Obesity in older adults with vitamin D deficit: a systematic review and meta-analysis
Keywords:
obesity, waist circumference, body mass index, vitamin D, systematic review.Abstract
Introduction: Obesity and vitamin D deficiency are alterations that are present in the elderly, but their association is not yet clear.Objective: To carry out a systematic review with meta-analysis to determine the association between obesity and vitamin D deficiency.
Methods: Systematic review of observational studies. The search was performed in Pubmed/Medline, SCOPUS, Web of Science, Cochrane Library and EMBASE. Obesity was measured through body mass index and abdominal waist, and vitamin D deficiency by 25-hydroxy-vitamin D. Data were combined using a random effects model and association measures were calculated through the odds ratio (OR). Heterogeneity was measured according to chi squared.
Results: Five studies were included (n=17 700). An association was found between vitamin D and obesity according to body mass index (OR= 1.36; 95 % CI: 1.04-1.77) and according to abdominal waist (OR= 1.74; 95 % CI: 1.26-2.40). The heterogeneity of effects between studies was moderate to high.
Conclusions: An association was found between the presence of obesity and vitamin D deficiency in the elderly population.
Downloads
Download data is not yet available.
References
1. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019; 92:6-10. DOI 10.1016/j.metabol.2018.09.005
2. Donini LM, Rosano A, Di Lazzaro L, Lubrano C, Carbonelli M, Pinto A, et al. Impact of Disability, Psychological Status, and Comorbidity on Health-Related Quality of Life Perceived by Subjects with Obesity. Obes Facts. 2020;13(2):191-200. DOI:10.1159/000506079
3. Kalish VB. Obesity in Older Adults. Prim Care. 2016;43(1):137-44. DOI: 10.1016/j.pop.2015.10.002
4. Ding L, Liang Y, Tan ECK, Hu Y, Zhang C, Liu Y, et al. Smoking, heavy drinking, physical inactivity, and obesity among middle-aged and older adults in China: cross-sectional findings from the baseline survey of CHARLS 2011-2012. BMC Public Health. 2020;20(1):1062. DOI: 10.1186/s12889-020-08625-5
5. Instituto Nacional de Salud. Ministerio de Salud. Alimentación y Nutrición. Vigilancia del Estado Nutricional en Población. [acceso: 16/09/2021]. Disponible en: http://web.ins.gob.pe/es/alimentacion-y-nutricion/vigilancia-alimentaria-y-nutricional/vigilancia-del-estado-nutricional-en-poblacion
6. Cetin DC, Nasr G. Obesity in the elderly: more complicated than you think. Cleve Clin J Med. 2014; 81(1):51-61. DOI: 10.3949/ccjm.81a.12165
7. Jensen GL. Obesity and functional decline: epidemiology and geriatric consequences. Clin Geriatr Med. 2005; 21(4):677-87. DOI: 10.1016/j.cger.2005.06.007
8. Shapiro H, Pecht T, Shaco-Levy R, Harman-Boehm I, Kirshtein B, Kuperman Y, et al. Adipose tissue foam cells are present in human obesity. J Clin Endocrinol Metab. 2013; 98(3):1173-81. DOI: 10.1210/jc.2012-2745
9. Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol. 2019; 181(5):907-15. DOI: 10.1111/bjd.17980
10. Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014; 111(1):23-45. DOI: 10.1017/S0007114513001840
11. van Schoor N, Lips P. Global Overview of Vitamin D Status. Endocrinol Metab Clin North Am. 2017; 46(4):845-70. DOI: 10.1016/j.ecl.2017.07.002
12. Marcos-Pérez D, Sánchez-Flores M, Proietti S, Bonassi S, Costa S, Teixeira JP, et al. Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(8):E2286. DOI: 10.3390/nu12082286
13. Segheto KJ, Pereira M, Silva DCG da, Carvalho CJ de, Massardi FR, Kakehasi AM, et al. Vitamin D and bone health in adults: a systematic review and meta-analysis. Cien Saude Colet. 2021; 26(8):3221-44. DOI: 10.1590/1413-81232021268.15012020
14. Lucato P, Solmi M, Maggi S, Bertocco A, Bano G, Trevisan C, et al. Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis. Maturitas. 2017; 100:8-15. DOI: 10.1016/j.maturitas.2017.02.016
15. Okereke OI, Singh A. The role of vitamin D in the prevention of late-life depression. J Affect Disord. 2016; 198:1-14. DOI: 10.1016/j.jad.2016.03.022
16. Yang J, Ou-Yang J, Huang J. Low serum vitamin D levels increase the mortality of cardiovascular disease in older adults: A dose-response meta-analysis of prospective studies. Medicine (Baltimore). 2019; 98(34): e16733. DOI:10.1097/MD.0000000000016733
17. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016 [acceso: 16/09/2021]; 22(7 Suppl):s176-185.. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27356115/
18. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. DOI: 10.1371/journal.pmed.1000097
19. Modesti PA, Reboldi G, Cappuccio FP, Agyemang C, Remuzzi G, Rapi S, et al. Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis. PLOS ONE. 2016; 11(1):e0147601. DOI: 10.1371/journal.pone.0147601
20. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186
21. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022. [acceso: 27/11/2021]. Disponible en: https://training.cochrane.org/handbook
22. Zhu X-L, Chen Z-H, Li Y, Yang P-T, Liu L, Wu L-X, et al. Associations of vitamin D with novel and traditional anthropometric indices according to age and sex: a cross-sectional study in central southern China. Eat Weight Disord. 2020; 25(6):1651-61. DOI: 10.1007/s40519-019-00803-8
23. Cheng Q, Du Y, Hong W, Tang W, Li H, Chen M, et al. Factors associated to serum 25-hydroxyvitamin D levels among older adult populations in urban and suburban communities in Shanghai, China. BMC Geriatr. 2017; 17(1):246. DOI: 10.1186/s12877-017-0632-z
24. Orces C, Lorenzo C, Guarneros JE. The Prevalence and Determinants of Vitamin D Inadequacy among U.S. Older Adults: National Health and Nutrition Examination Survey 2007-2014. Cureus. 2019; 11(8):e5300. DOI:10.7759/cureus.5300
25. Orces CH, López Gavilánez E. Determinants of vitamin D supplementation among older adults and its effect on 25(OH)D levels according to bone mineral density status. Nutr Hosp. 2020;37(1):28-36. DOI: 10.20960/nh.02917
26. Sousa-Santos AR, Afonso C, Santos A, Borges N, Moreira P, Padrão P, et al. The association between 25(OH)D levels, frailty status and obesity indices in older adults. PLoS One. 2018; 13(8):e0198650. DOI: 10.1371/journal.pone.0198650
27. Mathus-Vliegen EM. Obesity and the Elderly. Journal of Clinical Gastroenterology. 2012; 46(7):533-44. DOI: 10.1097/MCG.0b013e31825692ce
28. Gažarová M, Galšneiderová M, Mečiarová L. Obesity diagnosis and mortality risk based on a body shape index (ABSI) and other indices and anthropometric parameters in university students. Rocz Panstw Zakl Hig. 2019; 70(3):267-75. DOI: 10.32394/rpzh.2019.0077
29. Vieth R, Holick MF. Chapter 57B - The IOM-Endocrine Society Controversy on Recommended Vitamin D Targets: In Support of the Endocrine Society Position. En: Feldman D, editor. Vitamin D (Fourth Edition). Academic Press; 2018. p109:107. DOI: 10.1016/B978-0-12-809965-0.00059-8
30. Graham L. IOM Releases Report on Dietary Refernce Intakes for Calcium and Vitamin D. AFP. 2011 [acceso: 27/11/2021]; 83(11):1352. Disponible en: http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx
31. Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev. 2000 [acceso: 27/11/2021]; 28(4):165-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11064850/
32. Valentini A, Perrone MA, Cianfarani MA, Tarantino U, Massoud R, Merra G, et al. Obesity, vitamin D status and physical activity: 1,25(OH)2D as a potential marker of vitamin D deficiency in obese subjects. Panminerva Med. 2020; 62(2):83-92. DOI: 10.23736/S0031-0808.20.03770-2
33. González-Molero I, Rojo-Martínez G, Morcillo S, Gutierrez C, Rubio E, Pérez-Valero V, et al. Hypovitaminosis D and incidence of obesity: a prospective study. Eur J Clin Nutr. 2013; 67(6):680-2. DOI: 10.1038/ejcn.2013.48
34. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72(3):690-3. DOI: 10.1093/ajcn/72.3.690
35. Agarwal S, Tooze JA, Bauer DC, Cauley JA, Harris TB, Koster A, et al. Association between 25-Hydroxyvitamin D and Metabolic Syndrome in Older Adults: The Health, Aging and Body Composition Study. Int J Endocrinol. 2021; 2021: 6671823. DOI: 10.1155/2021/6671823
36. Awad AB, Alappat L, Valerio M. Vitamin d and metabolic syndrome risk factors: evidence and mechanisms. Crit Rev Food Sci Nutr. 2012; 52(2):103-12. DOI: 10.1080/10408391003785458
37. Drincic AT, Armas LAG, Van Diest EE, Heaney RP. Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring). 2012; 20(7):1444-8. DOI: 10.1038/oby.2011.404
38. Shi H, Norman AW, Okamura WH, Sen A, Zemel MB. 1alpha,25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via nongenomic action. FASEB J. 2001; 15(14):2751-3. DOI: 10.1096/fj.01-0584fje
39. Pereira M, Ribas de Farias Costa P, Miranda Pereira E, Russoni de Lima Lago I, Marlucia Oliveira A. Does vitamin D deficiency increase the risk of obesity in adults and the elderly? A systematic review of prospective cohort studies. Public Health. 2021; 190:123-31 DOI: 10.1016/j.puhe.2020.04.031
2. Donini LM, Rosano A, Di Lazzaro L, Lubrano C, Carbonelli M, Pinto A, et al. Impact of Disability, Psychological Status, and Comorbidity on Health-Related Quality of Life Perceived by Subjects with Obesity. Obes Facts. 2020;13(2):191-200. DOI:10.1159/000506079
3. Kalish VB. Obesity in Older Adults. Prim Care. 2016;43(1):137-44. DOI: 10.1016/j.pop.2015.10.002
4. Ding L, Liang Y, Tan ECK, Hu Y, Zhang C, Liu Y, et al. Smoking, heavy drinking, physical inactivity, and obesity among middle-aged and older adults in China: cross-sectional findings from the baseline survey of CHARLS 2011-2012. BMC Public Health. 2020;20(1):1062. DOI: 10.1186/s12889-020-08625-5
5. Instituto Nacional de Salud. Ministerio de Salud. Alimentación y Nutrición. Vigilancia del Estado Nutricional en Población. [acceso: 16/09/2021]. Disponible en: http://web.ins.gob.pe/es/alimentacion-y-nutricion/vigilancia-alimentaria-y-nutricional/vigilancia-del-estado-nutricional-en-poblacion
6. Cetin DC, Nasr G. Obesity in the elderly: more complicated than you think. Cleve Clin J Med. 2014; 81(1):51-61. DOI: 10.3949/ccjm.81a.12165
7. Jensen GL. Obesity and functional decline: epidemiology and geriatric consequences. Clin Geriatr Med. 2005; 21(4):677-87. DOI: 10.1016/j.cger.2005.06.007
8. Shapiro H, Pecht T, Shaco-Levy R, Harman-Boehm I, Kirshtein B, Kuperman Y, et al. Adipose tissue foam cells are present in human obesity. J Clin Endocrinol Metab. 2013; 98(3):1173-81. DOI: 10.1210/jc.2012-2745
9. Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol. 2019; 181(5):907-15. DOI: 10.1111/bjd.17980
10. Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014; 111(1):23-45. DOI: 10.1017/S0007114513001840
11. van Schoor N, Lips P. Global Overview of Vitamin D Status. Endocrinol Metab Clin North Am. 2017; 46(4):845-70. DOI: 10.1016/j.ecl.2017.07.002
12. Marcos-Pérez D, Sánchez-Flores M, Proietti S, Bonassi S, Costa S, Teixeira JP, et al. Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(8):E2286. DOI: 10.3390/nu12082286
13. Segheto KJ, Pereira M, Silva DCG da, Carvalho CJ de, Massardi FR, Kakehasi AM, et al. Vitamin D and bone health in adults: a systematic review and meta-analysis. Cien Saude Colet. 2021; 26(8):3221-44. DOI: 10.1590/1413-81232021268.15012020
14. Lucato P, Solmi M, Maggi S, Bertocco A, Bano G, Trevisan C, et al. Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis. Maturitas. 2017; 100:8-15. DOI: 10.1016/j.maturitas.2017.02.016
15. Okereke OI, Singh A. The role of vitamin D in the prevention of late-life depression. J Affect Disord. 2016; 198:1-14. DOI: 10.1016/j.jad.2016.03.022
16. Yang J, Ou-Yang J, Huang J. Low serum vitamin D levels increase the mortality of cardiovascular disease in older adults: A dose-response meta-analysis of prospective studies. Medicine (Baltimore). 2019; 98(34): e16733. DOI:10.1097/MD.0000000000016733
17. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016 [acceso: 16/09/2021]; 22(7 Suppl):s176-185.. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27356115/
18. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. DOI: 10.1371/journal.pmed.1000097
19. Modesti PA, Reboldi G, Cappuccio FP, Agyemang C, Remuzzi G, Rapi S, et al. Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis. PLOS ONE. 2016; 11(1):e0147601. DOI: 10.1371/journal.pone.0147601
20. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186
21. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022. [acceso: 27/11/2021]. Disponible en: https://training.cochrane.org/handbook
22. Zhu X-L, Chen Z-H, Li Y, Yang P-T, Liu L, Wu L-X, et al. Associations of vitamin D with novel and traditional anthropometric indices according to age and sex: a cross-sectional study in central southern China. Eat Weight Disord. 2020; 25(6):1651-61. DOI: 10.1007/s40519-019-00803-8
23. Cheng Q, Du Y, Hong W, Tang W, Li H, Chen M, et al. Factors associated to serum 25-hydroxyvitamin D levels among older adult populations in urban and suburban communities in Shanghai, China. BMC Geriatr. 2017; 17(1):246. DOI: 10.1186/s12877-017-0632-z
24. Orces C, Lorenzo C, Guarneros JE. The Prevalence and Determinants of Vitamin D Inadequacy among U.S. Older Adults: National Health and Nutrition Examination Survey 2007-2014. Cureus. 2019; 11(8):e5300. DOI:10.7759/cureus.5300
25. Orces CH, López Gavilánez E. Determinants of vitamin D supplementation among older adults and its effect on 25(OH)D levels according to bone mineral density status. Nutr Hosp. 2020;37(1):28-36. DOI: 10.20960/nh.02917
26. Sousa-Santos AR, Afonso C, Santos A, Borges N, Moreira P, Padrão P, et al. The association between 25(OH)D levels, frailty status and obesity indices in older adults. PLoS One. 2018; 13(8):e0198650. DOI: 10.1371/journal.pone.0198650
27. Mathus-Vliegen EM. Obesity and the Elderly. Journal of Clinical Gastroenterology. 2012; 46(7):533-44. DOI: 10.1097/MCG.0b013e31825692ce
28. Gažarová M, Galšneiderová M, Mečiarová L. Obesity diagnosis and mortality risk based on a body shape index (ABSI) and other indices and anthropometric parameters in university students. Rocz Panstw Zakl Hig. 2019; 70(3):267-75. DOI: 10.32394/rpzh.2019.0077
29. Vieth R, Holick MF. Chapter 57B - The IOM-Endocrine Society Controversy on Recommended Vitamin D Targets: In Support of the Endocrine Society Position. En: Feldman D, editor. Vitamin D (Fourth Edition). Academic Press; 2018. p109:107. DOI: 10.1016/B978-0-12-809965-0.00059-8
30. Graham L. IOM Releases Report on Dietary Refernce Intakes for Calcium and Vitamin D. AFP. 2011 [acceso: 27/11/2021]; 83(11):1352. Disponible en: http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx
31. Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev. 2000 [acceso: 27/11/2021]; 28(4):165-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11064850/
32. Valentini A, Perrone MA, Cianfarani MA, Tarantino U, Massoud R, Merra G, et al. Obesity, vitamin D status and physical activity: 1,25(OH)2D as a potential marker of vitamin D deficiency in obese subjects. Panminerva Med. 2020; 62(2):83-92. DOI: 10.23736/S0031-0808.20.03770-2
33. González-Molero I, Rojo-Martínez G, Morcillo S, Gutierrez C, Rubio E, Pérez-Valero V, et al. Hypovitaminosis D and incidence of obesity: a prospective study. Eur J Clin Nutr. 2013; 67(6):680-2. DOI: 10.1038/ejcn.2013.48
34. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72(3):690-3. DOI: 10.1093/ajcn/72.3.690
35. Agarwal S, Tooze JA, Bauer DC, Cauley JA, Harris TB, Koster A, et al. Association between 25-Hydroxyvitamin D and Metabolic Syndrome in Older Adults: The Health, Aging and Body Composition Study. Int J Endocrinol. 2021; 2021: 6671823. DOI: 10.1155/2021/6671823
36. Awad AB, Alappat L, Valerio M. Vitamin d and metabolic syndrome risk factors: evidence and mechanisms. Crit Rev Food Sci Nutr. 2012; 52(2):103-12. DOI: 10.1080/10408391003785458
37. Drincic AT, Armas LAG, Van Diest EE, Heaney RP. Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring). 2012; 20(7):1444-8. DOI: 10.1038/oby.2011.404
38. Shi H, Norman AW, Okamura WH, Sen A, Zemel MB. 1alpha,25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via nongenomic action. FASEB J. 2001; 15(14):2751-3. DOI: 10.1096/fj.01-0584fje
39. Pereira M, Ribas de Farias Costa P, Miranda Pereira E, Russoni de Lima Lago I, Marlucia Oliveira A. Does vitamin D deficiency increase the risk of obesity in adults and the elderly? A systematic review of prospective cohort studies. Public Health. 2021; 190:123-31 DOI: 10.1016/j.puhe.2020.04.031
Published
2022-11-06
How to Cite
1.
Rodas Alvarado L, Vera-Ponce VJ, Torres-Malca JR, Talavera JE, Zuzunaga-Montoya FE, De La Cruz-Vargas JA. Obesity in older adults with vitamin D deficit: a systematic review and meta-analysis. Rev Cubana Med Milit [Internet]. 2022 Nov. 6 [cited 2025 Apr. 17];51(4):e02202096. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2096
Issue
Section
Research Article
License
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
