title: Sun Exposure Guidelines and Serum Vitamin D Status in Denmark: The StatusD Study.
abstract: Little is known on how vitamin D status is affected by adherence to UVB-limiting sun exposure guidelines. Our aim was to investigate the relationship between adherence to the Danish sun exposure guidelines and vitamin D status. In total, 3194 Danes (2625 adults, 569 children) were recruited among the general population, and more than 92% had blood samples taken both autumn and spring. Using linear regression, we associated serum vitamin D concentrations to questionnaire responses on: seeking shade, wearing a sunhat, wearing protective clothing or using sunscreen. The odds ratio (OR) of either low (<25 or 50 nmol/L) or adequate/high (≥50 nmol/L) vitamin D status was examined using logistic regression. For adults, those who always sought shade or wore protective clothing compared to those who did not had lower levels of vitamin D (autumn concentrations for shade: 7.2 nmol/L lower (-11.0--3.6 nmol/L); for protective clothing: 9.9 nmol/L lower (-13.6--6.2 nmol/L). Adherence to all four guidelines was also associated with lower vitamin D concentrations (autumn: 9.7 nmol/L lower (-14.3--5.1 nmol/L). Use of sunscreen was associated with adequate vitamin D status, as those who always sought shade compared to those who did not had an OR (95% CI) of 1.68 (1.25-2.35) of having ≥50 nmol/L during both spring and autumn. No associations were found with wearing a sunhat, and there were no clear associations for children. In conclusion, adherence to the sun exposure guidelines on shade and protective clothing was associated with lower vitamin D status among Danish adults, but not children.
authors.affiliation: Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark. louhan@cancer.dk.
authors.forename: Louise
authors.initials: L
authors.lastname: Hansen
authors.affiliation: Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark. annet@cancer.dk.
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: Department of Prevention and Information, Danish Cancer Society, Copenhagen DK-2100, Denmark. brk@cancer.dk.
authors.forename: Brian
authors.initials: B
authors.lastname: Køster
authors.affiliation: Danish Health Authority, Health Promotion, Copenhagen DK-2300, Denmark. chb@sst.DK.
authors.forename: Christine
authors.initials: C
authors.lastname: Brot
authors.affiliation: Technical University of Denmark, National Food Institute, Division for Diet, Disease Prevention and Toxicology, Research Group for Risk-Benefit, Søborg DK-2860, Denmark. rian@food.dtu.dk.
authors.forename: Rikke
authors.initials: R
authors.lastname: Andersen
authors.affiliation: Statens Serum Institute, Department of Congenital Disorders, Danish Centre for Neonatal Screening, Copenhagen DK-2300, Denmark. mlq@ssi.dk.
authors.forename: Marika
authors.initials: M
authors.lastname: Lundqvist
authors.affiliation: Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark. jane@cancer.dk.
authors.forename: Jane
authors.initials: J
authors.lastname: Christensen
authors.affiliation: Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen DK-2100, Denmark. anja@cancer.dk.
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013472:Sunlight; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: StatusD; skin cancer; sun exposure guidelines; vitamin D