{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:26:48Z","timestamp":1791664008848,"version":"4.3.4"},"reference-count":588,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) &lt;50\u2009nmol\/L or 20\u2009ng\/mL) is common in Europe and the Middle East. It occurs in &lt;20% of the population in Northern Europe, in 30\u201360% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D &lt;30\u2009nmol\/L or 12\u2009ng\/mL) is found in &gt;10% of Europeans. The European Calcified Tissue Society (ECTS) advises that the measurement of serum 25(OH)D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defects and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non-Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficiency, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer.<\/jats:p>","DOI":"10.1530\/eje-18-0736","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T12:02:01Z","timestamp":1549368121000},"page":"P23-P54","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":591,"title":["Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society"],"prefix":"10.1093","volume":"180","author":[{"given":"Paul","family":"Lips","sequence":"first","affiliation":[{"name":"1Endocrine Section, Department of Internal Medicine, Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D","family":"Cashman","sequence":"additional","affiliation":[{"name":"2Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Lamberg-Allardt","sequence":"additional","affiliation":[{"name":"3Calcium Research Unit, Department of Food and Nutritional Sciences, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike Annette","family":"Bischoff-Ferrari","sequence":"additional","affiliation":[{"name":"4Department of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Obermayer-Pietsch","sequence":"additional","affiliation":[{"name":"5Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Bianchi","sequence":"additional","affiliation":[{"name":"6Bone Metabolism Unit, Istituto Auxologico Italiano IRCCS, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Stepan","sequence":"additional","affiliation":[{"name":"7Institute of Rheumatology, Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada","family":"El-Hajj Fuleihan","sequence":"additional","affiliation":[{"name":"8Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, 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