Seemingly paradoxical seasonal influences on vitamin D status in nursing-home elderly people from a Mediterranean area.

OBJECTIVE: We investigated vitamin D status in institutionalized elderly subjects by measuring serum 25-hydroxyvitamin D (25[OH]D) and its association with season and other factors: age, gender, nutritional status, cognitive function, functional ability, dietary intake, vitamin D supplement consumption, and disease. METHODS: The cross-sectional study included 86 subjects, 65-94 y of age (29 men and 57 women), who lived in three nursing homes in Murcia, a Spanish Mediterranean area. The Mini Nutritional Assessment, Short Portable Mental Status Questionnaire, and BI were used to evaluate nutritional status, functional ability, and cognitive function, respectively. Serum 25(OH)D concentrations were used to assess vitamin D status. The thresholds of inadequacy were considered to be <25 nmol/L (vitamin D deficiency) and <50 nmol/L (vitamin D insufficiency). RESULTS: Body mass index was 28.8 +/- 5.8 kg/m(2) (mean +/- SD). Vitamin D dietary intake was very much below the recommended dietary intake. The Mini Nutritional Assessment was 23.6 +/- 4.0, cognitive function was 7.8 +/- 1.9, and functional ability 82.9 +/- 23.1. The percentages of subjects with inadequate serum 25(OH)D concentrations were 58.2% and 32.6%, taking into consideration cutoffs of 50 and 25 nmol/L, respectively. Vitamin D deficiency was more common in women (40.3%) than in men (20.7%). Serum 25(OH)D concentrations varied significantly with the season in which the samples were taken, but not with the other factors analyzed. CONCLUSION: In this Mediterranean area, a substantial percentage of institutionalized subjects showed an inadequate vitamin D status, which could be remedied by the consumption of vitamin D-fortified foods and/or vitamin D supplements, especially during the summer months.

Vitamins and minerals: a model for safe addition to foods.

BACKGROUND: Significant subgroups in most European populations have intakes below nationally recommended levels for several vitamins, minerals and trace elements, placing individuals at risk of suboptimal intake of important vitamins and minerals. The voluntary addition of micronutrients to the appropriate foods may help address the risks associated with low micronutrient intakes. However, concerns need to be addressed regarding the potential for unacceptably high intakes, particularly for those people consuming very large amounts of food. AIM OF THE STUDY: To develop a model to estimate the level of each micronutrient that can be added safely to foods. METHODS: A theoretical model was developed based on the critical factors which determine the risk of unacceptably high intake for each micronutrient at high levels of food/energy intakes. These included 1) Tolerable Upper Intake Levels (UL), 2) high micronutrient intakes in Europe at the 95(th) percentile intake for each nutrient, 3) the proportion of fortified foods in the diets of individuals at the 95(th) percentile for energy intakes, 4) the proportion of foods to which micronutrients could practically be added, and 5) a range of estimates for the fractions of foods which might be actually fortified for each nutrient. A maximum level was set up for each micronutrient per typical serving or 100 kcal portion. The outputs of the model were then compared against a recent model developed by AFSSA, based on the food intake data in France. RESULTS: Three categories of micronutrients were identified, in which micronutrients could be added safely to foods at levels (per serving, e. g., 100 kcal) 1) greater than 1 European Commission Recommended Daily Intake (EC RDA): vitamin B12, vitamin C, vitamin E, riboflavin, panthothenic acid, niacin and thiamine; 2) between 50 and 100 % of the EC RDA: vitamin B6, vitamin D, folic acid, biotin, copper, iodine and selenium; 3) between 10 and 40 % of the EC RDA: iron, zinc, calcium, phosphorus and magnesium. A fourth category consisting of retinol, for which high end intake levels are close to UL for some population subgroups in Europe and thus requires further consideration. CONCLUSIONS: A wide range of vitamins and minerals can be added safely to foods at nutritionally important levels in the current diets of Europeans.