Vitamin D deficiency and insufficiency in the Georgia Older Americans Nutrition Program.

Serum 25-hydroxyvitamin D (25(OH)D) status in older adults enrolled in community-based meal programs is not well characterized. The objective was to identify predictors of poor serum 25(OH)D status and the response to vitamin D supplementation in a convenience sample from the Older Americans Act Nutrition Program (OAANP) in northeast Georgia (N = 158, mean age = 77 years, 81% women, 69% Caucasian, 31% African American). Mean serum 25(OH)D was 55nmol/l, and intakes of vitamin D and calcium from foods were very low. Vitamin D insufficiency (25(OH)D 25- < 50 nmol/l) occurred in 36.7%. Vitamin D deficiency occurred in 8.2% (25(OH)D < 25 nmol/l) and was associated with low milk intake, low sunlight exposure, receiving meals at home, tobacco use, depression, dementia, antianxiety medication, poor instrumental activities of daily living, and low calf circumference (p < or = 0.05). When non-supplement users (n = 28) were given a multivitamin with vitamin D (10 microg/d) and calcium (450 mg/d) for 4 months, 25(OH)D increased from 50 to 78 nmol/l, the prevalence of poor vitamin D status (25(OH)D < 50 nmol/l) decreased from 61% to 14%, and serum alkaline phosphatase decreased by 10% (p < 0.01). High body weight appeared to attenuate the increase in 25(OH)D in response to the multivitamin supplement (p < or = 0.05). In conclusion, OAANP services did not prevent poor vitamin D and calcium status, but a supplement with vitamin D and calcium was beneficial.