Abstract
Vitamin D deficiency is a common health concern worldwide. We aim to compare the prevalence of vitamin D deficiency among older adults (65+) in China and the United States (US). We used data from the 2011 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in China (n = 2180), and 2011–2014 National Health and Nutrition Examination Survey (NHANES) in the US (n = 2283). Serum 25-hydroxyvitamin D [25(OH)D] was measured and a level of under 30/50 nmol/L was defined as vitamin D severe deficiency/deficiency. Risk factors of vitamin D deficiency were examined by multivariate regression models. We found that the mean 25(OH)D concentration was lower in China than in the US (45.1 vs. 83.5 nmol/L), with Chinese elderly lower than American elderly for every age group. 70.3% in China and 17.4% in the US were considered as vitamin D deficiency (30.6% and 3.4% were considered as severe deficiency). Older age, females, ethnic minorities, higher household income, self-rated “very bad” health, and never drinkers, were statistically significant in predicting lower serum 25(OH)D levels in China. In the US, males, ethnic minorities, lower income, self-rated “very bad” health, physically inactive, overweight, and obese were related to lower serum 25(OH)D levels. Our findings suggest that different interventional strategies are needed to improve vitamin D deficiency and its associated negative health outcomes in China and the US.
Highlights
Vitamin D deficiency is a serious health condition worldwide
Chinese Longitudinal Healthy Longevity Survey (CLHLS) had a larger proportion of older adults aged 80 years and older (67.0%), with a mean age of 85.9 years old, compared to 26.7% in National Health and Nutrition Examination Survey (NHANES) with a mean age of 73.3 years old (Table 1)
Vitamin D is an essential micronutrient to human health, but there is no consensus on the optimal level of vitamin D
Summary
Vitamin D deficiency is a serious health condition worldwide. Vitamin D is essential for human bone health, and severe vitamin D deficiency increases the risk of many diseasesincluding osteomalacia, osteoporosis, muscle weakness, hip fractures, diabetes, cancer, heart disease, arthritis, and poor general health in the elderly[1,2,3]. The aging process is considered a risk of vitamin D deficiency, because of debilitated ability to synthesize vitamin D from sunlight, activation of vitamin D in the kidney, and less outdoor exercise and activity[4]. The US National Academy of Medicine (formerly the Institute of Medicine) considers a serum 25-hydroxyvitamin D (25(OH)D) level of at least 50 nmol/L as the adequate exposure to vitamin D to maintain bone health. Individuals with levels less than 30 nmol/L are considered as severe deficient[5]. We aim to report serum 25(OH)D concentrations in China and the United States (US) using data from the CLHLS (Chinese Longitudinal Healthy Longevity Survey) and the NHANES (US National Health and Nutrition Examination Survey), which are nationally representative surveys of older adults from both countries
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