Vitamin D deficiency in Europe: pandemic? Academic Article uri icon


  • BACKGROUND:Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. OBJECTIVE:This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe. DESIGN:The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography-tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n= 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. RESULTS:An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October-March) and summer (April-November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. CONCLUSIONS:Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.


  • Cashman, Kevin D
  • Dowling, Kirsten G
  • Škrabáková, Zuzana
  • Gonzalez-Gross, Marcela
  • Valtueña, Jara
  • De Henauw, Stefaan
  • Moreno, Luis
  • Damsgaard, Camilla T
  • Michaelsen, Kim F
  • Mølgaard, Christian
  • Jorde, Rolf
  • Grimnes, Guri
  • Moschonis, George
  • Mavrogianni, Christina
  • Manios, Yannis
  • Thamm, Michael
  • Mensink, Gert BM
  • Rabenberg, Martina
  • Busch, Markus A
  • Cox, Lorna
  • Meadows, Sarah
  • Goldberg, Gail
  • Prentice, Ann
  • Dekker, Jacqueline M
  • Nijpels, Giel
  • Pilz, Stefan
  • Swart, Karin M
  • van Schoor, Natasja M
  • Lips, Paul
  • Eiriksdottir, Gudny
  • Gudnason, Vilmundur
  • Cotch, Mary Frances
  • Koskinen, Seppo
  • Lamberg-Allardt, Christel
  • Durazo-Arvizu, Ramon A
  • Sempos, Christopher T
  • Kiely, Mairead

publication date

  • 2016

has subject area