Vitamin D status is inversely associated with markers of risk for type 2 diabetes: A population based study in Victoria, Australia

A growing body of evidence suggests a protective role of Vitamin D on the risk of type 2 diabetes mellitus (T2DM). We investigated this relationship in a population sample from one Australian state. The data of 3,393 Australian adults aged 18±75 years who participated in the 2009±2010 Victorian Health Monitor survey was analyzed. Socio-demographic information, biomedical variables, and dietary intakes were collected and fasting blood samples were analyzed for 25, hydroxycholecalciferol (25OHD), HbA1c, fasting plasma glucose (FPG), and lipid profiles. Logistic regression analyses were used to evaluate the association between tertiles of serum 25OHD and categories of FPG (<5.6 mmol/L vs. 5.6±6.9 mmol/L), and HbA1c (<5.7% vs. 5.7±6.4%). After adjusting for social, dietary, biomedical and metabolic syndrome (MetS) components (waist circumference, HDL cholesterol, triglycerides, and blood pressure), every 10 nmol/L increment in serum 25OHD significantly reduced the adjusted odds ratio (AOR) of a higher FPG [AOR 0.91, (0.86, 0.97); p = 0.002] and a higher HbA1c [AOR 0.94, (0.90, 0.98); p = 0.009]. Analysis by tertiles of 25OHD indicated that after adjustment for socio-demographic and dietary variables, those with high 25OHD (65±204 nmol/L) had reduced odds of a higher FPG [AOR 0.60, (0.43, 0.83); p = 0.008] as well as higher HbA1c [AOR 0.67, (0.53, 0.85); p = 0.005] compared to the lowest 25OHD (10±44 nmol/L) tertile. On final adjustment for other components of MetS, those in the highest tertile of 25OHD had significantly reduced odds of higher FPG [AOR 0.61, (0.44, 0.84); p = 0.011] and of higher HbA1c [AOR 0.74, (0.58, 0.93); p = 0.041] vs. low 25OHD tertile. Overall, the data support a direct, protective effect of higher 25OHD on FPG and HbA1c; two criteria for assessment of risk of T2DM

Vitamin D status and dietary calcium in chronic disease: Potential associations with metabolic syndrome and type 2 diabetes mellitus in Australian adults

The thesis is based on data of a population sample of Victoria, Australia. Besides traditional factors, greater sitting time was a novel determinant of lower 25OHD. A systematic review and meta-analysis proposes a volumetric dilution and sequestration phenomenon accounts for the lower 25OHD in obesity. Greater 25OHD, calcium intake and their combination were significantly associated with a better biomedical risk profile, reduced adjusted odds for metabolic syndrome as well as type 2 diabetes

Reductions in body weight and percent fat mass increase the vitamin D status of obese subjects: A systematic review and metaregression analysis

The purpose of this review was to confirm a volumetric dilution of vitamin D in obesity. It was based on the hypothesis that weight loss, particularly fat loss, would increase serum 25-hydroxyvitamin D (25OHD) in the obese. We conducted a systematic review of the literature over the last 21 years and included human trials that reported changes in 25OHD, weight, or body composition after weight loss. Study arms were excluded if vitamin D was supplemented, dietary intake exceeded 800 IU/d, or extreme sun exposure was reported. Eighteen of 23 trials that met our criteria documented an increase in vitamin D status with weight loss. Metaregression analyses indicated a marginally significant effect of weight loss on unadjusted weighted mean difference of 25OHD (β = −0.60 [95% confidence interval {CI}, −1.24 to +0.04] nmol/L; P = .06) and after adjustment for study quality (Jadad score ≥3) (β = −0.64 [95% CI, −1.28 to +0.01] nmol/L; P = .05). The effect of percent fat mass on weighted mean difference of 25OHD was also marginally significant before (β = −0.91 [95% CI, −1.96 to +0.15] nmol/L; P = .08) and after adjustment of study quality (β = −1.05 [95% CI, −2.18 to +0.08] nmol/L; P = .06). Collectively, these outcomes support a volumetric dilution of vitamin D. The slopes of the respective regression lines, however, indicate a smaller increase in 25OHD than would be expected from a direct mobilization of stores into the circulation. Hence, sequestration of 25OHD and its conversion to inactive metabolites would also play a role. Future studies could relate changes in body fat compartments to the enzymatic regulation of 25OHD in response to weight loss

Certain Dietary Patterns Are Beneficial for the Metabolic Syndrome: Reviewing the Evidence

The metabolic syndrome (MetS) is a global public health issue of increasing magnitude. The Asia-Pacific region is expected to be hardest hit due to large population numbers, rising obesity, and insulin resistance (IR). This review assessed the protective effects of dietary patterns and their components on MetS. A literature search was conducted using prominent electronic databases and search terms that included in combination: diet, dietary components, dietary patterns, and metabolic syndrome. Articles were restricted to prospective studies and high quality randomized controlled trials that were conducted on humans, reported in the English language, and within the time period of 2000 to 2012. Traditional factors such as age, gender, physical activity, and obesity were associated with risk of MetS; however, these potential confounders were not always accounted for in study outcomes. Three dietary patterns emerged from the review; a Mediterranean dietary pattern, dietary approaches to stop hypertension diet, and the Nordic Diet. Potential contributors to their beneficial effects on prevalence of MetS or reduction in MetS components included increases in fruits, vegetables, whole grains, dairy and dairy components, calcium, vitamin D, and whey protein, as well as monounsaturated fatty acids, and omega-3 fatty acids. Additional prospective and high quality randomized controlled trial studies that investigate Mediterranean dietary pattern, the dietary approaches to stop hypertension diet, and the Nordic Diet would cement the protective benefits of these diets against the MetS

Vitamin D status and calcium intake in systemic inflammation, insulin resistance and the metabolic syndrome: An update on current evidence

Background: Insufficient vitamin D status and inadequate intakes of calcium are a global concern and appear to be inversely linked to the global explosion in prevalence of the metabolic syndrome (MetS). Scope and approach: This review provides an update of the current evidence on causal linkages between these nutrients and MetS. We adopted a simplified model that explored the effects of vitamin D and calcium on systemic inflammation and insulin resistance (IR), as initial derangements in the progression to MetS. We selected systematic reviews (SR) and meta-analyses (MA) of randomized controlled trials (RCTs) or large scale observational studies to better understand the evidence base in the area. Key findings and conclusions: Observational data provided the best evidence for an inverse association between vitamin D status and presence of MetS. There was no convincing evidence from RCTs, except when participants with impaired glucose tolerance were studied. The influence of dietary calcium on systemic inflammation, IR and MetS has been inadequately studied to allow a firm conclusion. However, cellular and molecular evidence support a role for intra-cellular calcium in related disease states. Future long-term RCTs in adequately sampled participant groups are needed. Central to uncovering such extra-skeletal effects is the endpoint of interest, the selection of the study population, the potential of prior genotyping, consensus on ‘optimal’ vitamin D status, and the duration required of future trials. The concomitant study of mechanistic pathways in such trials could uncover potential targets for functional food development and drug therapy

Socio-demographic and clinical characteristics of participants by FPG and HbA1c.

<p>Socio-demographic and clinical characteristics of participants by FPG and HbA1c.</p

The association of serum 25OHD and HbA1c: Crude and adjusted odds ratio and their 95% CI based on logistic regression.

<p>The association of serum 25OHD and HbA1c: Crude and adjusted odds ratio and their 95% CI based on logistic regression.</p

The association of serum 25OHD and FPG: Crude and adjusted odds ratio and their 95% CI based on logistic regression.

<p>The association of serum 25OHD and FPG: Crude and adjusted odds ratio and their 95% CI based on logistic regression.</p

The associations of vitamin D status and dietary calcium with the metabolic syndrome: an analysis of the Victorian Health Monitor survey

Objective: To examine the associations between serum 25-hydroxyvitamin D (25(OH)D), dietary Ca intake and presence of the metabolic syndrome (MetS). Design: A stratified cluster sample of a population aged 18–75 years from the Victorian Health Monitor survey. Setting: Non-institutionalized adults living in private dwellings in Victoria, Australia. Subjects: Adults (n 3404) with complete data and without type 1 or type 2 diabetes. Results: Adjusted for sociodemographic factors, physical characteristics and dietary covariates including Ca intake, every 10 nmol/l increase in serum 25(OH)D was significantly associated with decreased odds of MetS (adjusted odds ratio (AOR)=0·85, 95 % CI 0·80, 0·89; P<0·001). Relative to the low 25(OH)D tertile (median 33 nmol/l), there was a progressive decrease in odds of MetS that reached significance with the high 25(OH)D tertile (median 77 nmol/l; AOR=0·35, 95 % CI 0·26, 0·48; P<0·001). Every 500 mg/d increase in Ca intake adjusted for 25(OH)D did not reduce odds of MetS (AOR=0·81, 95 % CI 0·66, 1·06; P=0·141) but approached significance if unadjusted for 25(OH)D in the final model (AOR=0·81, 95 % CI 0·64, 1·02; P=0·073). No significant effect was obtained for tertiles of Ca intake. However, Ca and vitamin D tertile combinations suggested a beneficial effect of high Ca (median 1233 mg/d) only at low and medium 25(OH)D. The high 25(OH)D tertile was associated with significantly decreased odds of MetS regardless of Ca intake. Conclusions: A high vitamin D status significantly reduced the odds of MetS. A high Ca intake may have a similar favourable outcome but only at lower circulating concentrations of 25(OH)D