-all' approach as it is more biologically relevant to the individual. Information and computing technology, smartphones and mobile applications have become an integral part of modern life and thereby present the opportunity for novel methods to encourage individuals to lead a healthier lifestyle. This article introduces the European Union-funded PROTEIN project (PeRsOnalised nutriTion for hEalthy livINg) consortium and introduces the associated work packages. The primary objective of the PROTEIN project is to produce a novel adaptable mobile application suite based on sound nutrition and physical activity advice from experts in their field, accessible to all population groups, with differing health outcomes, whose behaviour can be tracked with a variety of sensors and health hazard perception. The mobile application 'ecosystem' that will be developed by the consortium includes a platform, mobile suite, cloud services, artificial intelligence advisor, game suite, modelling of expert's knowledge, users' behaviour data collection, data analysis and a dashboard for healthcare professionals. It is proposed that users will find the provision of personalised nutrition advice and real-time data capture through a smartphone application useful, and importantly, will be encouraged by this to make positive health behaviour changes.

BACKGROUND:The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has re-ignited interest in the possible role of vitamin D in modulation of host responses to respiratory pathogens. Indeed, vitamin D supplementation has been proposed as a potential preventative or therapeutic strategy. Recommendations for any intervention, particularly in the context of a potentially fatal pandemic infection, should be strictly based on clinically informed appraisal of the evidence base. In this narrative review, we examine current evidence relating to vitamin D and COVID-19 and consider the most appropriate practical recommendations. OBSERVATIONS:Although there are a growing number of studies investigating the links between vitamin D and COVID-19, they are mostly small and observational with high risk of bias, residual confounding, and reverse causality. Extrapolation of molecular actions of 1,25(OH)2-vitamin D to an effect of increased 25(OH)-vitamin D as a result of vitamin D supplementation is generally unfounded, as is the automatic conclusion of causal mechanisms from observational studies linking low 25(OH)-vitamin D to incident disease. Efficacy is ideally demonstrated in the context of adequately powered randomised intervention studies, although such approaches may not always be feasible. CONCLUSIONS:At present, evidence to support vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive. In the absence of any further compelling data, adherence to existing national guidance on vitamin D supplementation to prevent vitamin D deficiency, predicated principally on maintaining musculoskeletal health, appears appropriate.

At northern latitudes, non-ethnic population groups can be at an increased risk of vitamin D deficiency (defined as a 25-hydroxyvitamin D [25(OH)D] status ≤30 nmol/L). The vitamin D status of ethnic minority groups has been examined both in UK and European populations, but not in the Irish context. The aim of this study is to assess the vitamin D status from a selection of the Dublin population of South East Asian descent. A search was conducted, using the laboratory information system of St James's Hospital, Dublin, for vitamin D requests by General practitioners. From 2013 to 2016, 186 participants were identified and 25(OH)D analysis was quantified using liquid chromatography-tandem mass spectrometry (LC-MS-MS). Overall, the median age was 32 years, 51% were male, and the 25(OH)D concentration ranged from 10 to 154 nmol/L. In total, 66.7% of the total sample were vitamin D deficient and 6.7% had a 25(OH)D status greater than 50 nmol/L (the 25(OH)D concentration defined by the EU as 'sufficient'). Females had a significantly higher 25(OH)D concentration than males (25.0 vs. 18.0 nmol/L; p = 0.001) but both groups had a significant proportion with deficient status (56% and 76.8%, respectively). Seasonal variation of 25(OH)D was not evident while high rates of deficiency were also observed in those aged <18 years and >50 years. Given the importance of vitamin D for health, this sub-population could be at a significantly increased risk of rickets, impaired bone metabolism, and osteoporosis. In addition, vitamin D deficiency has been associated with several non-bone related conditions, including cardiovascular disease and diabetes. Currently, there is no unique vitamin D intake or vitamin D status maintenance guidelines recommended for adults of non-Irish descent; this needs to be considered by the relevant public health bodies in Ireland.

The primary source of vitamin D is through synthesis in the skin, following exposure to sunlight containing ultraviolet B (UVB) radiation. Supply through skin exposure can be supplemented by the diet, but there are relatively few dietary sources, especially those which provide a large amount of vitamin D per serving. Research into the effects of vitamin D status in different population groups has become an increasingly popular topic. The current interest surrounding vitamin D research in sport remains focused on the potential ergogenic effects of vitamin D on physical performance. However, the relationship between vitamin D (dietary intake and status) and musculoskeletal health in university athlete cohorts residing at higher latitudes (>40°N) remains underinvestigated. Within this review, the possible physiological roles that vitamin D may play within sport performance for recreational and professional athletes, as well as military recruits, will be discussed. The focus will be on muscular strength, cardiovascular health and the incidence of illness, including upper respiratory tract infections. Specifically, the effect that vitamin D deficiency {defined as a plasma/serum 25-hydroxyvitamin D [25(OH)D] concentration of <25 nmol/l} may have on musculoskeletal health, including the incidence of stress fractures, is discussed. The review also seeks to highlight avenues for future research within vitamin D and sport, in particular for populations residing at higher latitudes (>40°N) where wintertime vitamin D deficiency is prevalent. It is hoped that this review will help to raise the awareness of the importance of existing advice in the UK for the avoidance of vitamin D deficiency and international vitamin D guidelines (such as in the US) on the achievement of vitamin D sufficiency [serum 25(OH)D >50 nmol/l] for optimum health and performance in athletes, both professional and recreational.

Following the work of Avenell et al. that has raised concerns about the integrity of the Yamaguchi Osteoporosis Prevention Study (YOPS) conducted by Ishida and Kawai we issue here an adjustment to all meta-analysis estimates that contained this work within our systematic review.

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D 2 and vitamin D 3 , both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

We undertook a systematic review and meta-analysis of published papers assessing dietary protein and bone health. We found little benefit of increasing protein intake for bone health in healthy adults but no indication of any detrimental effect, at least within the protein intakes of the populations studied. This systematic review and meta-analysis analysed the relationship between dietary protein and bone health across the life-course. The PubMed database was searched for all relevant human studies from the 1st January 1976 to 22nd January 2016, including all bone outcomes except calcium metabolism. The searches identified 127 papers for inclusion, including 74 correlational studies, 23 fracture or osteoporosis risk studies and 30 supplementation trials. Protein intake accounted for 0–4% of areal BMC and areal BMD variance in adults and 0–14% of areal BMC variance in children and adolescents. However, when confounder adjusted (5 studies) adult lumbar spine and femoral neck BMD associations were not statistically significant. There was no association between protein intake and relative risk (RR) of osteoporotic fractures for total (RR (random) = 0.94; 0.72 to 1.23, I 2 = 32%), animal (RR (random) = 0.98; 0.76 to 1.27, I 2 = 46%) or vegetable protein (RR (fixed) = 0.97 (0.89 to 1.09, I 2 = 15%). In total protein supplementation studies, pooled effect sizes were not statistically significant for LSBMD (total n = 255, MD (fixed) = 0.04 g/cm 2 (0.00 to 0.08, P = 0.07), I 2 = 0%) or FNBMD (total n = 435, MD (random) = 0.01 g/cm 2 (−0.03 to 0.05, P = 0.59), I 2 = 68%). There appears to be little benefit of increasing protein intake for bone health in healthy adults but there is also clearly no indication of any detrimental effect, at least within the protein intakes of the populations studied (around 0.8–1.3 g/Kg/day). More studies are urgently required on the association between protein intake and bone health in children and adolescents.