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A systematic review of vitamin D status and dietary intake in various Slovenian populations Cover

A systematic review of vitamin D status and dietary intake in various Slovenian populations

Slovenian Journal of Public Health
Volume 61 (2022): Issue 1 (March 2022)
By: ,  ,  ,  ,  ,  ,   and    
Open Access
|Jan 2022
Figures & tables

Figures & Tables

Figure 1

PRISMA flow diagram (16) of the literature review process for vitamin D intake and status in various Slovenian populations. Notes: WOS: Web of Science; COBISS: Co-operative Online Bibliographic System & Services, 25(OH)D: 25-hydroxy-vitamin D; VitD: Vitamin D.

Figure 2

Box plots of the weighted mean serum 25(OH) D levels for different bi-monthly periods (n=280; monitoring time frame: 12 months in 2017-2018) with a presentation of outliers (●). Results of a nationally representative Nutrihealth study (ClinicalTrial.gov:NCT03284840) reproduced from (20) with approval of the authors.

Figure 3

Forest plot of studies with at least 50 healthy subjects evaluating the proportion of insufficient serum 25(OH)D level (<50 nmol/L). *Note: In one study (Soltirovska et al. 2015) sampling was carried out across the year, but the majority of the samples were collected during extended summer.

Figure 4

Forest plot of studies with at least 50 healthy subjects evaluating the proportion of non-optimal serum 25(OH)D level (<75 nmol/L). *Note: In one study (Dovnik et al. 2015), the non-optimal 25(OH)D level was set at 80 nmol/L.

Supplementary table 1

Review of reports for vitamin D status in the Slovenian population.

Mean conc.±SD or (95% CI) [nmol/L]Prevalence of conc. < 50 nmol/LPrevalence of conc. > 50 nmol/LPubl. type
Avberšek-LužnikJan 2014 -Self-paying subjects7365.1±33.0<25 nmol/L: 9.6%25-75 nmol/L:B
2016 (23)Dec 2015from laboratory49.3%
information systemApr-Sept:25-75 nmol/L:
in Gorenjska region75.3±37.149.3%>75 nmol/L: 41.1%
Age: 19-90; meanOct-Mar:
49 years55.7±25.7
Blazina, BrataničOct - MayChildren andD1: 55D1: 55.1‘Common’A
et al. 2010 (43)adolescents withdeficiency
(year notceliac disease onD2: 19D2: 53.9between Dec
provided)strictly compliantand Apr
to a gluten-free diet
(D1) and not strictly
compliant to a
gluten-free diet (D2):
D1 age: 11.4±4.3
years; 3.8–17.6 years
D2 age: 13.4±4.8
years; 3.8–20.7 years
Dovnik, MujezinovićSept 2013Pregnant women398Mothers:Mothers: <25Mothers 50–80A,
et al. 2014, Dovnik, Mujezinović et al. 2015,Dec 2013and neonatesMothers:43.4±23.8nmol/L: 23.6%nmol/L: 27.9%A, B,
Dovnik, Mujezinović etAge:Sept 100Sep: 54.3±25.2Sept: 10.0%Sept: 40.0%B,
Mar 2014Dec 99Dec: 33.3±18.6Dec: 41.4%Dec: 16.2%
al. 2015, Dovnik 2016,All: 29.6±4.7 yearsMar 10Mar: 28.5±17.1Mar: 34.0%Mar: 12.0%B,
Dovnik, Mujezinović et al. 2017, Dovnik,Jun 2014Sept: 29.1±4.2 years Dec: 29.3±5.2 yearsJun 99Jun: 54.8±24.1Jun: 9.1%Jun: 43.4%C1
Mujezinović et al.Mar: 29.6±4.6 years401Neonates:Mothers: 25–50Mothers >80
2017 (33-38)Jun: 30.3±4.9 yearsNeonates:55.2±30.9nmol/L: 41.5%nmol/L: 7%
Sept 100Sep: 72.9±31.7Sept: 38.0%Sept: 12.0%
Dec 100Dec: 52.5±27.3Dec: 40.4%Dec: 2.0%
Mar 101Mar: 36.4±22.6Mar: 53.0%Mar: 13.0%
Jun 100Jun: 59.5±24.9Jun: 34.3%Jun: 13.1%
Neonates:Neonates:
<50 nmol/L:50–75 nmol/L:
47.6%27.4%
>75 nmol/L:
24.9%
Ekart, Vodošek HojsOutpatients7255.75±27.59B
et al. 2013 (45)with chronic
kidney disease in
predialysis clinic
Age: 60.72±12.7 years
Ferant and KozarMar 2011 -Pediatrics patientsCD: 35CD: 32.5A,
2012, Šikić Pogačar,Apr 2012with celiacB,
Dolinšek et al. 2013,disease (CD) andIBD: 35IBD: 32.6C4,
Ferant, Kozar etinflammatory bowelK: 34K: 49.9
al. 2014 (40-42)disease (IBD)
Age: 10-18 years
Gradišnik 2017,Feb - Mar 2016Institutionalized8033.0±27.0IR: <7.5A,
Velnar, Gradišnik etresidents (IR),nmol: 14%C3
al. 2018 (28, 29)controls living
(K) at homeIR: 42IR: 27.0K: <7.5 nmol: 13%
Age: 51-93 yearsK: 38K: 39.5
Gros 2008 (55)2006Participants inJanJanC3
the laboratory forM: 54M: 31.9±16.2
Jan, Feb, Mar,analysis of hormonesF: 120F: 40.3±39.0
Aug, Sept, Octand tumour markers
FebFeb
M:48M: 32.2±27.3
F: 82F: 29.5±21.7
MarMar
M: 67M: 27.6±21.8
F: 140F: 28.7±19.9
AugAug
F: 34F: 59.6±35.4
SeptSept
M: 54M: 52.2±33.8
F: 81F: 55.9±26.3
OctOct
M: 42M: 55.8±23.9
F: 118F: 56.0±27.6
Hribar, Hristov et2017 - 2018A nationallyAdults: 125Adults: 50.7<30 nmol/L<75 nmol/LA
al. 2020 (20)representative sample(45.4–56.0)
Summer:of adults and elderlySummer: 52Adults: 24.9%Adults: 83.3%
May-Oct,Summer: 70.4
Winter:Age adults:Winter: 73(62.2–78.5)Adults winter: 40.8%Adults winter: 98.0%
Nov-Apr18-64 years;Winter: 36.7
Adults summer:Adults summer:
mean 46.5±13.2Elderly: 155(32.5–40.9)2.6%62.6%
Age elderly:Summer: 64Elderly: 23.5%Elderly: 84.4%
65-75 years; mean 68.6±2.8Winter: 91Elderly: 47.7 (43.9–51.5)ElderlyElderly winter:
winter: 7.8%92.2%
Summer: 60.1
(54.0–66.2)Elderly summer:Elderly summer:
34.6%73.4%
Winter: 39.0
(35.0–43.0)
<50 nmol/L
Adults: 58.2%
Adults winter:
81.6%
Adults summer:
25.3%
Elderly: 62.9%
Elderly winter:
78.8%
Elderly summer:
40.2%
Humar 2015,2000 - 2010Patients with18BeforeB,
Osredkar, Humar etIgA nephropathysupplementation:C3
al. 2015 (49, 50)before and after40.5±17.6
cholecalciferol
supplementationAfter
supplementation:
Age: 47.1±10.1 years65.0±27.3
Jakopin, Pečovnik-May 2008 -Haemodialysis10128.6±16.7<12 nmol/L:40 – 75 nmol/L:A,
Balon et al. 2011,May 2010patients16.8%28.7%C1
Jakopin 2013 (46, 47)
Age: 63.3±13.5 years12 – 37 nmol/L:>75nmol/L: 3%
51.5%
40 – 75 nmol/L:
28.7%
Jakše, Sekulič 2020 (39) Apr (year notIndoor femaleAG: 1767.6±36.2<50 nmol/L:51–75 nmol/L:A
provided)athletes:S: 1435.5%32.3%
athletes engagedS: 35.7%S: 21.4%
in weight-bearingAG: 65.1±36.0
(artistic gymnasticS: 70.6±37.5AG: 35.3%AG: 41.2%
(AG)) and non->75 nmol/L:
weight-bearing32.3%
(swimming (S)) sport
S: 42.9%
Age: 16.9±4.4 years
AG: 23.5%
Krajnc, Čokolič et2014 - 2017Hospitalised and2082Median: 62.9Most individualsB
al. 2018 (54)outpatient patientslower than
mostly with75 nmol/L
osteoporosis and
vitamin D risk factors
for insufficiency
Krajnc, Čokolič et(year notOutpatient type4558.0±35.1B
al. 2013 (51)provided)II diabetics
Age: 59±8 years,
mean: 10±8
Kšela and ZavratnikApr 2011Ambulatory4733.8±17.12 patients aboveB
2013 (52)patients with type75 nmol/L
II diabetes mellitus
Age: 65±8.7 years
Marc 1993 (18)(year notHaemodialysis8529.2±22.8C2
provided)patients (DP)
and continuousDP: 51DP: 39.5
peritoneal dialysisCAPD: 34CAPD: 13.8
patients (CAPD)
Osredkar, Marc1994 - 1995Individuals from240Feb: 61.3A
1996 (22)general populationApr: 71.5
included on periodicJun: 92.8
medical examinationsAug: 81.8
Oct: 74.5
Dec: 70.3
Pajek, Čuk et al. 2017,2014 - 2015Dialysis patientsDP: 5468.0±28.4A,
Šturm 2017 (24, 25)(DP) from nineC2
HaemodialysisK: 81DP: 73.1±35.4
outpatient centresK: 64.6±22
and controls (K)
Age: 56.1±15.2 years
Pajk 2011 (30)Jan 2009 -Postmenopausal45748.2±27.4<25 nmol/L:25-75 nmol/L:C3
Dec 2010women from25.8%56.7%
endocrinology55-6955-69 years:
and nephrologyyears: 17051.6±27.025-75 nmol/L:>75 nmol/L:
outpatients centres70-7970-79 years:56.7%17.5%
Age: 55 - 90 years,years: 16648.8±26.8
mean: 72.780-9080-90 years:
years: 12142.7±28.3
Pečovnik-Balon, JakopinSept 2005 –Haemodialysis10258±35.610.5–50>50 nmol/L: 52%A
et al. 2009 (48)Sept 2007patients treatednmol/L: 48%
at the Department
of Haemodialysis
Age: 60.5±13.1 years
Rakuša, Vrtovec2009 - 2018Heart transplantation12373.5 (54.7–89.6)<24.9 nmol/L:50.0–74.9A
et al. 2020 (57)recipients5.1%nmol/L: 33.4%
Median age: 57 years25.0–49.9>75.0 nmol/L:
nmol/L: 16.2%45.3%
Rondaij, Rotovnik Kozjek et al. 2021 (59)Jan 2017 - Dec 2018Chronic intestinal failure patients on6341.3<30 nmol/L: 24%50-75 nmol/L: 26%
long-term home30-50 nmol/L:
parenteral nutrition48%
Median age: 65 years
Salkić 2016 (56)Summer: SeptOutpatient clinicSummer:Summer: 58.6C3
- Nov 2015laboratory776
Winter: 52.3
Winter: JanAge: 64.5 yearsWinter: 434
- Mar 2015
Soltirovska Salamon,Dec 2010 -Pregnant Women13274.7±27.5<50 nmol/L: 14%50-75 nmol/L:A
Benedik et al. 2015 (17)Oct 2012in 3. trimester41%
Smaller subsamplesAge: 30.6±4.4 years
of same population
(31, 32)
Tesovnik, Kovac(year notJuvenile population
et al. 2015 (44)provided)with type I diabetes
Age: 4-14 years,
median: 8.7
Tomažič, Ul etJan - Feb 2006HIV-infected male96T1: 35.8<50 nmol/L: 82%A
al. 2007 (58)population, different treatments: on threeT1: 24T2: 26.5T1: 75%
T1: antiretroviralT2: 37T3: 36.5T2: 89%
treatment naïve; T2:
treated with non-T3: 35T3: 82%
protease-inhibitor
antiretroviral
treatment; T3:
treated with
protease-inhibitor
containing
antiretroviral
treatment
Age: 43 years
Trdan 2016 (26)2014 - 2015DM and controls818DM: 31.6±17.4C3
age: 67.6 yearsDM: 266K: 49.2±29.6
K age: 55.4 yearsK: 552
Troskot and DuhovnikAutumn 2011Patients treated withP: 32P: 55.6±25.2P:P:C4
2013 (27)- spring 2013antiepileptic drugs<50 nmol/L:50-70 nmol/L:
carbamazepine and46.9%31.3%
oxcarbazepine healthy controls (P) and (K)>75 nmol/L: 21%
P age: 28-59 yearsK:K:
K: 22K: 50.6±20<50 nmol/L:50-70 nmol/L:
K age: 29-60 years59.1%31.8%
>75 nmol/L: 9.1%
Vindišar, Goličnik(year notPatients with3839.6±11.920-50 nmol/L:>50 nmol/L:B
et al. 2009 (53)provided)hip fracture85.8%13.2%
Age: 58- 95 years,
mean 79 years
Vujasinović, Kunst(year notPatients 1 year after22<65 nmol/L:A
et al. 2016 (104)provided)bariatric surgery95.4%
Age: 42.0±9.2 years
Žmitek, Hribar etJan - Mar 2019Healthy adults, mostly23844.0±17.0<30 nmol/L: 21%50 -75 nmol/L:A
al. 2020 (21)from Central SloveniaM: 44.3±16.030 -50 nmol/L:31%
Age: 18–65 years;45%>75 nmol/L: 3%
mean 37.7±11.4F: 43.8±18.0

[i] Notes: Jan - January, Feb - February, Mar - March, Apr - April, Jun - June, Aug - August, Sept - September, Oct - October, Nov - November, Dec - December, K- control group, CD - celiac disease, IR - Institutionalised residents, IBD - inflammatory bowel disease, DP - Dialysis patients, P - Patients treated with antiepileptic drugs carbamazepine and oxcarbazepine, DM - diabetes patients, T1 - antiretroviral treatment naïve; T2 - treated with non-protease-inhibitor antiretroviral treatment; T3 - treated with protease-inhibitor containing antiretroviral CAPD - treatment continuous peritoneal dialysis patients, AG- artistic gymnastic, S- swimming, D1 -strictly compliant to a gluten-free diet, D2 - not strictly compliant to a gluten-free diet, M - male, F - female, Publication type (A - scientific paper, B- conference paper, C - academic thesis; 1 - doctoral, 2 - master, 3 - diploma, 4 - other)

Supplementary table 2

Review of reports for vitamin D intake in the Slovenian population.

AuthorsPopulationMean vitamin D intake [μg/day]Data collectionPublication type
Fidler Mis, Kobe et al.TeenagersM: 4±4sq-FFQ (n=2,661)A
2012 (61)Age 15-16 yearsF: 4±33DDR for adjustment
M: n=1,010(n=197)
F: n=1,214
Gregorič 2019 (69, 70)Elderly in residential home2 x 24h-recall: 1.1±0.62 x 24 h-recallA, C3
n=493DDR: 1.3±0.73DDR
Age: 65-91 years
Gregorič 2015 (62)Teenagers from 10 primaryAll: 1.72 x 24h recallC1
schools
Age 11-15 years n=3276. grade
6. grade: age 11-12 years,F: 1.6±0.9
mean 12.0±0.1M: 1.9±1.3
F: n=79
M: n=788. grade
8. grade 13-15 years, mean 14.0±0.2F: 1.5±1.3
F: n=84M: 1.9±1.3
M: n=86
Hribar 2021 (19)AdolescentsAdolescents2 x 24h recallA
Age: 10-17 yearsAll: 2.7adjusted with FPQ
M: n=238M: 3.0
F: n=230F: 2.4
AdultsAdults
Age: 18-64 yearsAll: 2.9
M: n=173M: 3.4
F: n=191F: 2.3
ElderlyElderly
Age: 65-74 yearsAll: 2.5
M: n=213M: 2.6
F: n=203F: 2.3
Jakše 2020 (71)Healthy, active adults afterFood, supplements, and plant-3DDRA
dietary intervention studybased meal replacements:
Age: 18-78 years,M: 7.1±5.8
mean 39.6 yearsF: 14.2±19.4
M: n= 42Food:
F: n=109M: 0.5 ±1.1
F: 0.6 ±1.0
Supplements, and plant-
based meal replacements:
M: 6.6±5.7
F: 13.6±19.3
Jeretina 2019 (66)Healthy peri- andFood: 1.3±0.93sq-FFQ for fish, milk,C2
postmenopausal womenFood and supplements:and milk products
Age: 40 - 65 years,4.1±10.8
mean 57.1±4.7 years
n=59
Juvan 1997 (68)Students eating2.67DDRC3
vegetarian dietsSemi-vegetarians: 3.3
n=14Lacto-ovo vegetarians: 2.8
Semi-vegetarians: 21%Lacto vegetarians: 1.1
Lacto-ovo vegetarians: 58%
Lacto vegetarians: 21%
Koch and GregoričNationally representativeConsumed with breakfast24h-recallA
2009 (63)data from secondaryM: 0.3±0.5
school studentsF: 0.2±0.4
Age: mean 18 years
M: n=216
F: n=237
Kocuvan Mijatov andAdult female coeliac3DDRA
Mičetić-Turk 2016 (72)disease patients2.6
Age: 23 - 76 years
n=40
Lichthammer, Nagy etTeenage and adultsq-FFQA
al. 2015 (65)populationAll: 2.57
Age: 15-75 years, mean 38.8 n=81-------14-18 years: 3.7±3.3 19-29 years: 3.0±2.1
30-69 years: 2.5±1.7
Lopert 2019 (73)Female patients with>70 years: 1.0±2.4FFQ, 24h-recallC2
osteoporosisFFQ: 1.8
Age: mean 71.4 years24h-recall: 1.4
n=43
Poličnik, PokornPre-school children in3DDRA
et al. 2013 (60)Central SloveniaAll: 1.1±0.7
Age: 2-6 years, average 4.2M: 1.0±0.7
n=129F: 1.1±0.7
M: n=68
F: n=61
Soltirovska Salamon,Pregnant women in4DDRA
Benedik et al. 2015 (17)third trimester
Age: 30.6±4.4 years
n=132
Urh, Babnik etElderly in a residential home7DDRA
al. 2017 (67)Age: mean 82.2 years2.6
n=48
Zdešar-Kotnik 2019 (64)Pupils of 1. years of2x24h-recallC1
Secondary schoolM: 1.4 (0.8 – 2.5)
M: Age: 13.5 years; n=162F: 1.0 (0.6 – 1.7)
F: Age: 15.4 years; n=180

[i] Notes: M - males, F - females, DDR - day dietary record, FFQ - food frequency questionnaire, FPQ – food propensity questionnaire, sq - semi-quantitative; Publication type (A - scientific paper, B - conference paper, C - academic thesis; 1 - doctoral, 2 - master, 3 - diploma, 4 - other)

DOI: https://doi.org/10.2478/sjph-2022-0009 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
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Language: English, Slovenian
Page range: 55 - 72
Submitted on: Aug 26, 2021
Accepted on: Nov 5, 2021
Published on: Jan 3, 2022
Published by: National Institute of Public Health, Slovenia
In partnership with: Paradigm Publishing Services
Keywords:
vitamin D,
dietary intake,
serum 25-hydroxy-vitamin D,
vitamin D deficiency,
systematic reviews,
Slovenia
Related subjects:
Medicine,
Clinical medicine,
Hygiene and environmental medicine

© 2022 Maša Hribar, Evgen Benedik, Matej Gregorič, Urška Blaznik, Andreja Kukec, Hristo Hristov, Katja Žmitek, Igor Pravst, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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