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      The relationship between weight change history and 25(OH)D concentrations in adults Translated title: La relación entre la historia del cambio ponderal y las concentraciones de 25(OH)D en los adultos

      research-article
      Nutrición Hospitalaria
      Grupo Arán
      Cambio ponderal, Vitamina D, Peso máximo, NHANES, Weight change, Vitamin D, Maximum weight, NHANES

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          Abstract

          Abstract Background: although obesity has been consistently associated with lower 25-OH hydroxyvitamin D-25(OH)D-levels, little is known about the effect of weight change on serum 25(OH)D levels. Methods: the present analysis was based on data from the National Health and Nutrition Examination Survey. Percent weight changes were calculated from participant-reported maximum lifetime weight and weight in the past year and 10 years ago. Subsequently, general linear models adjusted for potential confounders were assembled to examine 25(OH)D concentrations across percent weight change categories. Results: a total of 6,237 participants with a mean age of 57.5 (SE, 0.2) years comprised the study sample. After adjustment for potential confounders, subjects who have gained weight ≥ 5 % in the past year and 10 years before had on average 4.5 and 5.1 nmol/L lower 25(OH)D levels than those with a stable weight, respectively. Moreover, this association persisted even among participants with adequate vitamin D intake. Notably, subjects who lost weight > 5 % from their maximum reported weight had significantly higher 25(OH)D levels than those who did not. Conclusion: subjects with a stable weight and those who lost weight ≥ 5% from their maximum reported lifetime weight had significantly higher 25(OH)D concentrations than those who did not. Thus, maintaining a healthy weight over time may be an effective strategy to reach optimal serum 25(OH)D levels.

          Translated abstract

          Resumen Antecedentes: aunque la obesidad se ha asociado consistentemente con niveles más bajos de 25-OH-vitamina D (25(OH)D), poco se sabe sobre el efecto del cambio de peso en los niveles de 25(OH)D. Métodos: el presente análisis se basó en datos de la Encuesta Nacional de Examen de Salud y Nutrición. Los cambios porcentuales en el peso se calcularon a partir del peso medido actual y el peso máximo reportado, peso en el último año, y hace 10 años. Se usaron modelos lineales generales ajustados por posibles cofactores para examinar las concentraciones de 25(OH)D de acuerdo con el porcentaje de cambio ponderal. Resultados: un total de 6.237 participantes con una edad promedio de 57,5 años constituyen la muestra del estudio. Los sujetos que aumentaron de peso ≥ 5 % en el año anterior y en los 10 años previos tuvieron en promedio 4,5 y 5,1 nmol/L menos de 25(OH)D que aquellos con peso estable, respectivamente. Además, esta asociación persistió incluso entre los participantes con una ingesta adecuada de vitamina D. Por el contrario, los sujetos que perdieron ≥ 5 % de su peso máximo reportado tuvieron niveles más altos de 25(OH)D comparados con aquellos que no perdieron peso. Conclusión: los sujetos con un peso estable y aquellos que perdieron ≥ 5 % de su peso máximo reportado tuvieron concentraciones significativamente más altas de 25(OH)D frente a aquellos que aumentaron de peso. Por lo tanto, mantener un peso saludable con el tiempo puede ser una estrategia eficaz para alcanzar niveles óptimos de 25(OH)D.

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          Most cited references25

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          Decreased bioavailability of vitamin D in obesity.

          Obesity is associated with vitamin D insufficiency and secondary hyperparathyroidism. This study assessed whether obesity alters the cutaneous production of vitamin D(3) (cholecalciferol) or the intestinal absorption of vitamin D(2) (ergocalciferol). Healthy, white, obese [body mass index (BMI; in kg/m(2)) > or = 30] and matched lean control subjects (BMI
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            Body fat content and 25-hydroxyvitamin D levels in healthy women.

            Obesity is associated with alterations in the vitamin D endocrine system. Lower levels of serum 25-hydroxyvitamin D (25-OHD) in morbidly obese individuals may be secondary to an alteration in tissue distribution resulting from an increase in adipose mass. Therefore, morbidly obese individuals are expected to need higher doses of vitamin D supplementation than the general population. However, it is still unknown whether adiposity (or percentage body fat) should be taken into consideration while assessing vitamin D requirements in the general population. To study the relationship between 25-OHD levels and percentage body fat content in healthy women, we studied 410 healthy women between 20 and 80 yr of age with body mass index ranging from 17 to 30 kg/m2. We analyzed the correlation between serum 25-OHD level and percentage body fat measured by dual energy x-ray absorptiometry. We also analyzed the influence of season, dietary vitamin D intake, age, and race on this relationship. The levels of serum 25-OHD inversely correlated with percentage body fat. The correlation was -0.13 (P = 0.013) after adjusting for race, age, season, and dietary vitamin D intake. In a multiple stepwise regression, race and season were found to have a major influence on serum 25-OHD (cumulative R2 = 0.34), and percentage body fat, although modest (additional R2 = 0.02), also had an independent statistically significant influence on serum 25-OHD levels. We conclude, percentage body fat content is inversely related to the serum 25-OHD levels in healthy women.
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              Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity.

              Vitamin D status is known to be poor in obese individuals; there is no consensus as to the reason. Cross-sectional study of the relation between serum 25-hydroxyvitamin D (25(OH)D) concentration and body size in the baseline data from unsupplemented adults entering two study cohorts in our research unit, N = 686. Regression analyses of body size variables against serum 25(OH)D concentration, using both linear and hyperbolic models. The fit to a hyperbolic model of 25(OH)D against body weight completely removed the obesity-related component of inter-individual variability in serum 25(OH)D concentration. The hyperbolic fit using total body weight was significantly better than any linear model, and specifically better than any using BMI. Dilution of ingested or cutaneously synthesized vitamin D in the large fat mass of obese patients fully explains their typically low vitamin D status. There is no evidence for sequestration of supplemental or endogenous cholecalciferol. Vitamin D replacement therapy needs to be adjusted for body size if desired serum 25(OH)D concentrations are to be achieved.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                October 2020
                : 37
                : 5
                : 970-976
                Affiliations
                [1] Laredo Texas orgnameLaredo Medical Center orgdiv1Department of Medicine USA
                Article
                S0212-16112020000700013 S0212-1611(20)03700500013
                10.20960/nh.03133
                8989c913-fc5e-4350-a405-b2c765330f79

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 27 June 2020
                : 27 April 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Papers

                Weight change,Vitamin D,NHANES,Maximum weight,Cambio ponderal,Vitamina D,Peso máximo

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