{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:57:24Z","timestamp":1784534244483,"version":"3.55.0"},"reference-count":42,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,1,5]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Evidence from randomised controlled trials suggests that vitamin D may reduce multimorbidity, but very few studies have investigated specific determinants of vitamin D2 and D3 (two isoforms of 25-hydroxyvitamin D). The aim of the study was to investigate the determinants of vitamin D2 and D3 and to identify the risk factors associated with hypovitaminosis D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Northern Finland Birth Cohort 1966.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      2374 male and 2384 female participants with data on serum 25(OH)D\n                      <jats:sub>2<\/jats:sub>\n                      and 25(OH)D\n                      <jats:sub>3<\/jats:sub>\n                      concentrations measured at 31\u2005years of age (1997), together with comprehensive measures of daylight, anthropometric, social, lifestyle and contraceptive cofactors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We assessed a wide range of potential determinants prior to a nationwide fortification programme introduced in Finland. The determinants of 25(OH)D\n                      <jats:sub>2<\/jats:sub>\n                      , 25(OH)D\n                      <jats:sub>3<\/jats:sub>\n                      and 25(OH)D concentrations were analysed by linear regression and risk factors for being in lower tertile of 25(OH)D concentration by ordinal logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At the time of sampling, 72% of the participants were vitamin D sufficient (\u226550\u2005nmol\/L). Low sunlight exposure period (vs high) was associated positively with 25(OH)D\n                      <jats:sub>2<\/jats:sub>\n                      and negatively with 25(OH)D\n                      <jats:sub>3<\/jats:sub>\n                      concentrations. Use of oral contraceptives (vs non-users) was associated with an increase of 0.17\u2005nmol\/L (95% CI 0.08 to 0.27) and 0.48\u2005nmol\/L (95% CI 0.41 to 0.56) in 25(OH)D\n                      <jats:sub>2<\/jats:sub>\n                      and 25(OH)D\n                      <jats:sub>3<\/jats:sub>\n                      concentrations. Sex, season, latitude, alcohol consumption and physical activity were the factors most strongly associated with 25(OH)D concentration. Risk factors for low vitamin D status were low sunlight exposure defined by time of sampling, residing in northern latitudes, obesity, higher waist circumference, low physical activity and unhealthy diet.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We demonstrate some differential associations of environmental and lifestyle factors with 25(OH)D\n                      <jats:sub>2<\/jats:sub>\n                      and 25(OH)D\n                      <jats:sub>3<\/jats:sub>\n                      raising important questions related to personalised healthcare. Future strategies could implement lifestyle modification and supplementation to improve vitamin D2 and D3 status, accounting for seasonal, lifestyle, metabolic and endocrine status.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013161","type":"journal-article","created":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T20:40:26Z","timestamp":1488832826000},"page":"e013161","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Potential determinants of vitamin D in Finnish adults: a cross-sectional study from the Northern Finland birth cohort 1966"],"prefix":"10.1136","volume":"7","author":[{"given":"Saranya","family":"Palaniswamy","sequence":"first","affiliation":[{"name":"Biocenter Oulu, University of Oulu, Oulu, Finland"},{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Hypp\u00f6nen","sequence":"additional","affiliation":[{"name":"Centre for Population Health Research, School of Health Sciences and Sansom Institute, University of South Australia, South Australian Health and Medical Research Institute, Adelaide, Australia"},{"name":"Population, Policy and Practice, Institute of Child Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan M","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Jokelainen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"MRC and Unit of Primary Care, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Lowry","sequence":"additional","affiliation":[{"name":"Biocenter Oulu, University of Oulu, Oulu, Finland"},{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirkka","family":"Kein\u00e4nen-Kiukaanniemi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"MRC and Unit of Primary Care, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Heinz","family":"Herzig","sequence":"additional","affiliation":[{"name":"Biocenter Oulu, University of Oulu, Oulu, Finland"},{"name":"Department of Physiology, Institute of Biomedicine, University of Oulu, Oulu, Finland"},{"name":"Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland"},{"name":"CEU Cardenal Herrera University, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjo-Riitta","family":"J\u00e4rvelin","sequence":"additional","affiliation":[{"name":"Biocenter Oulu, University of Oulu, Oulu, Finland"},{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"MRC and Unit of Primary Care, Oulu University Hospital, Oulu, Finland"},{"name":"Department of Epidemiology and Biostatistics, School of Public health, Imperial College London, London, UK"},{"name":"MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Sebert","sequence":"additional","affiliation":[{"name":"Biocenter Oulu, University of Oulu, Oulu, Finland"},{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"Department of Genomics of Complex Diseases, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,6]]},"reference":[{"key":"2025121512480259000_7.3.e013161.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001383"},{"key":"2025121512480259000_7.3.e013161.2","doi-asserted-by":"publisher","DOI":"10.1096\/fj.12-210880"},{"key":"2025121512480259000_7.3.e013161.3","doi-asserted-by":"crossref","first-page":"e0141081","DOI":"10.1371\/journal.pone.0141081","article-title":"The relationship of serum 25-hydroxyvitamin D and insulin resistance among nondiabetic Canadians: a longitudinal analysis of participants of a preventive health program","volume":"10","author":"Pham","year":"2015","journal-title":"PLoS ONE"},{"key":"2025121512480259000_7.3.e013161.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g6330"},{"key":"2025121512480259000_7.3.e013161.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.05.011"},{"key":"2025121512480259000_7.3.e013161.6","doi-asserted-by":"crossref","first-page":"164","DOI":"10.3402\/ijch.v67i2-3.18258","article-title":"Vitamin D and living in northern latitudes\u2014an endemic risk area for vitamin D deficiency","volume":"67","author":"Huotari","year":"2008","journal-title":"Int J Circumpolar Health"},{"key":"2025121512480259000_7.3.e013161.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070553"},{"key":"2025121512480259000_7.3.e013161.8","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1017\/S0007114516001227","article-title":"Food fortification as a means to increase vitamin D intake","volume":"115","author":"Itkonen","year":"2016","journal-title":"Br J Nutr"},{"key":"2025121512480259000_7.3.e013161.9","doi-asserted-by":"crossref","first-page":"22671","DOI":"10.3402\/fnr.v57i0.22671","article-title":"Vitamin D\u2014a systematic literature review for the 5th edition of the Nordic Nutrition Recommendations","volume":"57","author":"Lamberg-Allardt","year":"2013","journal-title":"Food Nutr Res"},{"key":"2025121512480259000_7.3.e013161.10","doi-asserted-by":"publisher","DOI":"10.3390\/nu7075111"},{"key":"2025121512480259000_7.3.e013161.11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1743-7075-12-2","article-title":"Sex-specific determinants of serum 25-hydroxyvitamin D3 concentrations in an elderly German cohort: a cross-sectional study","volume":"12","author":"Jungert","year":"2015","journal-title":"Nutr Metab (Lond)"},{"key":"2025121512480259000_7.3.e013161.12","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.113.076430"},{"key":"2025121512480259000_7.3.e013161.13","doi-asserted-by":"crossref","first-page":"e186","DOI":"10.1038\/nutd.2015.36","article-title":"The need to redefine age- and gender-specific overweight and obese body mass index cutoff points","volume":"5","author":"Nevill","year":"2015","journal-title":"Nutr Diabetes"},{"key":"2025121512480259000_7.3.e013161.14","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1093\/jn\/136.4.1130","article-title":"Strategies to improve vitamin D status in northern European children: exploring the merits of vitamin D fortification and supplementation","volume":"136","author":"Tylavsky","year":"2006","journal-title":"J Nutr"},{"issue":"193","key":"2025121512480259000_7.3.e013161.15","first-page":"1+","article-title":"Groups at risk in low birth weight infants and perinatal mortality","volume":"193","author":"Rantakallio","year":"1969","journal-title":"Acta Paediatr Scand"},{"key":"2025121512480259000_7.3.e013161.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.1988.tb00180.x"},{"key":"2025121512480259000_7.3.e013161.17","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000148304.33869.ee"},{"key":"2025121512480259000_7.3.e013161.18","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv203"},{"key":"2025121512480259000_7.3.e013161.19","unstructured":"IOM (Institute of Medicine). Dietary reference intakes for calcium and vitamin D. Washington DC: The National Academic Press, 2011."},{"key":"2025121512480259000_7.3.e013161.20","unstructured":"Finnish Meteorological Institute. Seasons in Finland. 2016. http:\/\/en.ilmatieteenlaitos.fi\/seasons-in-finland (accessed 5 Jun 2016)."},{"key":"2025121512480259000_7.3.e013161.21","first-page":"i","article-title":"Report of a WHO consultation","volume":"894","author":"Obesity: preventing and managing the global epidemic","year":"2000","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2025121512480259000_7.3.e013161.22","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"2025121512480259000_7.3.e013161.23","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601765"},{"key":"2025121512480259000_7.3.e013161.24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038607"},{"key":"2025121512480259000_7.3.e013161.25","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-535"},{"key":"2025121512480259000_7.3.e013161.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.013"},{"key":"2025121512480259000_7.3.e013161.27","doi-asserted-by":"crossref","first-page":"253","DOI":"10.3109\/07853890.2015.1020860","article-title":"Determinants of serum 25(OH)D concentration in young and middle-aged adults. The Cardiovascular Risk in Young Finns Study","volume":"47","author":"Voipio","year":"2015","journal-title":"Ann Med"},{"key":"2025121512480259000_7.3.e013161.28","doi-asserted-by":"crossref","first-page":"e100235","DOI":"10.1371\/journal.pone.0100235","article-title":"Association of serum 25-hydroxyvitamin D with lifestyle factors and metabolic and cardiovascular disease markers: population-based cross-sectional study (FIN-D2D)","volume":"9","author":"Miettinen","year":"2014","journal-title":"PLoS ONE"},{"key":"2025121512480259000_7.3.e013161.29","unstructured":"Statistics of Finland, National Institute for Health and Welfare. Obesity. 2016. http:\/\/findikaattori.fi\/en\/62 (accessed 13 October 2016)."},{"key":"2025121512480259000_7.3.e013161.30","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1093\/ajcn\/85.3.860","article-title":"Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors","volume":"85","author":"Hypponen","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"2025121512480259000_7.3.e013161.31","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2516"},{"key":"2025121512480259000_7.3.e013161.32","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-012-0354-0"},{"key":"2025121512480259000_7.3.e013161.33","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s12020-015-0641-7","article-title":"Longitudinal associations between lifestyle and vitamin D: a general population study with repeated vitamin D measurements","volume":"51","author":"Skaaby","year":"2016","journal-title":"Endocrine"},{"key":"2025121512480259000_7.3.e013161.34","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3389\/fphys.2014.00228","article-title":"Vitamin D and adipose tissue-more than storage","volume":"5","author":"Mutt","year":"2014","journal-title":"Front Physiol"},{"key":"2025121512480259000_7.3.e013161.35","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-014-0755-z"},{"key":"2025121512480259000_7.3.e013161.36","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1998.10718760"},{"key":"2025121512480259000_7.3.e013161.37","doi-asserted-by":"publisher","DOI":"10.3390\/nu5093470"},{"key":"2025121512480259000_7.3.e013161.38","doi-asserted-by":"publisher","DOI":"10.3945\/jn.108.096180"},{"key":"2025121512480259000_7.3.e013161.39","doi-asserted-by":"publisher","DOI":"10.1042\/bj2470073"},{"key":"2025121512480259000_7.3.e013161.40","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.031070"},{"key":"2025121512480259000_7.3.e013161.41","doi-asserted-by":"crossref","unstructured":"Nordic Council of Ministers. Nordic nutrition recommendations 2012. Integrating nutrition and physical activity, 5th edn. Copenhagen: Nordic Council of Ministers, 2014.","DOI":"10.26530\/OAPEN_483279"},{"key":"2025121512480259000_7.3.e013161.42","doi-asserted-by":"crossref","first-page":"e0153611","DOI":"10.1371\/journal.pone.0153611","article-title":"Serum 25-hydroxyvitamin D status and longitudinal changes in weight and waist circumference: influence of genetic predisposition to adiposity","volume":"11","author":"Larsen","year":"2016","journal-title":"PLoS ONE"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:48:11Z","timestamp":1765831691000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3,6]]},"published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1136\/bmjopen-2016-013161"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013161","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}