{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:00:17Z","timestamp":1787029217678,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T00:00:00Z","timestamp":1519689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["1R01NS075308"],"award-info":[{"award-number":["1R01NS075308"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Multiple sclerosis (MS) incidence and serum 25-hydroxyvitamin D (25OHD) levels vary by race\/ethnicity. We examined the consistency of beneficial effects of 25OHD and\/or sun exposure for MS risk across multiple racial\/ethnic groups. We recruited incident MS cases and controls (blacks 116 cases\/131 controls; Hispanics 183\/197; whites 247\/267) from the membership of Kaiser Permanente Southern California into the MS Sunshine Study to simultaneously examine sun exposure and 25OHD, accounting for genetic ancestry and other factors. Higher lifetime ultraviolet radiation exposure (a rigorous measure of sun exposure) was associated with a lower risk of MS independent of serum 25OHD levels in blacks (adjusted OR = 0.53, 95% CI = 0.31\u20130.83; p = 0.007) and whites (OR = 0.68, 95% CI = 0.48\u20130.94; p = 0.020) with a similar magnitude of effect that did not reach statistical significance in Hispanics (OR = 0.66, 95% CI = 0.42\u20131.04; p = 0.071). Higher serum 25OHD levels were associated with a lower risk of MS only in whites. No association was found in Hispanics or blacks regardless of how 25OHD was modeled. Lifetime sun exposure appears to reduce the risk of MS regardless of race\/ethnicity. In contrast, serum 25OHD levels are not associated with MS risk in blacks or Hispanics. Our findings challenge the biological plausibility of vitamin D deficiency as causal for MS and call into question the targeting of specific serum 25OHD levels to achieve health benefits, particularly in blacks and Hispanics.<\/jats:p>","DOI":"10.3390\/nu10030268","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T14:18:08Z","timestamp":1519741088000},"page":"268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["MS Sunshine Study: Sun Exposure But Not Vitamin D Is Associated with Multiple Sclerosis Risk in Blacks and Hispanics"],"prefix":"10.3390","volume":"10","author":[{"given":"Annette","family":"Langer-Gould","sequence":"first","affiliation":[{"name":"Los Angeles Medical Center, Department of Neurology, Southern California Permanente Medical Group, 100 S Los Robles, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-3541","authenticated-orcid":false,"given":"Robyn","family":"Lucas","sequence":"additional","affiliation":[{"name":"College of Medicine, Biology &amp; Environment, Australian National University, Canberra, ACT 2000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anny","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edlin","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Haraszti","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"},{"name":"Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Quach","sequence":"additional","affiliation":[{"name":"QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720-7356, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Barcellos","sequence":"additional","affiliation":[{"name":"QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720-7356, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2832","DOI":"10.1001\/jama.296.23.2832","article-title":"Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis","volume":"296","author":"Munger","year":"2006","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1212\/WNL.0b013e31820af93d","article-title":"Sun exposure and vitamin D are independent risk factors for cns demyelination","volume":"76","author":"Lucas","year":"2011","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1212\/WNL.0b013e3182752ea8","article-title":"Vitamin D as a protective factor in multiple sclerosis","volume":"79","author":"Salzer","year":"2012","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1055\/s-0036-1579693","article-title":"Epidemiology of multiple sclerosis: From risk factors to prevention-an update","volume":"36","author":"Ascherio","year":"2016","journal-title":"Semin. 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