title: Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study.
abstract: BACKGROUND
  Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study).
  
  
  METHODS
  Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry.
  The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public healthVitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared to healthy controls. Early adulthood is a critical time in young woman's lives as their independence, behaviours and lifestyle choices are established. These choices made as a young adult lay down the foundation for future health trajectories for not only for themselves but also for their potential partners and families. Addressing vitamin D deficiency, poor bone health and mental ill-health at a younger age may ultimately improve their wellbeing, productivity and long-term health outcomes. This study is of particular significance as the interplay between vitamin D, depression and bone health is currently uncertain and such knowledge is crucial for understanding, prevention and treatment of these conditions.
authors.affiliation: Department of Medicine, Royal Melbourne Hospital, University of Melbourne , Parkville.
authors.forename: Emma T
authors.initials: ET
authors.lastname: Callegari
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne , Parkville.
authors.forename: Nicola
authors.initials: N
authors.lastname: Reavley
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.affiliation: Melbourne EpiCentre, Royal Melbourne Hospital, University of Melbourne , Parkville.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gorelik
authors.affiliation: Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville; Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Wark
keywords: Vitamin D; bone mineral density; depression; dual energy x-ray absorptiometry; osteoporosis