Dejavniki preskrbljenosti odraslih prebivalcev Slovenije z vitaminom D

Hribar, Maša (author), Žmitek, Katja (mentor)

Vitamin D (VitD) je ključen za normalno delovanje telesa, sodeluje pri metabolizmu kalcija in fosforja ter je povezan z dejavniki tveganja za nastanek različnih bolezni. Endogena sinteza VitD v koži ob izpostavitvi ultravijoličnim žarkom tipa B je ključna, medtem ko postane v odsotnosti endogene sinteze glavni vir prehranski vnos. Le malo živil naravno vsebuje VitD, a še tam se pogosto nahaja v manjših koncentracijah. Prehranski vir VitD so tudi živila, obogatena z VitD, in prehranska dopolnila. Cilj doktorskega dela je bil na osnovi serumskih koncentracij 25-hidroksivitamina D (25(OH)D) oceniti preskrbljenost in dejavnike preskrbljenosti z VitD v Sloveniji. Sistematični pregled literature je pokazal visoko razširjenost pomanjkanja, sploh v zimskem času. Nacionalno reprezentativna raziskava Nutrihealth pa je potrdila zaskrbljujoče rezultate. V obdobju podaljšane zime je bilo pomanjkanje ugotovljeno pri 81,6 % odraslih in 78,8 % starejših odraslih, hudo pomanjkanje pri 40,8 % odraslih in 34,6 % starejših odraslih. Dodatno smo preučevali dejavnike, ki vplivajo na preskrbljenost z VitD. Pozimi je bila razširjenost pomanjkanja VitD pogostejša pri tistih z indeksom telesne mase (ITM) nad 30 in tistih s svetlejšo konstitutivno obarvanostjo kože, medtem ko je bila poleti podoptimalna preskrbljenost pogostejša pri tistih z ITM nad 30, tistih s svetlejšo konstitutivno obarvanostjo kože, nižjim prehranskim vnosom VitD, ter tistih ki se pokrivajo z oblačili z namenom zaščite kože pred soncem. Poleg tega je sistematični pregled literature prehranskega vnosa VitD razkril nizke vnose pri vseh populacijah. V sistematični pregled je bila vključena tudi nacionalno reprezentativna raziskava, v sklopu katere je bil vnos VitD 2,7 µg pri mladostnikih, 2,9 µg pri odraslih in 2,5 µg pri starejših odraslih. V okviru doktorskega dela smo ugotovili zaskrbljujočo nizko preskrbljenost z VitD, kar je posledica vpliva različnih dejavnikov, med katerimi izstopajo ITM, konstitutivna obarvanost kože in prehranski vnos. Pomanjkanje VitD pomeni velik javnozdravstveni problem, ki zahteva sistematičen pristop na več nivojih. Pomembno je zasnovati politike in javnozdravstvene ukrepe, ki bodo omejili razširjenost pomanjkanja VitD v Sloveniji.

• Language: Slovenian
• Keywords: vitamin D, preskrbljenost z vitaminom D, prehranski vnos, 25-hidroksivitamin D, dejavniki preskrbljenosti z vitaminom D
• Work type: Doctoral dissertation
• Typology: 2.08 - Doctoral Dissertation
• Organization: BF - Biotechnical Faculty
• Publisher: [M. Hribar]
• Year: 2024
• PID: 20.500.12556/RUL-158941
• UDC: 613.2:612.392.015.6:577.161.2
• COBISS.SI-ID: 199834371
• Publication date in RUL: 23.06.2024

Secondary language

• Language: English
• Title: Parameters influencing vitamin D status in the adult Slovenian population

Abstract

Vitamin D (VitD) is essential for the normal functioning of the body, as it participates in the metabolism of calcium and phosphorus, and the lack of it is associated with risk factors for developing various diseases. Endogenous synthesis of VitD in the skin—which happens upon exposure to ultraviolet B radiation—is a primary source of VitD, while in the absence of this process, the crucial source becomes dietary intake. Only a few foods naturally contain VitD, and even those often contain in smaller quantities. Therefore, fortified foods and dietary supplements can be an important source of VitD. The aim of the doctoral thesis was to assess the VitD status and factors influencing VitD status in Slovenia. A systematic literature review revealed a high prevalence of low VitD status, particularly during the wintertime. The nationally representative Nutrihealth study confirmed alarming results. During an extended winter period, insufficiency was observed in 81.6% of adults and 78.8% of older adults, while deficiency was observed in 40.8% of adults and 34.6% of older adults. Additionally, factors influencing VitD status were investigated. The Nutri-D study has indicated a higher prevalence of deficiency in winter among individuals with higher a body mass index and a lighter constitutive skin color. In contrast, suboptimal levels during summertime were more common in those with a higher body mass index, lighter constitutive skin color, lower dietary VitD intake, and those protecting themselves from the sun with clothing. Furthermore, a systematic review of the dietary VitD intake revealed low intakes across all populations. The SI.Menu research study which was included in the systematic review, reported VitD intake of 2.7 µg in adolescents, 2.9 µg in adults, and 2.5 µg in older adults. In the scope of the doctoral thesis, we identified highly prevalent low VitD status, which was influenced by various factors, especially body mass index, constitutive skin color, and dietary intake. VitD deficiency is a major public health risk, that requires a systematic approach on multiple levels. It is of the utmost importance to design conductive policies and take rigorous public health measures at both individual and national levels to reduce the prevalence of VitD deficiency in Slovenia.

• Keywords: vitamin D, vitamin D status, dietary intake, 25-hydroxyvitamin D, parameters of vitamin D status