title: The vitamin D status of prison inmates.
abstract: BACKGROUND
  There is no comprehensive, systematic analysis of the vitamin D status of prisoners in the scientific literature.
  
  
  OBJECTIVE
  To investigate the vitamin D status and its determinants in US prison inmates.
  
  
  OBJECTIVE
  Given the uniformity of dietary intake amongst inmates, vitamin D status will be determined by non-dietary factors such as skin pigmentation, security level-, and the duration of incarceration.
  
  
  METHODS
  A retrospective study of 526 inmates (males, n=502, age 48.6 ± 12.5 years; females, n=24, age 44.1 ± 12.2) in Massachusetts prisons. Vitamin D sufficiency, insufficiency, and deficiency were respectively defined as a 25(OH)D concentration 75 nmol/L; 50 to 75 nmol/L; and <50 nmol/L. The Massachusetts Department of Correction Statement of Nutritional Adequacy stated that each inmate received the recommended daily allowance of vitamin D daily. Security level of incarceration was designated as minimum, medium, and maximum. Racial groups were categorized as Black, white, Asian, and Others.
  
  
  RESULTS
  Serum 25(OH)D levels peaked in summer and autumn, and decreased in winter and spring. Vitamin D deficiency occurred in 50.5% of blacks, 29.3% of whites, and 14.3% of Asian inmates (p=0.007). Black inmates had significantly lower serum 25(OH)D level than white inmates at the maximum security level (p=0.015), medium security level (p=0.001), but not at the minimum security level (p=0.40). After adjusting for covariates black inmates at a maximum security level had a four-fold higher risk for vitamin D deficiency than white inmates at the same security level (OR 3.9 [95% CI 1.3-11.7].
  
  
  CONCLUSIONS
  The vitamin D status of prison inmates is determined by skin pigmentation, seasons, and the security level of incarceration.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Benjamin Udoka
authors.initials: BU
authors.lastname: Nwosu
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Louise
authors.initials: L
authors.lastname: Maranda
authors.affiliation: Department of Correction, Massachusetts Partnership for Correctional Healthcare, Norton, Massachusetts, United States of America.
authors.forename: Rosalie
authors.initials: R
authors.lastname: Berry
authors.affiliation: Department of Correction, Massachusetts Partnership for Correctional Healthcare, Norton, Massachusetts, United States of America.
authors.forename: Barbara
authors.initials: B
authors.lastname: Colocino
authors.affiliation: Department of Correction, Massachusetts Partnership for Correctional Healthcare, Norton, Massachusetts, United States of America.
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Flores
authors.affiliation: Department of Correction, Massachusetts Partnership for Correctional Healthcare, Norton, Massachusetts, United States of America.
authors.forename: Kerry
authors.initials: K
authors.lastname: Folkman
authors.affiliation: Department of Family and Community Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Thomas
authors.initials: T
authors.lastname: Groblewski
authors.affiliation: Department of Family and Community Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ruze
mesh_terms: D044383:Black People; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D011329:Prisoners; D012621:Seasons; D012637:Security Measures; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood; D044465:White People; D001741:Black or African American
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D