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Vitamin D insufficiency among African-Americans in the southeastern United States: implications for cancer disparities (United States)

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Abstract

Objective

To determine the prevalence and predictors of vitamin D insufficiency among black and white adult residents of the southern US.

Methods

A cross-sectional analysis of serum 25(OH)D levels using baseline blood samples from 395 Southern Community Cohort Study (SCCS) participants. Participants were African-American and white adults aged 40–79 who enrolled in the study from 2002–2004. We defined hypovitaminosis D as serum 25(OH)D levels ≤15 ng/ml.

Results

Hypovitaminosis D prevalence was 45% among blacks and 11% among whites. Vitamin D intake from diet and supplements was associated with modest increases in circulating 25(OH)D (0.5–0.7 ng/ml per 100 IU increment), but hypovitaminosis D was found for 32% of blacks with intake ≥400 IU/day. Body mass index (BMI) was a strong predictor of risk for hypovitaminosis D among black women (OR = 6.5, 95% CI 1.7–25.1 for BMI ≥30 kg/m2 vs. 18–24.9 kg/m2). UVR exposure estimated by residential location was positively associated with 25(OH)D levels among all groups except white women.

Conclusions

Hypovitaminosis D was present in a substantial proportion of the African-American population studied, even in the South and among those meeting recommended dietary guidelines. Vitamin D should continue to be a studied target for ameliorating racial cancer disparities in the US.

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References

  1. Calvo MS, Whiting SJ, Barton CN (2005) Vitamin D intake: a global perspective of current status. J Nutr 135:310–316

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  3. Harris SS, Soteriades E, Coolidge JA et al (2000) Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab 85:4125–4130

    Article  PubMed  CAS  Google Scholar 

  4. Nesby-O’Dell S, Scanlon KS, Cogswell ME et al (2002) Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third national health and nutrition examination survey, 1988–1994. Am J Clin Nutr 76:187–192

    PubMed  CAS  Google Scholar 

  5. Weisberg P, Scanlon KS, Li R et al (2004) Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. Am J Clin Nutr 80:1697S–1705S

    PubMed  CAS  Google Scholar 

  6. Wortsman J, Matsuoka LY, Chen TC et al (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72:690–693

    PubMed  CAS  Google Scholar 

  7. Pogue SJ (1995) Vitamin D synthesis in the elderly. Dermatol Nurs 7:103–105

    PubMed  CAS  Google Scholar 

  8. Clemens TL, Adams JS, Henderson SL et al (1982) Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet 1:74–76

    Article  PubMed  CAS  Google Scholar 

  9. Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135:317–322

    PubMed  CAS  Google Scholar 

  10. Dawson-Hughes B (2004) Racial/ethnic considerations in making recommendations for vitamin D for adult and elderly men and women. Am J Clin Nutr 80:1763S–1766S

    PubMed  CAS  Google Scholar 

  11. Signorello LB, Hargreaves MK, Steinwandel MD et al (2005) Southern community cohort study: establishing a cohort to investigate health disparities. J Natl Med Assoc 97:972–979

    PubMed  Google Scholar 

  12. Buchowski MS, Schlundt DG, Hargreaves MK et al (2003) Development of a culturally sensistive food frequency questionnaire for use in the Southern community cohort study. Cell Mol Biol 49:1295–1304

    PubMed  CAS  Google Scholar 

  13. Hollis BW, Kamerud JQ, Selvaag SR et al (1993) Determination of vitamin D status by radioimmunoassay with an 125I-labeled tracer. Clin Chem 39:529–533

    PubMed  CAS  Google Scholar 

  14. Yanoff LB, Parikh SJ, Spitalnik A et al (2006) The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans. Clin Endocrinol (Oxf) 64:523–529

    Article  CAS  Google Scholar 

  15. Thomas MK, Lloyd-Jones DM, Thadhani RI et al (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  PubMed  CAS  Google Scholar 

  16. Webb AR, Pilbeam C, Hanafin N, Holick MF (1990) An evaluation of the relative contributions of exposure to sunlight and of diet to the circulating concentrations of 25-hydroxyvitamin D in an elderly nursing home population in Boston. Am J Clin Nutr 51:1075–1081

    PubMed  CAS  Google Scholar 

  17. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Food, Nutrition Board, Institute of Medicine. (1999) Vitamin D. In: Dietary references intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy Press, Washington, DC, pp 250–287

  18. Dawson-Hughes B, Heaney RP, Holick MF et al (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716

    Article  PubMed  CAS  Google Scholar 

  19. Vieth R (2004) Why the optimal requirement for Vitamin D3 is probably much higher than what is officially recommended for adults. J Steroid Biochem Mol Biol 89–90:575–579

    Article  PubMed  CAS  Google Scholar 

  20. Bischoff-Ferrari HA, Giovannucci E, Willett WC et al (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28

    PubMed  CAS  Google Scholar 

  21. Kimlin MG (2004) The climatology of Vitamin D producing ultraviolet radiation over the United States. J Steroid Biochem Mol Biol 89–90:479–483

    Article  PubMed  CAS  Google Scholar 

  22. Buchowski MS, Semenya J, Johnson AO (2002) Dietary calcium intake in lactose maldigesting intolerant and tolerant African–American women. J Am Coll Nutr 21:47–54

    PubMed  CAS  Google Scholar 

  23. Jarvis JK, Miller GD (2002) Overcoming the barrier of lactose intolerance to reduce health disparities. J Natl Med Assoc 94:55–66

    PubMed  Google Scholar 

  24. Radimer K, Bindewald B, Hughes J et al (2004) Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999–2000. Am J Epidemiol 160:339–349

    Article  PubMed  Google Scholar 

  25. Moore C, Murphy MM, Keast DR et al (2004) Vitamin D intake in the United States. J Am Diet Assoc 104:980–983

    Article  PubMed  CAS  Google Scholar 

  26. Byers KG, Savaiano DA (2005) The myth of increased lactose intolerance in African–Americans. J Am Coll Nutr 24:569S–573S

    PubMed  CAS  Google Scholar 

  27. Calvo MS, Whiting SJ (2006) Public health strategies to overcome barriers to optimal vitamin D status in populations with special needs. J Nutr 136:1135–1139

    PubMed  CAS  Google Scholar 

  28. Looker AC (2005) Body fat and Vitamin D status in black versus white women. J Clin Endrocrinol Metab 90:635–640

    Article  CAS  Google Scholar 

  29. Zadshir A, Tareen N, Pan D, Norris K, Martins D (2005) The prevalence of hypovitaminosis D among US adults: data from the NHANES III. Ethn Dis 15:97–101

    Google Scholar 

  30. Feskanich D, Ma J, Fuchs CS et al (2004) Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev 13:1502–1508

    PubMed  CAS  Google Scholar 

  31. Uitterlinden AG, Fang Y, Van Meurs JB et al (2004) Genetics and biology of vitamin D receptor polymorphisms. Gene 338:143–156

    Article  PubMed  CAS  Google Scholar 

  32. Schwartz GG, Whitlatch LW, Chen TC et al (1998) Human prostate cells synthesize 1,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3. Cancer Epidemiol Biomarkers Prev 7:391–395

    PubMed  CAS  Google Scholar 

  33. Zehnder D, Bland R, Williams MC et al (2001) Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. J Clin Endocrinol Metab 86:888–894

    Article  PubMed  CAS  Google Scholar 

  34. Lin R, White JH (2004) The pleiotropic actions of vitamin D. Bioessays 26:21–28

    Article  PubMed  CAS  Google Scholar 

  35. Lowe L, Hansen CM, Senaratne S et al (2003) Mechanisms implicated in the growth regulatory effects of vitamin D compounds in breast cancer cells. Recent Results Cancer Res 164:99–110

    PubMed  CAS  Google Scholar 

  36. Bao BY, Yao J, Lee YF (2006) 1{alpha}, 25-dihydroxyvitamin D3 suppress interleukin-8-mediated prostate cancer cell angiogenesis. Carcinogenesis 27:1883–1893

    Article  PubMed  CAS  Google Scholar 

  37. Furigay P, Swamy N (2004) Anti-endothelial properties of 1,25-dihydroxy-3-epi-vitamin D3, a natural metabolite of calcitriol. J Steroid Biochem Mol Biol 89–90:427–431

    Article  PubMed  CAS  Google Scholar 

  38. Nakagawa K, Sasaki Y, Kato S et al (2005) 22-Oxa-1alpha,25-dihydroxyvitamin D3 inhibits metastasis and angiogenesis in lung cancer. Carcinogenesis 26:1044–1054

    Article  PubMed  CAS  Google Scholar 

  39. Garland CF, Garland FC (1980) Do sunlight and vitamin D reduce the likelihood of colon cancer? Int J Epidemiol 9:227–231

    Article  PubMed  CAS  Google Scholar 

  40. Grant WB (2003) Ecologic studies of solar UV-B radiation and cancer mortality rates. Recent Results Cancer Res 164:371–377

    PubMed  CAS  Google Scholar 

  41. Giovannucci E (2005) The epidemiology of vitamin D and cancer incidence and mortality: a review (United States). Cancer Causes Control 16:83–95

    Article  PubMed  Google Scholar 

  42. Schwartz GG (2005) Vitamin D and the epidemiology of prostate cancer. Semin Dial 18:276–289

    Article  PubMed  Google Scholar 

  43. Rukin NJ, Luscombe C, Moon S et al (2007) Prostate cancer susceptibility is mediated by interactions between exposure to ultraviolet radiation and polymorphisms in the 5′ haplotype block of the vitamin D receptor gene. Cancer Lett 247:328–335

    Article  PubMed  CAS  Google Scholar 

  44. Moon S, Holley S, Bodiwala D et al (2006) Associations between G/A1229, A/G3944, T/C30875, C/T48200 and C/T65013 genotypes and haplotypes in the vitamin D receptor gene, ultraviolet radiation and susceptibility to prostate cancer. Ann Hum Genet 70:226–236

    Article  PubMed  CAS  Google Scholar 

  45. Chen WY, Bertone-Johnson ER, Hunter DJ et al (2005) Associations between polymorphisms in the vitamin D receptor and breast cancer risk. Cancer Epidemiol Biomarkers Prev 14:2335–2339

    Article  PubMed  CAS  Google Scholar 

  46. Giovannucci E (2006) The epidemiology of vitamin D and colorectal cancer: recent findings. Curr Opin Gastroenterol 22:24–29

    Article  PubMed  CAS  Google Scholar 

  47. Giovannucci E, Liu Y, Rimm EB et al (2006) Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst 98:451–459

    Article  PubMed  CAS  Google Scholar 

  48. Wu K, Feskanich D, Fuchs CS et al (2007) A nested case–control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. J Natl Cancer Inst 99:1120–1129

    Article  PubMed  CAS  Google Scholar 

  49. Wactawski-Wende J, Kotchen JM, Anderson GL et al (2006) Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 354:684–696

    Article  PubMed  CAS  Google Scholar 

  50. Lappe JM, Travers-Gustafson D, Davies KM et al (2007) Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 85:1586–1591

    PubMed  CAS  Google Scholar 

  51. Jemal A, Siegel R, Ward E et al (2006) Cancer statistics, 2006. CA Cancer J Clin 56:106–130

    PubMed  Google Scholar 

  52. Wudel LJ Jr, Chapman WC, Shyr Y et al (2002) Disparate outcomes in patients with colorectal cancer: effect of race on long-term survival. Arch Surg 137:550–554

    Article  PubMed  Google Scholar 

  53. Polite BN, Dignam JJ, Olopade OI (2006) Colorectal cancer model of health disparities: understanding mortality differences in minority populations. J Clin Oncol 24:2179–2187

    Article  PubMed  Google Scholar 

  54. Cooper GS, Yuan Z, Landefeld CS et al (1996) Surgery for colorectal cancer: race-related differences in rates and survival among medicare beneficiaries. Am J Public Health 86:582–586

    Article  PubMed  CAS  Google Scholar 

  55. Dignam JJ, Colangelo L, Tian W et al (1999) Outcomes among African–Americans and Caucasians in colon cancer adjuvant therapy trials: findings from the national surgical adjuvant breast and bowel project. J Natl Cancer Inst 91:1933–1940

    Article  PubMed  CAS  Google Scholar 

  56. Polite BN, Dignam JJ, Olopade OI (2005) Colorectal cancer and race: understanding the differences in outcomes between African Americans and whites. Med Clin North Am 89:771–793

    Article  PubMed  Google Scholar 

  57. Moan J, Porojnicu AC, Robsahm TE et al (2005) Solar radiation, vitamin D and survival rate of colon cancer in Norway. J Photochem Photobiol B 78:189–193

    Article  PubMed  CAS  Google Scholar 

  58. Schwartz GG (2005) Vitramin D and the epidemiology of prostate cancer. Semin Dial 18:276–289

    Article  PubMed  Google Scholar 

  59. Li H, Stampfer MJ, Hollis BJ et al (2007) A prospective study of plasma Vitamin D metabolites, Vitamin D receptor polymorphisms, and prostate cancer. PLOS Med 4:562–571

    CAS  Google Scholar 

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Acknowledgment

The Southern Community Cohort Study is funded by a grant from the National Cancer Institute (R01 CA092447).

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Authors and Affiliations

  1. Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA

    Kathleen M. Egan, Lisa B. Signorello & William J. Blot

  2. Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Kathleen M. Egan

  3. International Epidemiology Institute, 1455 Research Blvd., Suite 550, Rockville, MD, 20850, USA

    Lisa B. Signorello, Heather M. Munro & William J. Blot

  4. Meharry Medical College, Nashville, TN, USA

    Margaret K. Hargreaves

  5. Medical University of South Carolina, Charleston, SC, USA

    Bruce W. Hollis

Authors
  1. Kathleen M. Egan
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  2. Lisa B. Signorello
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  3. Heather M. Munro
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  4. Margaret K. Hargreaves
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  5. Bruce W. Hollis
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  6. William J. Blot
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Correspondence to Lisa B. Signorello.

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Egan, K.M., Signorello, L.B., Munro, H.M. et al. Vitamin D insufficiency among African-Americans in the southeastern United States: implications for cancer disparities (United States). Cancer Causes Control 19, 527–535 (2008). https://doi.org/10.1007/s10552-008-9115-z

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  • DOI: https://doi.org/10.1007/s10552-008-9115-z

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