{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:28:54Z","timestamp":1790836134609,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["201440_Z_16_Z"],"award-info":[{"award-number":["201440_Z_16_Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["205039\/Z\/16\/Z"],"award-info":[{"award-number":["205039\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,12,22]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>No recent large studies have described the distribution of vitamin D status in the UK. Understanding the epidemiology of vitamin D deficiency is important to inform targeted public health recommendations. This study aimed to investigate the distribution of factors associated with serum vitamin D status in a large national cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The UK Biobank, a prospective cohort study following the health and well-being of middle-aged and older adults recruited between 2006 and 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 449 943 participants aged 40\u201369 years with measured serum vitamin D status were eligible for the analysis. Participants completed a questionnaire about sex, age, ethnic background, vitamin D supplementation, smoking, drinking and socioeconomic status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We investigated the distribution of serum vitamin D status and the association between demographic factors and vitamin D deficiency or insufficiency. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level &lt;25 nmol\/L. Multivariable logistic regression was used to assess the association between demographic factors and vitamin D status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Asian (n=4297\/8000, 53.7%) and black (n=2459\/7046, 34.9%) participants had a higher proportion of vitamin D deficiency than white participants (n=50 920\/422 907, 12%). During spring and winter, the proportion of vitamin D deficiency was higher across the UK and higher in the north than in the south. Male sex, abnormal body mass index, non-white ethnic backgrounds, smoking and being more socioeconomically deprived were associated with higher odds of vitamin D deficiency. Increasing age, taking vitamin D supplements and drinking alcohol were associated with lower odds of deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vitamin D status varied among different ethnic groups and by season and geographical area within the UK. Taking supplements was associated with a lower risk of vitamin D deficiency. These findings support the vitamin D supplementation recommendations of Public Health England.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038503","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T13:55:13Z","timestamp":1609941313000},"page":"e038503","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Distribution of vitamin D status in the UK: a cross-sectional analysis of UK Biobank"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4720-6738","authenticated-orcid":false,"given":"Liang-Yu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-7441","authenticated-orcid":false,"given":"Sinead","family":"Langan","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-3180","authenticated-orcid":false,"given":"Charlotte","family":"Warren-Gash","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"key":"2025120601072478000_11.1.e038503.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070553"},{"key":"2025120601072478000_11.1.e038503.2","unstructured":"Public Health England . PHE publishes new advice on vitamin D, 2016. Available: https:\/\/www.gov.uk\/government\/news\/phe-publishes-new-advice-on-vitamin-d [Accessed 05 October 2020]."},{"key":"2025120601072478000_11.1.e038503.3","doi-asserted-by":"crossref","DOI":"10.3390\/nu10111656","article-title":"Vitamin D: nutrient, hormone, and immunomodulator","volume":"10","author":"Sassi","year":"2018","journal-title":"Nutrients"},{"key":"2025120601072478000_11.1.e038503.4","doi-asserted-by":"crossref","unstructured":"Mann EH , Pfeffer PE , Hawrylowicz CM . Chapter 104 - Vitamin D and Adaptive Immunology in Health and Disease. In: Feldman D , ed. Vitamin D. Fourth Edition. Academic Press, 2018: 937\u201349.","DOI":"10.1016\/B978-0-12-809963-6.00104-8"},{"key":"2025120601072478000_11.1.e038503.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6583"},{"key":"2025120601072478000_11.1.e038503.6","unstructured":"The Scientific Advisory Committee on Nutrition . Vitamin D and health: public health England 2016."},{"key":"2025120601072478000_11.1.e038503.7","unstructured":"Royal Osteoporosis Society . Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management.. In: . 10. 2 ed. Royal Osteoporosis Society, 2018."},{"key":"2025120601072478000_11.1.e038503.8","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.3.860"},{"key":"2025120601072478000_11.1.e038503.9","unstructured":"Public Health England . National Diet and Nutrition Survey Results from Years 1, 2, 3 and 4 (combined) of the Rolling Programme (2008\/2009 \u2013 2011\/2012). In: Bates B , Lennox A , Prentice A , eds. National Diet and Nutrition Survey (NDNS). Public Health England, 2017."},{"key":"2025120601072478000_11.1.e038503.10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779"},{"key":"2025120601072478000_11.1.e038503.11","unstructured":"UK Biobank . Uk Biobank biomarker panel 2015."},{"key":"2025120601072478000_11.1.e038503.12","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx246"},{"key":"2025120601072478000_11.1.e038503.13","unstructured":"UK Biobank . Index of multiple deprivation scores 2018."},{"key":"2025120601072478000_11.1.e038503.14","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym276"},{"key":"2025120601072478000_11.1.e038503.15","unstructured":"CDC . CDC vitamin D Standardization-Certification program (CDC VDSCP) 2020."},{"key":"2025120601072478000_11.1.e038503.16","unstructured":"UK Biobank . Biomarker assay quality procedures: approaches used to minimise systematic and random errors. 1.2 ed, 2019."},{"key":"2025120601072478000_11.1.e038503.17","unstructured":"UK Biobank . 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