Skip to main content Accessibility help

Predictors of decline in vitamin D status in middle-aged and elderly individuals: a 5-year follow-up study

  • Kazutoshi Nakamura (a1), Kaori Kitamura (a1), Yumi Watanabe (a1), Toshiko Saito (a2), Akemi Takahashi (a3), Ryosaku Kobayashi (a3), Rieko Oshiki (a3), Keiko Kabasawa (a4), Ribeka Takachi (a5), Shoichiro Tsugane (a6), Masayuki Iki (a7), Ayako Sasaki (a8) and Kei Watanabe (a9)...


Little is known about predictors of decline in vitamin D status (vitamin D decline) over time. We aimed to determine demographic and lifestyle variables associated with vitamin D decline by sufficiently controlling for seasonal effects of vitamin D uptake in a middle-aged to elderly population. Using a longitudinal study design within the larger framework of the Murakami Cohort Study, we examined 1044 individuals aged between 40 and 74 years, who provided blood samples at baseline and at 5-year follow-up, the latter of which were taken on a date near the baseline examination (±14 d). Blood 25-hydroxyvitamin D (25(OH)D) concentrations were determined with the Liaison® 25OH Vitamin D Total Assay. A self-administered questionnaire collected demographic, body size and lifestyle information. Vitamin D decline was defined as the lowest tertile of 5-year changes in blood 25(OH)D (Δ25(OH)D) concentration (<6·7 nmol/l). Proportions of those with vitamin D decline were 182/438 (41·6 %) in men and 166/606 (27·4 %) in women (P < 0·0001). In men, risk of vitamin D decline was significantly lower in those with an outdoor occupation (P = 0·0099) and those with the highest quartile of metabolic equivalent score (OR 0·34; 95 % CI 0·14, 0·83), and higher in those with ‘university or higher’ levels of education (OR 2·92; 95 % CI 1·04, 8·19). In women, risk of vitamin D decline tended to be lower with higher levels of vitamin D intake (Pfor trend = 0·0651) and green tea consumption (Pfor trend = 0·0025). Predictors of vitamin D decline differ by sex, suggesting that a sex-dependent intervention may help to maintain long-term vitamin D levels.


Corresponding author

*Corresponding author: Kazutoshi Nakamura, fax +81 25-227-0764, email


Hide All
1.Ebeling, PR & Eisman, JA (2011). Vitamin D and osteoporosis. In Vitamin D, vol. 2, 3rd ed., pp. 11291142 [Feldman, D, Pike, JW and Adams, JS, editors]. Boston, MA: Elsevier Academic Press.
2.Berridge, MJ (2017) Vitamin D deficiency accelerates ageing and age-related diseases: a novel hypothesis. J Physiol 595, 68256836.
3.Mondul, AM, Weinstein, SJ, Layne, TM, et al. (2017) Vitamin D and cancer risk and mortality: state of the science, gaps, and challenges. Epidemiol Rev 39, 2848.
4.Budhathoki, S, Hidaka, A, Yamaji, T, et al. (2018) Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort. BMJ 360, k671.
5.Zhang, R, Li, B, Gao, X, et al. (2017) Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: dose–response meta-analysis of prospective studies. Am J Clin Nutr 105, 810819.
6.Lucato, P, Solmi, M, Maggi, S, et al. (2017) Low vitamin D levels increase the risk of type 2 diabetes in older adults: a systematic review and meta-analysis. Maturitas 100, 815.
7.Aspell, N, Laird, E, Healy, M, et al. (2019) The prevalence and determinants of vitamin D status in community-dwelling older adults: results from the English Longitudinal Study of Ageing (ELSA). Nutrients 11, 1253.
8.Carvalho, AC, Santos, NC, Portugal-Nunes, C, et al. (2019) 25-OH Vitamin D levels and cognitive performance: longitudinal assessment in a healthy aging cohort. Front Aging Neurosci 11, 330.
9.Nakamura, K, Kitamura, K, Takachi, R, et al. (2015) Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 74, 10–7.
10.Skaaby, T, Husemoen, LL, Thuesen, BH, et al. (2016) Longitudinal associations between lifestyle and vitamin D: a general population study with repeated vitamin D measurements. Endocrine 51, 342350.
11.Mirfakhraee, S, Ayers, CR, McGuire, DK, et al. (2017) Longitudinal changes in serum 25-hydroxyvitamin D in the Dallas Heart Study. Clin Endocrinol 87, 242248.
12.Yoshimura, N, Muraki, S, Oka, H, et al. (2015) Factors affecting changes in the serum levels of 25-hydroxyvitamin D: a 3-year follow-up of the ROAD study. Osteoporos Int 26, 2597–605.
13.van Schoor, NM, Knol, DL, et al. (2014) Longitudinal changes and seasonal variations in serum 25-hydroxyvitamin D levels in different age groups: results of the Longitudinal Aging Study Amsterdam. Osteoporos Int 25, 14831491.
14.Nakamura, K, Takachi, R, Kitamura, K, et al. (2018) The Murakami Cohort Study of vitamin D for the prevention of musculoskeletal and other age-related diseases: a study protocol. Environ Health Prev Med 23, 28.
15.Matsuo, S, Imai, E, Horio, M, et al. (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53, 982992.
16.Fujii, H, Yamamoto, S, Takeda-Imai, F, et al. (2011) Validity and applicability of a simple questionnaire for the estimation of total and domain-specific physical activity. Diabetol Int 2, 4754.
17.Yokoyama, Y, Takachi, R, Ishihara, J, et al. (2016) Validity of short and long self-administered food frequency questionnaires in ranking dietary intake in middle-aged and elderly Japanese in the Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Protocol Area. J Epidemiol 26, 420432.
18.Lee, MJ, Hsu, HJ, Wu, IW, et al. (2019) Vitamin D deficiency in northern Taiwan: a community-based cohort study. BMC Public Health 19, 337.
19.Nakamura, K, Nashimoto, M, Okuda, Y, et al. (2002) Fish as a major source of vitamin D in the Japanese diet. Nutrition 18, 415416.
20.Nakamura, K (2006) Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis. J Bone Miner Metab 24, 16.
21.Cabrera, C, Artacho, R & Giménez, R (2006) Beneficial effects of green tea--a review. J Am Coll Nutr 25, 7999.


Related content

Powered by UNSILO
Type Description Title
Supplementary materials

Nakamura et al. supplementary material
Tables S1-S2

 Word (16 KB)
16 KB

Predictors of decline in vitamin D status in middle-aged and elderly individuals: a 5-year follow-up study

  • Kazutoshi Nakamura (a1), Kaori Kitamura (a1), Yumi Watanabe (a1), Toshiko Saito (a2), Akemi Takahashi (a3), Ryosaku Kobayashi (a3), Rieko Oshiki (a3), Keiko Kabasawa (a4), Ribeka Takachi (a5), Shoichiro Tsugane (a6), Masayuki Iki (a7), Ayako Sasaki (a8) and Kei Watanabe (a9)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.