Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study.

Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.

A comparative intervention trial of deer milk and an oral nutritional supplement efficacy for improving older adults' nutritional status, muscle mass and physical performance.

OBJECTIVES: To compare the effectiveness of deer milk (DM) for improving nutritional status, muscle mass and physical performance with that of a commercially available oral nutritional supplement (ONS) in older women. METHODS: This study was an 11-week randomised, double-blind, parallel group study. Healthy women (N = 120) aged 65-80 years, the majority having a body mass index (BMI) < 25 kg/m2 were recruited. The women were randomly assigned to either 200 ml DM or a commercial ONS for 11 weeks. Data on habitual macronutrient intake, nutritional status (Mini Nutrition Assessment-Short Form, MNA-SF; ≤7 malnourished, 8-11 at risk of malnutrition, ≥12 normal nutrition), anthropometrics/body composition, and physical performance were collected. Blood samples were collected for metabolic markers. RESULTS: 102 women (DM 45, ONS 57) completed the study, of whom 29% had a dietary protein intake of <1 g/kg body weight per day, and 38% at risk of malnutrition. There were no between group differences in percentage change in MNA-SF score and body composition (P > 0.05), but a trend for a difference in handgrip strength (DM 11.7 ± 49.8% vs. ONS -2.42 ± 17.9%, P = 0.06). Further exploratory analysis showed that there was a trend for a between group difference in percentage change in MNA-SF score, favoring DM (DM 7.72 + 13.0% vs. ONS 0.63 + 9.25%, P = 0.06) only in women at risk of malnutrition. There was also a between group difference in percentage change in muscle mass (DM 1.68 ± 2.77% vs. ONS -0.18 ± 2.81%, P = 0.02) in women with BMI ≥25 kg/m2 and in handgrip strength (DM 10.6 ± 23.6% vs. ONS -5.03 ± 18.1%, P < 0.01) in women with BMI<25 kg/m2. Total cholesterol, LDL and LDL:HDL ratio did not change over time (P > 0.05), but there was a between group difference in percentage change in these markers (total cholesterol: DM 3.01 ± 6.97% vs. ONS -2.65 ± 9.92%, P < 0.01; LDL: DM 4.22 ± 14.9% vs. ONS -6.05 ± 17.6%, P < 0.01; LDL:HDL ratio: DM: 2.27 ± 16.4% vs. ONS: -5.78 ± 18.2%, P = 0.02). CONCLUSION: Baseline nutritional status and BMI may modulate nutritional status, muscle mass and physical performance response to DM (as compared with ONS), suggesting DM may improve nutritional status and physical performance in women at risk of malnutrition and/or with lower BMI, and improve muscle mass in women with a higher BMI. The study was registered with the Australian New Zealand Clinical Trial Registry ACTRN12621000650897p.

Relationship between vitamin D, iron, and hepcidin in premenopausal females, potentially confounded by ethnicity.

PURPOSE: To investigate the associations between vitamin D, hepcidin, and iron status in premenopausal females of different ethnic cohorts residing in Auckland, New Zealand (NZ). METHODS: A total of 160 females aged 18-45 years participated in a cross-sectional study. Demographics, body composition, serum 25(OH)D, inflammatory markers (C-reactive protein and interleukin-6, IL-6), and iron biomarkers (serum ferritin, haemoglobin, soluble transferrin receptor, and hepcidin) were measured. Comparisons between parametric, non-parametric, and categorical variables were completed by using one-way ANOVA, Kruskal-Wallis, and Chi-squared tests, respectively. ANCOVA was used to compare serum 25(OH)D across iron parameter categories. RESULTS: Of the 160 participants, 60 were NZ European, 67 were South Asian, and 33 were from the 'other' ethnic groups. South Asians had significantly higher body fat percentage (BF%) and IL-6 concentration (38.34% and 1.66 pg·mL-1, respectively), compared to NZ Europeans (27.49% and 0.63 pg·mL-1, respectively, p < 0.001). South Asians had significantly lower 25(OH)D concentrations compared to NZ Europeans (33.59 nmol·L-1 vs 74.84 nmol·L-1, p < 0.001). In NZ Europeans, higher 25(OH)D concentration was seen in those with lower (≤ 3.5 nM) hepcidin concentration, p = 0.0046. In South Asians, higher 25(OH)D concentration was seen in those with higher (> 3.5 nM) hepcidin concentrations, p = 0.038. There were no associations between serum 25(OH)D and serum ferritin. CONCLUSION: Within South Asian women, an unexpected positive relationship between 25(OH)D and hepcidin concentration was observed which may be due to significantly higher IL-6 concentrations, BF%, and lower 25(OH)D concentrations. Future research is required to confirm these observations in this ethnic cohort.

Knowledge, attitudes and behaviours towards vitamin D and sun exposure of parents of infants and young children and health professionals in New Zealand.

BACKGROUND: Vitamin D deficiency may result in adverse long-term health consequences in adulthood if it occurs during fetal development, infancy and childhood. To effectively improve vitamin D status of infants/toddlers, there needs to be knowledge and awareness of vitamin D among parents and health professionals. AIMS: The aim of this study was to investigate parents' and health professionals' knowledge, attitudes and behaviours towards vitamin D and sun exposure over two timepoints. METHODS: The study was an ecological study over two timepoints (Parents 2009 and 2021; Health professionals 2010 and 2019) and used an online questionnaire. RESULTS: The analysis included 9834 parents (2009 n = 8032; 2021 n = 1802) and 283 health professionals (2010 n = 193; 2019 n = 90). Parents and health professionals had good knowledge of vitamin D sources, roles and risk factors for deficiency over two timepoints. There were however some confusions regarding the vitamin D content of breast milk, exclusive breastfeeding as a risk factor for deficiency, and ineffectiveness of sun exposure through glass windows in relation to vitamin D synthesis. In 2019, only 37% of health professionals indicated giving advice on supplements for infants/toddlers. Most parents and health professionals believed there was not enough information available to parents regarding vitamin D (>90%) and that skin cancer prevention messages make it difficult to get information about vitamin D across (>70%). CONCLUSION: Although parents and health professionals had good knowledge in most areas, knowledge of some specific sources and risk factors for vitamin D deficiency was poor.

Effect of green-lipped mussel (Perna canaliculus) supplementation on faecal microbiota, body composition and iron status markers in overweight and obese postmenopausal women: a randomised, double-blind, placebo-controlled trial.

The present study aimed to determine the effect of whole meat GSM powder on gut microbiota abundance, body composition and iron status markers in healthy overweight or obese postmenopausal women. This was a 3-months trial involving forty-nine healthy postmenopausal women with body mass index (BMI) between 25 and 35 kg/m2 who were randomly assigned to receive 3 g/d of either GSM powder (n 25) or placebo (n 24). The gut microbe abundance, serum iron status markers and body composition were measured at the baseline and the end of the study. The between-group comparison at the baseline showed a lower abundance of Bacteroides and Clostridium XIVa in the GSM group compared with the placebo (P = 0⋅04). At the baseline, the body fat (BF)% and gynoid fat% were higher in the GSM group compared with the placebo (P < 0⋅05). No significant changes were found in any of the outcome measures, except for ferritin levels that showed a significant reduction over time (time effect P = 0⋅01). Some trend was observed in bacteria including Bacteroides and Bifidobacterium which tended to increase in the GSM group while their abundance decreased or remained at their baseline level in the control group. Supplementation with GSM powder did not result in any significant changes in gut microbe abundance, body composition and iron markers compared with placebo. However, some commensal bacteria such as Bacteroides and Bifidobacteria tended to increase following supplementation with GSM powder. Overall, these findings can expand the knowledge surrounding the effects of whole GSM powder on these outcome measures in healthy postmenopausal women.

Body Fat Percentage and Blood Donation are the Strongest Determinants of Iron Stores in Premenopausal Women Joining the New Zealand Army.

INTRODUCTION: Suboptimal iron status is an issue for women joining the military because of its association with impaired aerobic performance, yet no studies have investigated dietary and non-dietary determinants of iron status simultaneously in this population. The purpose of this study was to explore associations between iron stores, dietary patterns (DPs), and potential non-dietary determinants of iron status in premenopausal women at the commencement of basic military training (BMT) in the New Zealand Army. METHODS: During week 1 of BMT, demographic, body composition, lifestyle, medical history, and dietary data were measured as potential determinants of serum ferritin (SF) in 101 participants. Following univariate analysis, age, body fat percentage, previous blood donation, at least 6 h of exercise per week that raised the heart rate, and a vegetarian DP were analyzed using a multiple linear regression model. RESULTS: An increase in body fat percentage was associated with increased SF (P < .009), although blood donation in the past year decreased SF (P < .011) compared to those participants who did not donate blood. There was no association between SF and a vegetarian DP or hours of exercise per week. The model explained 17.5% of the variance in SF at the commencement of BMT. CONCLUSION: Body fat percentage and blood donation in the past year were the strongest determinants of iron stores in healthy premenopausal women commencing BMT. It is recommended that women joining the New Zealand Army are provided information to maintain or improve their iron status based on these findings. This includes clinical screening of iron status, advice for women considering blood donation, and dietary advice regarding total energy requirements and iron bioavailability.

Plasma nervonic acid levels were negatively associated with attention levels in community-living older adults in New Zealand.

The global population is aging. Preserving function and independence of our aging population is paramount. A key component to maintaining independence is the preservation of cognitive function. Metabolomics can be used to identify biomarkers of cognition before noticeable deterioration. Our study investigated the plasma metabolome of 332 community-living New Zealanders between 65 and 74 years of age, using gas chromatography-mass spectrometry. Six cognitive domains were assessed. Of the 123 metabolites identified using an in-house mass spectral libraries of standards, nervonic acid had a significant, inverse association with the attention domain (P-value = 1.52E- 4; FDR = 0.019), after adjusting for covariates (apolipoprotein E -ε4 genotype, sex, body fat percentage (standardised by sex), age, education, deprivation index, physical activity, metabolic syndrome, polypharmacy, smoking status, and alcohol intake) and multiple testing. Attention is defined as the ability to concentrate on selected aspects of the environment while ignoring other stimuli. This is the first study to identify nervonic acid as a potential biomarker of attention in older adults. Future research should confirm this association in a longitudinal study.

The Inhibitory Effects of New Zealand Pine Bark (Enzogenol®) on α-Amylase, α-Glucosidase, and Dipeptidyl Peptidase-4 (DPP-4) Enzymes.

The New Zealand pine bark extract (Enzogenol®) has previously been shown to elicit acute hypoglycaemic effects in humans. The present study investigated the underlying mechanisms of Enzogenol® in reducing postprandial glucose in humans. The potential inhibitory action of Enzogenol® against digestive enzymes: α-amylase and α-glucosidase, and dipeptidyl peptidase-4 (DPP-4) enzyme was determined. Enzogenol® demonstrated the ability to inhibit all three enzymes: α-amylase enzyme activity (IC50 3.98 ± 0.11 mg/mL), α-glucosidase enzyme activity (IC50 13.02 ± 0.28 µg/mL), and DPP-4 enzyme activity (IC50 2.51 ± 0.04 mg/mL). The present findings indicate the potential for Enzogenol® to improve postprandial glycaemia by delaying carbohydrate digestion via the inhibition of digestive enzymes (α-amylase and α-glucosidase), and enhancing the incretin effect via inhibiting the dipeptidyl-peptidase-4 enzyme. The inhibitory actions of Enzogenol® on enzymes should therefore be further validated in humans for its potential use in type 2 diabetes mellitus prevention and management.

A Narrative Review of Human Clinical Trials on the Impact of Phenolic-Rich Plant Extracts on Prediabetes and Its Subgroups.

Phenolic-rich plant extracts have been demonstrated to improve glycemic control in individuals with prediabetes. However, there is increasing evidence that people with prediabetes are not a homogeneous group but exhibit different glycemic profiles leading to the existence of prediabetes subgroups. Prediabetes subgroups have been identified as: isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), and combined impaired fasting glucose and glucose intolerance (IFG/IGT). The present review investigates human clinical trials examining the hypoglycemic potential of phenolic-rich plant extracts in prediabetes and prediabetes subgroups. Artemisia princeps Pampanini, soy (Glycine max (L.) Merrill) leaf and Citrus junos Tanaka peel have been demonstrated to improve fasting glycemia and thus may be more useful for individuals with IFG with increasing hepatic insulin resistance. In contrast, white mulberry (Morus alba Linn.) leaf, persimmon (Diospyros kaki) leaf and Acacia. Mearnsii bark were shown to improve postprandial glycemia and hence may be preferably beneficial for individuals with IGT with increasing muscle insulin resistance. Elaeis guineensis leaf was observed to improve both fasting and postprandial glycemic measures depending on the dose. Current evidence remains scarce regarding the impact of the plant extracts on glycemic control in prediabetes subgroups and therefore warrants further study.

Dietary Patterns, Their Nutrients, and Associations with Socio-Demographic and Lifestyle Factors in Older New Zealand Adults.

Dietary patterns analyse combinations of foods eaten. This cross-sectional study identified dietary patterns and their nutrients. Associations between dietary patterns and socio-demographic and lifestyle factors were examined in older New Zealand adults. Dietary data (109-item food frequency questionnaire) from the Researching Eating, Activity and Cognitive Health (REACH) study (n = 367, 36% male, mean age = 70 years) were collapsed into 57 food groups. Using principal component analysis, three dietary patterns explained 18% of the variation in diet. Dietary pattern associations with sex, age, employment, living situation, education, deprivation score, physical activity, alcohol, and smoking, along with energy-adjusted nutrient intakes, were investigated using regression analysis. Higher 'Mediterranean' dietary pattern scores were associated with being female, higher physical activity, and higher education (p < 0.001, R2 = 0.07). Higher 'Western' pattern scores were associated with being male, higher alcohol intake, living with others, and secondary education (p < 0.001, R2 = 0.16). Higher 'prudent' pattern scores were associated with higher physical activity and lower alcohol intake (p < 0.001, R2 = 0.15). There were positive associations between beta-carotene equivalents, vitamin E, and folate and 'Mediterranean' dietary pattern scores (p < 0.0001, R2 ≥ 0.26); energy intake and 'Western' scores (p < 0.0001, R2 = 0.43); and fibre and carbohydrate and 'prudent' scores (p < 0.0001, R2 ≥ 0.25). Socio-demographic and lifestyle factors were associated with dietary patterns. Understanding relationships between these characteristics and dietary patterns can assist in health promotion.

Iron deficiency and risk factors in pre-menopausal females living in Auckland, New Zealand.

BACKGROUND AND OBJECTIVES: Iron deficiency is prevalent in New Zealand, with low dietary haem intake and blood loss previously identified as risk factors. However, the influence of the hormone hepcidin on iron status has not been investigated. METHODS AND STUDY DESIGN: Females (n=170) aged 18-45 residing in Auckland participated in a cross-sectional study. Iron status and inflammation were assessed with serum biomarkers including; serum ferritin, haemoglobin, soluble transferrin receptor, hepcidin, C-reactive protein and interleukin-6. Lifestyle factors were assessed using a series of validated questionnaires, including an iron food frequency questionnaire. Potential determinants of serum ferritin were identified using multiple linear regression analysis. RESULTS: Iron insufficiency was confirmed in 55.8% of participants (Serum ferritin <30 µg·L-1). Hepcidin levels were higher in those who were iron sufficient (Serum ferritin ≥30 µg·L-1) (6.62 nM vs 1.17 nM, p<0.001). South Asian females had higher hepcidin (8.78 nM) levels, compared to New Zealand Europeans (6.28 nM) (p=0.018), a result likely due to South Asians presenting with higher interleukin-6 (1.66 vs 0.63 pg·mL-1, p<0.001). Hepcidin (ß=0.082, p<0.001) and frequency of meat intake (ß=0.058, p=0.001) were identified as significant predictors of serum ferritin in New Zealand Europeans, while hepcidin was the only identified predictor in South Asians (ß=0.138, p<0.001) and those of other ethnicities (ß=0.117, p<0.002). CONCLUSIONS: This is the first study in New Zealand to show that hepcidin levels strongly predict serum ferritin in premenopausal females. Additionally, frequency of meat intake appears to be an important determinant of iron status in New Zealand Europeans.

Study protocol: associations between dietary patterns, cognitive function and metabolic syndrome in older adults - a cross-sectional study.

BACKGROUND: Loss of cognitive function is a significant issue as the world's population ages. Preserving cognitive function maintains independence in older adults bringing major societal and financial benefits. Lifestyle factors such as diet are modifiable risk factors, which may help preserve cognitive function. Most nutrition research aimed at preserving cognitive function and metabolic health has focussed on individual nutrients and foods, not allowing for food combinations and interactions. A dietary pattern approach considers the entire diet including its complexity. Previous research investigating dietary patterns and cognitive function has not always considered relevant covariates such as physical activity and the Apolipoprotein E genotype, which are known to have associations with cognitive function. The aim of the REACH (Researching Eating, Activity and Cognitive Health) study is to investigate associations between dietary patterns, cognitive function and metabolic syndrome, accounting for a range of covariates. METHODS: This cross-sectional study design will recruit older, community-living adults (65-74 years) from Auckland, New Zealand. Dietary data will be collected via a 109-item food frequency questionnaire validated using a 4-day food record. Cognitive function will be assessed using the Montreal Cognitive Assessment (paper based) and the Computerised Mental Performance Assessment System (COMPASS) - a testing suite covering six domains. Additional data will include genetic (Apolipoprotein E ε4) and biochemical markers (fasting glucose, HbA1c, lipids profile), anthropometric measurements (weight, height, waist and hip circumference, body composition using dual X-ray absorptiometry), blood pressure, physical activity (International Physical Activity Questionnaire - short form) and health and demographics (questionnaire). Dietary patterns will be derived by principal component analysis. Associations between cognitive function and dietary patterns will be examined using multiple regression analysis. Covariates and interaction factors will include age, education, socio-economic status, physical activity, Apolipoprotein E ε4 genotype, family history of dementia or cognitive impairment, and lifestyle factors. Differences between participants with and without metabolic syndrome will also be examined. DISCUSSION: This study will bring new knowledge regarding associations between dietary patterns and cognitive function and metabolic health in older adults living in New Zealand. This is important for developing nutrition related recommendations to help older adults maintain cognitive function.

Iron status and associations with physical performance during basic combat training in female New Zealand Army recruits.

Decreases in Fe status have been reported in military women during initial training periods of 8-10 weeks. The present study aimed to characterise Fe status and associations with physical performance in female New Zealand Army recruits during a 16-week basic combat training (BCT) course. Fe status indicators - Hb, serum ferritin (sFer), soluble transferrin receptor (sTfR), transferrin saturation (TS) and erythrocyte distribution width (RDW) - were assessed at the beginning (baseline) and end of BCT in seventy-six volunteers without Fe-deficiency non-anaemia (sFer 10 mg/l at baseline or end. A timed 2·4 km run followed by maximum press-ups were performed at baseline and midpoint (week 8) to assess physical performance. Changes in Fe status were investigated using paired t tests and associations between Fe status and physical performance evaluated using Pearson correlation coefficients. sFer (56·6 (sd 33·7) v. 38·4 (sd 23·8) µg/l) and TS (38·8 (sd 13·9) v. 34·4 (sd 11·5) %) decreased (P<0·001 and P=0·014, respectively), while sTfR (1·21 (sd 0·27) v. 1·39 (sd 0·35) mg/l) and RDW (12·8 (sd 0·6) v. 13·2 (sd 0·7) %) increased (P<0·001) from baseline to end. Hb (140·6 (sd 7·5) v. 142·9 (sd 7·9) g/l) increased (P=0·009) during BCT. At end, sTfR was positively (r 0·29, P=0·012) and TS inversely associated (r -0·32, P=0·005) with midpoint run time. There were no significant correlations between Fe status and press-ups. Storage and functional Fe parameters indicated a decline in Fe status in female recruits during BCT. Correlations between tissue-Fe indicators and run times suggest impaired aerobic fitness. Optimal Fe status appears paramount for enabling success in female recruits during military training.

Dietary Intake, Anthropometric Characteristics, and Iron and Vitamin D Status of Female Adolescent Ballet Dancers Living in New Zealand.

Ballet dancing is a multifaceted activity requiring muscular power, strength, endurance, flexibility, and agility; necessitating demanding training schedules. Furthermore dancers may be under aesthetic pressure to maintain a lean physique, and adolescent dancers require extra nutrients for growth and development. This cross-sectional study investigated the nutritional status of 47 female adolescent ballet dancers (13-18 years) living in Auckland, New Zealand. Participants who danced at least 1 hr per day 5 days per week completed a 4-day estimated food record, anthropometric measurements (Dual-energy X-ray Absorptiometry) and hematological analysis (iron and vitamin D). Mean BMI was 19.7 ± 2.4 kg/m2 and percentage body fat, 23.5 ± 4.1%. The majority (89.4%) of dancers had a healthy weight (5th-85th percentile) using BMI-for-age growth charts. Food records showed a mean energy intake of 8097.3 ± 2155.6 kJ/day (48.9% carbohydrate, 16.9% protein, 33.8% fat, 14.0% saturated fat). Mean carbohydrate and protein intakes were 4.8 ± 1.4 and 1.6 ± 0.5 g/kg/day respectively. Over half (54.8%) of dancers consumed less than 5 g carbohydrate/kg/day, and 10 (23.8%) less than 1.2 g protein/kg/day. Over 60% consumed less than the estimated average requirement for calcium, folate, magnesium and selenium. Thirteen (28.3%) dancers had suboptimal iron status (serum ferritin (SF) < 20 µg/L). Of these, four had iron deficiency (SF < 12 µg/L, hemoglobin (Hb) ≥ 120 g/L) and one iron deficiency anemia (SF < 12 µg/L, Hb < 120 g/L). Mean serum 25-hydroxy vitamin D was 75.1 ± 18.6 nmol/L, 41 (91.1%) had concentrations above 50 nmol/L. Female adolescent ballet dancers are at risk for iron deficiency, and possibly inadequate nutrient intakes.

Postprandial metabolic responses of serum calcium, parathyroid hormone and C-telopeptide of type I collagen to three doses of calcium delivered in milk.

Acute doses of Ca rapidly increase serum Ca and reduce bone resorption concomitant with a reduction in serum parathyroid hormone (PTH) levels. The physiological response to a dose of Ca in milk and to a Ca salt may be different. The present study investigated Ca absorption patterns with increasing levels of fortification in milk, and the response to one dose of a Ca salt. A group of twenty-eight Asian women aged 20-45 years volunteered to attend the laboratory over several weeks. The fasted volunteers were randomised to one of three experimental drinks: 200 ml skimmed milk containing 250, 500 or 1000 mg Ca. A subgroup of seven volunteers also received a calcium gluconate/carbonate salt containing 1000 mg Ca in 200 ml water. Serial blood samples and urine were collected for 5 h from baseline. Different doses of Ca in milk resulted in a graded response in serum corrected Ca, PTH and C-telopeptide of type I collagen (CTx) but not ionised Ca. Serum Ca increased in response to all milk drinks and from 2 to 5 h the blood Ca levels were significantly different for the 250 and 1000 mg doses, as was the integrated response between the loads. The PTH response to the two higher doses was significantly more than following the 250 mg dose. The integrated response for CTx and urinary Ca between all three doses of Ca in milk was significantly different. A dose of Ca salt elicited a more immediate response reaching a plateau faster, and declining faster to baseline. Fortified milk is a safe matrix for delivering larger doses of Ca.

Vitamin D status and attitudes towards sun exposure in South Asian women living in Auckland, New Zealand.

OBJECTIVE: To determine the vitamin D status of women of South Asian origin living in Auckland, New Zealand, and to investigate their attitudes and behaviours with regard to sun exposure. DESIGN: Cross-sectional study. SETTING: Auckland, New Zealand. SUBJECTS: Women of South Asian origin (n 235) aged 20 years and older were tested for serum 25(OH)D, and 228 were included in these analyses. Of these, 140 completed a questionnaire about attitudes and behaviours to sun exposure, and health motivation. Exclusion criteria included high dose (>1000 IU/d) supplementation with 25(OH)D3, or any supplementation with 1,25(OH)2D3. RESULTS: As serum vitamin D concentrations were not normally distributed, data are reported as median (25th, 75th percentile). Median serum 25(OH)D3 was 27.5 (18.0, 41.0) nmol/l. Adequate concentrations (>50 nmol/l) were observed in only 16 % of the subjects. Concern about skin cancer and the strength of the New Zealand sun were the most prevalent reasons given for sun avoidance, with 65 % saying they did avoid the sun. However, a seasonal variation was observed, with concentrations reducing significantly (P < 0.001) from summer through to early spring by 19.5 nmol/l. CONCLUSIONS: The results of the present study suggest that South Asian women are at high risk of hypovitaminosis D, due, in part, to deliberate sun avoidance and an indoor lifestyle, and that they are especially vulnerable in winter and spring.