Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney

Known determinants of vitamin D status (measured in serum as 25(OH)D nmol/L) are exposure to sunlight and intake of vitamin D, either from foods or vitamin supplements. Recently, low vitamin D status in East Asian Australian immigrants has been reported. Thus the aim of this study was to investigate associations with vitamin D status in East Asian Australian immigrant women. In this cross-sectional study of women (n = 152 aged 18-92), 25(OH)D levels were measured from serum samples (radio-immuno assay). Demographics, sun exposure patterns, dietary intake and acculturation factors were obtained by questionnaire. In spring, 53% of the study population had serum 25(OH)D levels <50 nmol/L (deficiency); whereas in summer only 19% were deficient. Associations with vitamin D deficiency were younger age, higher education, more sun protection behavior, fewer minutes of sun exposure on weekends, low vitamin D and calcium intake through foods or supplements and less acculturation to Australian lifestyle. After multivariate adjustment, those who had no intake of vitamin D supplements (OR = 5.6, CI = 1.4-22), less sunlight exposure on weekends (OR = 2.7, CI = 1.0-7.3) and lower acculturation to Australian lifestyle (OR = 2.5, CI = 1.0-6.3) had increased risk of being deficient in vitamin D. Thus there is a need for vitamin D education in this "at-risk" population. This article is part of a Special Issue entitled 'Vitamin D Workshop'.