The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use

Background: The 2011 Dietary Reference Intakes (DRIs) for vitamin D use 25-hydroxyvitamin D [25(OH) D] concentrations to define vitamin D deficiency (<30 nmol/L), the Estimated Average Requirement (40 nmol/L), and the Recommended Dietary Allowance (RDA; 50 nmol/L). The Canadian population has not yet been assessed according to these recommendations. Objective: We determined the prevalence of meeting DRI recommendations and the role of vitamin D supplement use among Canadians aged 6-79 y. Design: Plasma 25(OH) D from a representative sample of Canadians in the Canadian Health Measures Survey-Cycle 1 (n = 5306) were used. Supplement use was assessed by household interview. Concentrations of 25(OH) D were compared in supplement users and nonusers by season and race. Results: Overall, 5.4%, 12.7%, and 25.7% of the participants had 25(OH) D concentrations below the 30-, 40-, and 50-nmol/ L cutoffs, respectively. In white Canadians, plasma 25(OH) D concentrations ranged from an undetectable percentage with concentrations <30 nmol/L in summer to 24.5% with concentrations <50 nmol/L in winter; the corresponding values ranged from 12.5% to 53.1% in nonwhite Canadians. Supplement users had significantly higher 25(OH) D concentrations than did nonusers, and no seasonal differences were found. In nonsupplement users, the prevalence of 25(OH) D concentrations <50 nmol/L in winter was 37.2% overall and was 60.7% in nonwhites. Conclusions: One-quarter of Canadians did not meet the RDA, but the use of vitamin D supplements contributed to a better 25(OH) D status. Nonwhite Canadians had the highest risk of not achieving DRI recommendations. More than one-third of Canadians not using supplements did not meet the RDA in winter. This suggests that current food choices alone are insufficient to maintain 25(OH) D concentrations of 50 nmol/L in many Canadians, especially in winter. Am J Clin Nutr 2011;94:128-35.