No Relationship Between Serum 25(OH) Vitamin D Concentrations and Perceptions of Vitamin D Dietary Intake Adequacy in US and German Adults Not Using Dietary Supplements

  • Regan L. BaileyEmail author
  • Sowmyanarayanan V. Thuppal
  • Katherine D. Sherif
  • Nigel Denby
  • Suzanne R. Steinbaum
  • Bryan Haycock
  • Alexandra E. Cowan
  • Jared R. Nieters
  • Clemens von Schacky


Vitamin D plays an important role in bone health, but dietary intakes are below recommendations. The purpose of this cross-sectional study was to compare perceptions of dietary vitamin adequacy with the biomarker of vitamin D exposure [25(OH)D] in two populations with (USA) and without (Germany) fortification among adults not using dietary supplements (n = 200). US adults were more racially diverse and younger, but did not differ with regard to educational attainment, income, UV exposure, or BMI. Mean concentrations were lower, and the prevalence of inadequacy (<20 ng/mL) and suboptimal (<30 ng/mL) 25(OH)D was higher in Germany (23 ng/mL; 70%; 82%) than in the USA (28 ng/mL; 17%; 36%), respectively. Most adults rated vitamin D as important for bone health; but, fewer Germans (22%) than US adults (50%) perceived their diet as adequate. Mean 25(OH)D concentrations and risk of vitamin D inadequacy did not differ by perceptions of dietary adequacy, ratings of a balanced diet, knowledge of vitamin D food sources, or by rankings of importance of vitamin D for health. Fortification with vitamin D in the USA may explain the higher 25(OH) concentrations as UV exposure, and BMI did not differ. Perceptions and knowledge of vitamin D were not related to status in either group.


Vitamin D Biomarker Diet Diet perceptions Serum 25(OH)D 


Author Contributions

RLB, CvS, KDS, ND, SRS, and BH conceived and designed the study; SVT and CvS performed all study procedures; SVT and AEC analyzed the data; RLB, SVT, and AEC wrote the paper. JN and AEC reviewed and edited the paper and prepared data presentation. All authors read and approved the final version of the manuscript.

Funding/Financial Disclosures

The study was supported through an unrestricted educational grant provided by Reckitt Benckiser, Parsippany, New Jersey, administered by Tonic LLC. The sponsors had no role in the study design, data collection, statistical analyses, interpretation of data, writing of the manuscript, or in the decision to publish the results.

Conflicts of Interest

SVT received postdoctoral training salary support as part of the grant that funded this project. CvS consults for Huntsworth Medical and BASF and received speaker’s honoraria from DSM. None of the other authors have any conflicts of interest to disclose.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Regan L. Bailey
    • 1
    Email author
  • Sowmyanarayanan V. Thuppal
    • 1
  • Katherine D. Sherif
    • 2
  • Nigel Denby
    • 3
  • Suzanne R. Steinbaum
    • 4
  • Bryan Haycock
    • 5
  • Alexandra E. Cowan
    • 1
  • Jared R. Nieters
    • 6
  • Clemens von Schacky
    • 7
  1. 1.Department of Nutrition SciencePurdue UniversityWest LafayetteUSA
  2. 2.Jefferson Women’s Primary CarePhiladelphiaUSA
  3. 3.Grub4Life and People Matter TVLondonUK
  4. 4.Women and Heart Disease CenterNew YorkUSA
  5. 5.Department of Nutrition and Integrative PhysiologyUniversity of UtahSalt Lake CityUSA
  6. 6.Mapleworks, LLCAmissvilleUSA
  7. 7.University of MunichMunichGermany

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