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爱尔兰的维生素 D 摄入与状况:一篇叙述性评论。

Vitamin D intake and status in Ireland: a narrative review.

机构信息

Mercers Institute for Research on Ageing, St James's Hospital, Dublin 8, Ireland.

School of Medicine, Trinity College Dublin, Dublin 2, Ireland.

出版信息

Proc Nutr Soc. 2023 May;82(2):157-171. doi: 10.1017/S0029665123002185. Epub 2023 Feb 14.

Abstract

Vitamin D is crucial for musculoskeletal health, with evidence suggesting non-skeletal benefits. Cutaneous vitamin D synthesis is limited in Ireland due to its northern latitude (52-55°N) and the population is dependent on dietary sources, yet intakes are inadequate. No study to-date has comprehensively examined vitamin D intakes and status in Ireland (Northern Ireland and the Republic). We aimed to review the evidence since 2010 and summarise the results in subgroups of the Irish population. We found that in the largest studies prevalence of deficiency [25-hydroxyvitamin D (25(OH)D) < 30 nm/l] was 15-17% in pregnancy, 15-23% in children and 13% in adults. Approximately half the population had 25(OH)D < 50 nm/l. There were only four small studies in an ethnic population with the largest in Southeast Asians finding that 67% were deficient. All studies found higher rates of deficiency and levels <50 nm/l in winter summer. Vitamin D intake was lowest in children (mean 2⋅3-4⋅2 μg/d) and pregnant women (mean 1⋅9-5⋅1 μg/d) and highest in older adults (6⋅9 μg/d), with over 90% of the population not meeting the recommended daily allowance. This review indicates that low vitamin D status and dietary vitamin D intake are widespread with children, adolescents, younger adults, pregnant women and ethnic minorities most at-risk. However, data are sparse in at-risk groups including the Travelling community, non-Europeans and institutionalised adults. Given the significant prevalence of deficiency, public health policies to promote better awareness of recommended vitamin D intakes and explore the options of food fortification are needed to address this issue.

摘要

维生素 D 对骨骼肌肉健康至关重要,有证据表明其还有非骨骼方面的益处。由于爱尔兰地处北纬 52-55 度,皮肤合成维生素 D 的量有限,加之人口依赖于饮食来源,但摄入量却不足,因此,其国内的维生素 D 摄入量和状况尚未有研究进行全面检测。截至目前,尚无研究全面检测爱尔兰(北爱尔兰和爱尔兰共和国)的维生素 D 摄入量和状况。我们旨在回顾 2010 年以来的相关证据,并按爱尔兰人群亚组总结结果。我们发现,在最大规模的研究中,妊娠期间缺乏症(25-羟维生素 D[25(OH)D]<30nm/l)的流行率为 15-17%,儿童为 15-23%,成人则为 13%。大约一半的人口 25(OH)D<50nm/l。仅有四项研究针对特定种族人群开展,其中最大规模的一项针对东南亚人群的研究发现,67%的人存在缺乏症。所有研究均发现,冬季和夏季缺乏症和 25(OH)D<50nm/l 的发生率更高。儿童(平均 2.3-4.2μg/d)和孕妇(平均 1.9-5.1μg/d)的维生素 D 摄入量最低,而老年人(6.9μg/d)最高,超过 90%的人未达到推荐的每日摄入量。本综述表明,维生素 D 状态和饮食维生素 D 摄入量低的现象广泛存在,儿童、青少年、年轻成年人、孕妇和少数族裔人群风险最高。然而,在高危人群(包括流浪人群、非欧洲裔人群和机构化成年人)中,相关数据却很缺乏。鉴于缺乏症的高发生率,需要制定公共卫生政策,以提高对推荐的维生素 D 摄入量的认识,并探讨强化食品的选择,以解决这一问题。

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