Sue Lanham New

Susan Lanham-New


Head of the Department of Nutritional Sciences
PhD; Registered Public Health Nutritionist (RPHNutr)
Personal assistant: Elise Frost-Bridges
+44 (0)1483 686920

My qualifications

2014 to present
FAfN Fellow of the Association for Nutrition
2013 to present
FRSB Fellow of the Royal Society of Biology 
1996 to present
RNutr (Registered Nutritionist) 
1996
PhD Nutrition and Metabolic Bone Disease
University of Aberdeen
1989
MSc Human Nutrition and Metabolism
University of Aberdeen
1987
BA (Commendation)  Sports Studies
Council for National Academic Awards (CNAA)

Affiliations and memberships

Trustee, British Nutrition Foundation
2019- present
Honorary Secretary, Nutrition Society
2017 - present
Governor, British Nutrition Foundation
2015 - 2019
Editorial Board, Osteoporosis Review
2006 - present
Member, British Nutrition Foundation (BNF) Scientific Committee
1998 - 2019
Member, Royal Osteoporosis Society (NOS) Nutrition Scientific Committee
1998 - present
Member - Nutrition Society Publications Committee as Editor-in-Chief of NS Textbooks
2008 - present
University of Surrey Committee’s, HoDs; Health & Safety; Athena Swan; Teaching and Research Committees; Surrey Sports Park Academic Committee
2010 – present
Member of SACN’s Potassium-Based Salts Working Group
2015 – 2018
Member of SACN’s Vitamin D Working Group
2010 - 2016
Member: Scientific Advisory Committee on Nutrition (SACN)
2009 – present

Research projects

Research collaborations

My teaching

Supervision

Postgraduate research supervision

Completed postgraduate research projects I have supervised

My publications

Publications

Canaj R, Wilson LR, Lanham-New SA, Tripkovic L (2012) Association between dietary vitamin D and bone health in Caucasian and South Asian women aged 20-64 years: baseline preliminary results of the D2-D3 study, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E216-E216 CAMBRIDGE UNIV PRESS
Tripkovic L, Wilson L, Hart K, Lanham-New S (2012) Reply to HM Macdonald et al, American Journal of Clinical Nutrition 96 (5) pp. 1153-1154
Hussein KS, Al Kadi HA, Lanham-New SA, Ardawi MSM (2012) Prevalence of vitamin D deficiency in pre- and postmenopausal Saudi women- A cross sectional study, BONE 50 pp. S138-S138 ELSEVIER SCIENCE INC
Lanham-New SA (2010) Acid-Base Homeostasis and the Skeleton: An Update on Current Thinking, NUTRITIONAL INFLUENCES ON BONE HEALTH pp. 167-171 SPRINGER-VERLAG BERLIN
Darling AL, Lee PA, Hanjra FK, Osborn A, Patel S, Duckworth A, Cardew P, Gray R, Berry JL, Lanham-New (2009) POOR VITAMIN D STATUS IS ASSOCIATED WITH A DETRIMENTAL EFFECT ON
MUSCULOSKELETAL HEALTH: RESULTS OF THE D-FINES STUDY,
McArthur AJ, Lanham-New SA, Davey T, Fallowfield JL (2014) Fruit and vegetable intake in Royal Naval Personnel: Effects of deployment at sea and associations with body composition and net endogenous acid production, PROCEEDINGS OF THE NUTRITION SOCIETY 73 (OCE1) pp. E10-E10 CAMBRIDGE UNIV PRESS
Darling AL, Hakim OA, Horton K, Gibbs MA, Cui L, Berry JL, Lanham-New SA, Hart KH (2013) Adaptations in tibial cortical thickness and total volumetric bone density in postmenopausal South Asian women with small bone size., Bone 55 (1) pp. 36-43
There is some evidence that South Asian women may have an increased risk of osteoporosis compared with Caucasian women, although whether South Asians are at increased risk of fracture is not clear. It is unknown whether older South Asian women differ from Caucasian women in bone geometry. This is the first study, to the authors' knowledge, to use peripheral Quantitative Computed Tomography (pQCT) to measure radial and tibial bone geometry in postmenopausal South Asian women. In comparison to Caucasian women, Asian women had smaller bone size at the 4% (-18% p
Alyahya K, Almazeed Z, Morgan JB, Berry J, Lanham-New SA, Lee WTK (2007) Low vitamin D status and poor eating habits among Kuwaiti adolescent females: a public health concern for optimisation of bone health, PROCEEDINGS OF THE NUTRITION SOCIETY 66 pp. 27A-27A CAMBRIDGE UNIV PRESS
Darling AL, Gossiel F, Hannon R, Eastell R, Lanham-New SA (2010) Preliminary evidence for menopausal but not ethnic or seasonal differences in bone resorption as measured by serum C-telopeptide: Early results of the D-FINES study,
Aim: Bone turnover is a well studied phenomenon, however it is still unclear as to whether bone shows a season driven rhythm over the course of the year, particularly in ethnic groups. Some studies have found a significant seasonal variation in bone resorption markers but others have not. This study aimed to establish if bone turnover shows significant seasonal variation as this has practical implications in terms of the use of bone markers in diagnostics. Method: The D-FINES study (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England) investigated 373 Surrey Caucasian (C) and Asian (A) women every season over a 12 month period (2006-2007). A random sub-sample of premenopausal C (n 18) and postmenopausal C (n 17); premenopausal A (n 13) and postmenopausal A (n 17) with blood samples for all seasons were selected. Serum C-telopeptide (sCTX) was determined by electrochemiluminescent immunoassay on a cobas e411 automated analyser (Roche Diagnostics).

Results: As shown in the Figure above, a mixed between-within subjects ANOVA showed there was no significant main effect of season F(3,59.0)=1.467, p=0.233. However, there was a significant between subjects effect of group F(3,61)=3.099, p=0.033, with post hoc tests showing significant differences between the two C groups (p=0.007) and between the postmenopausal A and premenopausal C groups (p=0.042) but no significant differences between the other groups. Last, there was no significant interaction between season and group F(9,143.741)=0.540, p=0.843. The lower sCTX in the younger premenopausal groups is as would be expected. However, unexpectedly, there was a non-significant trend in the postmenopausal groups for the A women to have a lower mean sCTX than the C women. In contrast, in the premenopausal women, the sCTX was lower in the C group. Therefore it appears that it is menopausal status, not ethnicity which is likely the main reason for the group differences. Indeed, there was no significant difference between ethnic groups of the same menopausal status. Conclusions: Overall, no evidence for a seasonal variation in bone resorption was found here but there was evidence for a menopausal difference in bone resorption. However, numbers of participants in this preliminary analysis was small, and the trend for an ethnic difference in the postmenopausal women might be statistically significant with higher subject numbers. Further analysis with a larger sample is planned.

Wynn E, Lanham-New SA, Krieg M-A, Whittamore DR, Burckhardt P (2008) Low estimates of dietary acid load are positively associated with bone ultrasound in women older than 75 years of age with a lifetime fracture, JOURNAL OF NUTRITION 138 (7) pp. 1349-1354 AMER SOC NUTRITIONAL SCIENCE
Macdonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern?, Osteoporos Int 22 (9) pp. 2461-2472
We assessed sunlight and dietary contributions to vitamin D status in British postmenopausal women. Our true longitudinal 25-hydroxyvitamin D (25(OH)D) measurements varied seasonally, being lower in the north compared to the south and lower in Asian women. Sunlight exposure in summer and spring provided 80% total annual intake of vitamin D.
Salim A, Lanham-New SA, Hakim OA (2012) Serum 25-Hydroxyvitamin D concentrations in relation to dietary fat intake and body fat concentration in Caucasian and Asian women, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E243-E243 CAMBRIDGE UNIV PRESS
Lanham-New SA (2011) Preface, Sport and Exercise Nutrition
Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, Chope G, Hyppönen E, Berry J, Vieth R, Lanham-New S (2012) Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis., Am J Clin Nutr 95 (6) pp. 1357-1364
BACKGROUND: Currently, there is a lack of clarity in the literature as to whether there is a definitive difference between the effects of vitamins D2 and D3 in the raising of serum 25-hydroxyvitamin D [25(OH)D]. OBJECTIVE: The objective of this article was to report a systematic review and meta-analysis of randomized controlled trials (RCTs) that have directly compared the effects of vitamin D2 and vitamin D3 on serum 25(OH)D concentrations in humans. DESIGN: The ISI Web of Knowledge (January 1966 to July 2011) database was searched electronically for all relevant studies in adults that directly compared vitamin D3 with vitamin D2. The Cochrane Clinical Trials Registry, International Standard Randomized Controlled Trials Number register, and clinicaltrials.gov were also searched for any unpublished trials. RESULTS: A meta-analysis of RCTs indicated that supplementation with vitamin D3 had a significant and positive effect in the raising of serum 25(OH)D concentrations compared with the effect of vitamin D2 (P = 0.001). When the frequency of dosage administration was compared, there was a significant response for vitamin D3 when given as a bolus dose (P = 0.0002) compared with administration of vitamin D2, but the effect was lost with daily supplementation. CONCLUSIONS: This meta-analysis indicates that vitamin D3 is more efficacious at raising serum 25(OH)D concentrations than is vitamin D2, and thus vitamin D3) could potentially become the preferred choice for supplementation. However, additional research is required to examine the metabolic pathways involved in oral and intramuscular administration of vitamin D and the effects across age, sex, and ethnicity, which this review was unable to verify.
Khojah SO, Khan JA, Balamesh KS, Berry JL, Gibbs M, Lanham-New SA, Dehlawi FMA (2013) Extensive hypovitaminosis D in partly veiled Saudi Arabian premenopausal and postmenopausal women: Influence on bone health, Life Science Journal 10 (4) pp. 3159-3166
The link between vitamin D and bone health is well established. However, little is known about the bone health, vitamin D status, and lifestyle characteristics of women living in Saudi Arabia. To characterize: i) bone health indices; ii) vitamin D status; iii) potential influential of sunlight exposure and physical activity level. A total of 100 premenopausal aged 20-30 years and 112 postmenopausal aged 45-60 years were included. Bone mineral density was determined at the lumbar spine and femoral neck. Serum levels of 25-hydroxyvitamin D, intact parathyroid hormone, and ionized calcium and phosphorus were measured. The subjects interviewed about their physical activity levels and lifestyle. Using the WHO criteria, 37% of the premenopausal and 52% of the postmenopausal were osteopenic at the lumbar spine. Vitamin D deficiency was highly prevalent in Saudi women, with 98% of women being below the IOM recommended level of 50nmol/L. There was a significant correlation between duration of sunlight exposure (min/day) and axial BMD and calcaneal bone mass in partly veiled women. These data indicate that younger and older Saudi Arabian women had poor bone health and that their vitamin D status and lifestyle factors do not promote skeletal integrity. © 2013. Marsland Press, Zhengzhou University.
Darling AL, Gossiel F, Hannon R, Eastell R, Lanham-New SA (2010) PRELIMINARY EVIDENCE FOR MENOPAUSAL BUT NOT ETHNIC OR SEASONAL DIFFERENCES IN BONE RESORPTION AS MEASURED BY SERUM C-TELOPEPTIDE IN THE D-FINES STUDY,
This study aimed to establish if bone turnover shows significant seasonal variation, and if this varies by ethnicity. The D-FINES study investigated 373 Surrey Caucasian (C) and Asian (A) women every season over a 12 month period (2006-2007). A random sub-sample of premenopausal C (n 18) and postmenopausal C (n 17); premenopausal A (n 13) and postmenopausal A (n 17) with blood samples for all seasons were selected. Serum C-telopeptide (sCTX) was determined by electrochemiluminescent immunoassay (Roche Diagnostics).

A mixed between-within subjects ANOVA showed there was no significant main effect of season on sCTX F(3,59.0)=1.467, p=0.233. However, there was a significant between subjects effect of group F(3,61)=3.099, p=0.033, with post hoc tests showing significant differences between the two C groups (p=0.007) and postmenopausal A and premenopausal C groups (p=0.042) but no significant differences between the other groups. Last, there was no significant interaction between season and group F(9,143.741)=0.540, p=0.843. It appears that it is menopausal status, not ethnicity which is likely the main reason for the group differences. Indeed, there was no significant difference between ethnic groups of the same menopausal status. Overall, no evidence for a seasonal variation in bone resorption was found here but there was evidence for a menopausal difference in bone resorption.

Darling AL, Hakim OA, Horton K, Gibbs MA, Cui L, Berry JL, Lanham-New SA, Hart KH (2012) Associations between vitamin D status and radial bone geometry in older South Asian and Caucasian women, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E230-E230 CAMBRIDGE UNIV PRESS
Smith TJ, Tripkovic L, Damsgaard, C, Mølgaard C, Ritz C, Wilson-Barnes SL, Dowling K, Hennessy A, Cashman K, Kiely M, Lanham-New SA, Hart KH (2016) Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 years: a dose-response, double-blind, randomized placebo-controlled trial, The American Journal of Clinical Nutrition 104 (5) 138065 pp. 1301-1309 American Society for Nutrition
Background Adolescents are a population group at high risk of low vitamin D status, yet the evidence base for establishing dietary vitamin D requirements to ensure adequacy remains weak. Objective To establish the distribution of vitamin D intakes required to maintain serum 25- hydroxyvitamin D [25(OH)D] concentrations above proposed cut-offs (25, 30, 40 and 50 nmol/L) during the winter-time in white males and females (14-18 years) in the UK (51o 9 N). Design In a dose-response trial, 110 adolescents (age 15.9 ± 1.4 years; 43% male) were randomizedto receive daily 0, 10 or 20 µg vitamin D3 supplements for 20 weeks during the winter-time. A non-linear regression model was fit to the total vitamin D intake (diet plus supplemental) and post-intervention serum 25(OH)D concentrations, and regression predicted values were used to estimate the vitamin D intakes required to maintain serum 25(OH)D concentrations above specific cut-offs. Results Mean (± SD) serum 25(OH)D concentrations increased from 49.2 ± 12.0 to 56.6 ± 12.4 nmol/L and from 51.7 ± 13.4 to 63.9 ± 10.6 nmol/L in the 10 and 20 µg/day groups respectively, and decreased in the placebo group from 46.8 ± 11.4 to 30.7 ± 8.6 nmol/L (all p d 0.001). Vitamin D intakes required to maintain post-intervention 25(OH)D concentrations > 25 and > 30 nmol/L in 97.5% of adolescents were estimated as 10.1 and 13.1 µg/day respectively, and 6.6 µg/day to maintain 50% of adolescents > 40 nmol/L. As the response of 25(OH)D plateaued at 46 nmol/L, there is uncertainty in estimating the vitamin D intake required to maintain 25(OH)D > 50 nmol/L in 97.5% of adolescents, but it did exceed 30 µg/day Conclusions Vitamin D intakes of between 10 and ~30 µg/day are required by white adolescents during the winter-time in order to maintain serum 25(OH)D concentrations > 25 ? 50 nmol/L, depending on the serum 25(OH)D threshold chosen.
Darling AL, Hart KH, Gibbs MA, Gossiel F, Kantermann T, Horton K, Johnsen S, Berry JL, Skene DJ, Eastell R, Vieth R, Lanham-New SA (2014) Greater seasonal cycling of 25-hydroxyvitamin D is associated with increased parathyroid hormone and bone resorption, Osteoporosis International 25 (3) pp. 933-941
This analysis assessed whether seasonal change in 25-hydroxyvitamin D concentration was associated with bone resorption, as evidenced by serum parathyroid hormone and C-terminal telopeptide concentrations. The main finding was that increased seasonal fluctuation in 25-hydroxyvitamin D was associated with increased levels of parathyroid hormone and C-terminal telopeptide. Introduction: It is established that adequate 25-hydroxyvitamin D (25(OH)D, vitamin D) concentration is required for healthy bone mineralisation. It is unknown whether seasonal fluctuations in 25(OH)D also impact on bone health. If large seasonal fluctuations in 25(OH)D were associated with increased bone resorption, this would suggest a detriment to bone health. Therefore, this analysis assessed whether there is an association between seasonal variation in 25(OH)D and bone resorption. Methods: The participants were (n = 279) Caucasian and (n = 88) South Asian women (mean (±SD); age 48.2 years (14.4)) who participated in the longitudinal Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England study (2006-2007). The main outcomes were serum 25(OH)D, serum parathyroid hormone (sPTH) and serum C-terminal telopeptide of collagen (sCTX), sampled once per season for each participant. Results: Non-linear mixed modelling showed the (amplitude/mesor) ratio for seasonal change in log 25(OH)D to be predictive of log sPTH (estimate = 0.057, 95 % CI (0.051, 0.063), p
Darling AL, Lee PA, Hanjra F, Osborn A, Starkey S, David D, Berry JL, Patel S, Duckworth A, Cardew P, Gray R, Nurmi-Lawton J, Lee WTK, Lanham-New SA (2009) DIFFERENCES IN INDICES OF BONE HEALTH IN UK CAUCASIAN AND ASIAN PREMENOPAUSAL WOMEN: RESULTS OF THE D-FINES STUDY, OSTEOPOROSIS INTERNATIONAL 20 pp. S311-S312 SPRINGER LONDON LTD
Jupe S, Lanham-New SA, Davey T, Fallowfield J (2014) Fruit and vegetable intake of a British Army Battalion deployed to Afghanistan - preliminary findings, PROCEEDINGS OF THE NUTRITION SOCIETY 73 (OCE1) pp. E39-E39 CAMBRIDGE UNIV PRESS
MacDonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Erratum: Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: A major cause for concern? (Osteoporosis International (2011) DOI: 10.1007/s00198-010-1467-x), Osteoporosis International 22 (9) pp. 2473-2474
Dumartheray EW, Lanham-New SA, Whittamore DR, Krieg M, Burckhardt P (2008) High mini nutritional assessment (MNA) correlates with bone ultrasound measurements in elderly fractured women, CALCIFIED TISSUE INT 82 pp. S181-S181 SPRINGER
Macdonald HM, McGuigan FE, Lanham-New SA, Fraser WD, Ralston SH, Reid DM (2008) Vitamin K-1 intake is associated with higher bone mineral density and reduced bone resorption in early postmenopausal Scottish women: no evidence of gene-nutrient interaction with apolipoprotein E polymorphisms, AMERICAN JOURNAL OF CLINICAL NUTRITION 87 (5) pp. 1513-1520 AMER SOC CLINICAL NUTRITION
Davey T, Dziubak A, Lanham-New SA, Fallowfield JL (2011) Previous diet of Royal Marine recruits in relation to training outcome, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E393-E393 CAMBRIDGE UNIV PRESS
Lanham-New SA, Stear SJ, Shirreffs SM, Collins AL (2011) Sport and Exercise Nutrition, Sport and Exercise Nutrition
Now widely adopted on courses throughout the world, the prestigious Nutrition Society Textbook series provides students with the scientific basics in nutrition in the context of a systems and disease approach rather than on a nutrient by nutrient basis. In addition books provide a means to enable teachers and students to explore the core principles of nutrition and to apply these throughout their training to foster critical thinking at all times. This NS Textbook on Sport and Exercise Nutrition has been written to cover the latest information on the science and practice of sport and exercise nutrition. A key concept behind this textbook is that it aims to combine the viewpoints of world leading nutrition experts from both academia/research and a practical stand point. Plus where necessary there are additional practitioner based authors to ensure theory is translated into practice for each chapter in the form of either 'practice tips' or 'information sheets' at the end of relevant chapters. The textbook in essence can be divided into three distinct but integrated parts: Part 1: covers the key components of the science that supports the practice of sport and exercise nutrition including comprehensive reviews on: nutrients both in general and as exercise fuels; exercise physiology; hydration, micronutrients; and supplements. Part 2: moves into focusing on specific nutrition strategies to support different types of training including: resistance; power/sprint; middle distance/speed endurance; endurance; technical/skill, team; and specific competition nutrition needs. The unique format of this textbook is that it breaks down nutrition support into training specific as opposed to the traditional sport specific support. This reflects the majority of current sport and exercise requirements of the need to undertake concurrent training and therefore facilitating targeted nutrition support to the different training components through the various macro and micro training cycles. Part 3: explores some of the practical issues encountered in working in the sport and exercise nutrition field and includes key sport related topics such as: disability sport; weight management; eating disorders; bone and gut health; immunity; injury; travel; and special populations and situations. READERSHIP: Students of nutrition and dietetics at both undergraduate and postgraduate level. All those working in the field of nutrition and related health sciences. © 2011 The Nutrition Society.
Darling AL, Lanham-New SA (2010) Dietary protein and bone health: The urgent need for large scale supplementation studies, In: Nutritional Influences on Bone Health
Fallowfield JL, Delves SK, Hill NE, Cobley R, Brown P, Lanham-New SA, Frost G, Brett SJ, Murphy KG, Montain SJ, Nicholson C, Stacey M, Ardley C, Shaw A, Bentley C, Wilson DR, Allsopp AJ (2014) Energy expenditure, nutritional status, body composition and physical fitness of Royal Marines during a 6-month operational deployment in Afghanistan, British Journal of Nutrition 112 (5) pp. 821-829
Understanding the nutritional demands on serving military personnel is critical to inform training schedules and dietary provision. Troops deployed to Afghanistan face austere living and working environments. Observations from the military and those reported in the British and US media indicated possible physical degradation of personnel deployed to Afghanistan. Therefore, the present study aimed to investigate the changes in body composition and nutritional status of military personnel deployed to Afghanistan and how these were related to physical fitness. In a cohort of British Royal Marines (n 249) deployed to Afghanistan for 6 months, body size and body composition were estimated from body mass, height, girth and skinfold measurements. Energy intake (EI) was estimated from food diaries and energy expenditure measured using the doubly labelled water method in a representative subgroup. Strength and aerobic fitness were assessed. The mean body mass of volunteers decreased over the first half of the deployment (-4·6 (sd 3·7) %), predominately reflecting fat loss. Body mass partially recovered (mean +2·2 (sd 2·9) %) between the mid-and post-deployment periods (P
Hussein KS, Al Kadi HA, Lanham-New SA, Ardawi MSM (2012) EFFECT OF HYPOVITAMINOSIS D ON MUSCLE FUNCTION AND PHYSICAL PERFORMANCE IN SAUDI WOMEN, OSTEOPOROSIS INTERNATIONAL 23 pp. S594-S594 SPRINGER LONDON LTD
Darling AL, Hart Kath, Gibbs MA, Gossiel F, Kantermann T, Horton K, Johnsen Sigurd, Berry JL, Skene Debra, Eastell R, Vieth R, Lanham-New Susan (2014) Greater seasonal cycling of 25-hydroxyvitamin D is associated with increased parathyroid hormone and bone resorption, OSTEOPOROSIS INTERNATIONAL 25 (3) pp. 933-941 SPRINGER LONDON LTD
SUMMARY: This analysis assessed whether seasonal change in 25-hydroxyvitamin D concentration was associated with bone resorption, as evidenced by serum parathyroid hormone and C-terminal telopeptide concentrations. The main finding was that increased seasonal fluctuation in 25-hydroxyvitamin D was associated with increased levels of parathyroid hormone and C-terminal telopeptide. INTRODUCTION: It is established that adequate 25-hydroxyvitamin D (25(OH)D, vitamin D) concentration is required for healthy bone mineralisation. It is unknown whether seasonal fluctuations in 25(OH)D also impact on bone health. If large seasonal fluctuations in 25(OH)D were associated with increased bone resorption, this would suggest a detriment to bone health. Therefore, this analysis assessed whether there is an association between seasonal variation in 25(OH)D and bone resorption. METHODS: The participants were (n = 279) Caucasian and (n = 88) South Asian women (mean (±SD); age 48.2 years (14.4)) who participated in the longitudinal Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England study (2006-2007). The main outcomes were serum 25(OH)D, serum parathyroid hormone (sPTH) and serum C-terminal telopeptide of collagen (sCTX), sampled once per season for each participant. RESULTS: Non-linear mixed modelling showed the (amplitude/mesor) ratio for seasonal change in log 25(OH)D to be predictive of log sPTH (estimate = 0.057, 95 % CI (0.051, 0.063), p
Macdonald RM, Black AJ, Sandison R, Aucott L, Hardcastle AJ, Lanham-New SA, Fraser WD, Reid DM (2006) Two year double blind randomized controlled trial in postmenopausal women shows no gain in BMD with potassium citrate treatment., JOURNAL OF BONE AND MINERAL RESEARCH 21 pp. S15-S15 AMER SOC BONE & MINERAL RES
Woods DR, Delves SK, Britland SE, Shaw A, Brown PE, Bentley C, Hornby S, Burnett A, Lanham-New SA, Fallowfield JL (2014) Nutritional status and the gonadotrophic response to a polar expedition, Applied Physiology, Nutrition and Metabolism 40 (3) pp. 292-297
©, 2006 National Research Council of Canada. All rights reserved.Polar expeditions have been associated with changes in the hypothalamic?pituitary?testicular axis consistent with central hypogonadism (i.e., decreased testosterone, luteinising hormone (LH), and follicle stimulating hormone (FSH)). These changes are typically associated with body mass loss. Our aim was to evaluate whether maintenance of body mass during a polar expedition could mitigate against the development of central hypogonadism. Male participants (n = 22) from a 42-day expedition (British Services Antarctic Expedition 2012) volunteered to take part in the study. Body mass, body composition, and strength data were recorded pre- and postexpedition in addition to assessment of serum testosterone, LH, FSH, thyroid hormones, insulin-like growth factor 1 (IGF-1), and trace elements. Energy provision and energy expenditure were assessed at mid- and end-expedition. Daily energy provision was 6335 ± 149 kcal·day?1. Estimated energy expenditure midexpedition was 5783 ± 1690 kcal·day?1. Body mass and percentage body fat did not change between pre- and postexpedition. Total testosterone (nmol·L?1) (14.0 ± 4.9 vs. 17.3 ± 4.0, p = 0.006), calculated free testosterone (pmol·L?1) (288 ± 82 vs. 350 ± 70, p = 0.003), and sex hormone binding globulin (nmol·L?1) (33 ± 12 vs. 36 ± 11, p = 0.023) concentrations increased. LH and FSH remained unchanged. Thyroid stimulating hormone (TSH; IU·L?1) (2.1 ± 0.8 vs. 4.1 ± 2.1, p
Davey T, Lanham-New SA, Shaw AM, Cobley R, Allsopp AJ, Hajjawi MO, Arnett TR, Taylor P, Cooper C, Fallowfield JL (2014) Fundamental differences in axial and appendicular bone density in stress fractured and uninjured Royal Marine recruits--a matched case-control study., Bone 73 pp. 120-126
Stress fracture is a common overuse injury within military training, resulting in significant economic losses to the military worldwide. Studies to date have failed to fully identify the bone density and bone structural differences between stress fractured personnel and controls due to inadequate adjustment for key confounding factors; namely age, body size and physical fitness; and poor sample size. The aim of this study was to investigate bone differences between male Royal Marine recruits who suffered a stress fracture during the 32 weeks of training and uninjured control recruits, matched for age, body weight, height and aerobic fitness. A total of 1090 recruits were followed through training and 78 recruits suffered at least one stress fracture. Bone mineral density (BMD) was measured at the lumbar spine (LS), femoral neck (FN) and whole body (WB) using Dual X-ray Absorptiometry in 62 matched pairs; tibial bone parameters were measured using peripheral Quantitative Computer Tomography in 51 matched pairs. Serum C-terminal peptide concentration was measured as a marker of bone resorption at baseline, week-15 and week-32. ANCOVA was used to determine differences between stress fractured recruits and controls. BMD at the LS, WB and FN sites was consistently lower in the stress fracture group (P
Berry JL, Darling AL, Kang'ombe AR, Torgerson DJ, Lanham-New SA (2010) INTERACTION BETWEEN DIET AND SUNLIGHT EXPOSURE ON VITAMIN D STATUS IN WOMEN LIVING IN
SOUTHERN ENGLAND: MULTILEVEL MODELLING ANALYSIS OF THE D-FINES STUDY,
The relative contribution of UVB sunlight exposure and dietary vitamin D intake to 25-hydroxyvitamin D
(25(OH)D) remains to be fully determined. The aim of this study was to examine these factors in combination using a
repeated measures multilevel modelling approach. The D-FINES study investigated 373 Surrey Caucasian and Asian
women in four seasons of the year for 25(0H)D, dietary vitamin D and UVB exposure. To capitalise on the clustered
nature of the repeated seasonal measurements within individuals, multilevel modelling was undertaken using MLwiN
v.2.1software. Thus seasonal data (dietary vitamin D (DietaryVitD), UV exposure (UVdosi), vitamin D status (VitDstatus))
were included at level one (ij) and individual level data (ethnicity, menopausal status (0=Caucasian, 1=Asian;
0=Premenopausal, 1=Postmenopausal)) at level two (j). Using a random intercept model, the following equation was
constructed, which was significantly different from an intercept only model (Log likelihood test- Chi square X2= 2216.51,
df=5, p 25(OH)Dij= 0j-0.130(0.283)DietaryVitDij + 1.199(0.201)UVdosiij -27.559(2.637) Ethnicity_j: -6.082(2.051)Menopause_1j ? 0.020(0.008)UVdosi2ij+ e
ij0j=56.650(1.825) + u0j
This model showed no effect of diet on 25(OH)D, but did show a significant interaction between Standard Erythema Dose
(SED)UV and 25(OH)D. Being of Caucasian ethnicity was associated with a 27.6 nmol/l higher 25(OH)D than Asian
ethnicity, and being of premenopausal status was associated with a 6.1 nmol/l higher 25(OH)D than postmenopausal
status. Total body fat mass and seasonal dietary calcium had initially been included in the model but were removed as
they were not significant parameters. Dietary vitamin D was retained, even though not a significant parameter as it was of
high theoretical and practical importance. The implications of this model are that UV exposure has an effect on vitamin D
status but dietary vitamin D does not. Ethnicity has a greater influence than menopausal status. This work is funded by
the FSA (Project No. NO5064). This work was funded by the UK Foods Standards Agency (NO5064). The views
expressed are those of the authors alone.
Disclosure of
Hakim OA, Hart K, Darling AL, Shojaee-Moradie F, Berry JL, Umpleby AM, Griffin BA, Lanham-New SA (2012) Homeostatic model assessment (HOMA) in relation to lipid profiles and vitamin D status in South Asian and Caucasian women: preliminary results from D-FINES, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE2) pp. E70-E70 CAMBRIDGE UNIV PRESS
Darling AL, Skene DJ, Lanham-New SA (2011) Preliminary evidence of an association between vitamin D status and self-assessed sleep duration but not overall sleep quality: results from the D-FINES study of South Asian and Caucasian pre- and post-menopausal women living in Southern England, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE3) pp. E88-E88 CAMBRIDGE UNIV PRESS
Darling AL, Hart KH, Lanham-New SA, Macdonald HM, Horton K, Kang'ombe AR, Berry JL (2012) Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women, Osteoporosis International pp. 1-12
Summary: This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern. Introduction: There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D. Methods: This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51° N), aged 20-55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry. Results: Serum 25(OH)D
Darling AL, Gossiel F, Hannon R, Skene DJ, Hart KH, Berry JL, Eastell R, Lanham-New SA (2011) An association between seasonal fluctuation 'cycling' of 25(OH)D and increased bone resorption but not BMD or BMC in UK South Asian and Caucasian women living at 51on, BONE 48 pp. S187-S187 ELSEVIER SCIENCE INC
Lanham-New SA, Pattison DJ, Berry JL, Woolf AD (2006) Nutritional influences on bone health in premenopausal women: Evidence of widespread vitamin D insufficiency and a positive effect of micronutrients on the skeleton., JOURNAL OF BONE AND MINERAL RESEARCH 21 pp. S328-S328 AMER SOC BONE & MINERAL RES
Darling AL, Kang'ombe AR, Dragen A, Diffey B, Lovell DP, Torgerson DJ, Lee PA, Lee WTK, Berry JL, Lanham-New (2009) INTERACTION BETWEEN DIET AND SUNLIGHT EXPOSURE ON VITAMIN D STATUS IN WOMEN LIVING
IN SOUTHERN ENGLAND: MULTILEVEL MODELLING ANALYSIS OF THE D-FINES STUDY,
A.L.Darling1, A.R.Kang?ombe2, A.Dragen1, B.Diffey3, D.P.Lovell1, D.J.Torgerson2, P.A. Lee1, W.T.K. Lee1, J.L. Berry4 and S.A. Lanham-New1
Darling AL, Gossiel F, Robertson F, Hill T, Eastell R, Lanham-New SA (2014) PREMENOPAUSAL MIGRANT SOUTH ASIAN WOMEN HAVE HIGHER URINARY N-TELOPEPTIDE THAN WOULD BE EXPECTED FOR THEIR AGE, OSTEOPOROSIS INTERNATIONAL 25 pp. S680-S680 SPRINGER LONDON LTD
Darling AL, Hakim OA, Hart KH, Lanham-New SA (2011) Body weight, height and ethnicity are the best predictors of fracture load at the tibia in UK dwelling South Asian and Caucasian postmenopausal women, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E392-E392 CAMBRIDGE UNIV PRESS
Frassetto LA, Lanham-New SA, Macdonald HM, Remer T, Sebastian A, Tucker KL, Tylavsky FA (2007) Standardizing terminology for estimating the diet-dependent net acid load to the metabolic system, JOURNAL OF NUTRITION 137 (6) pp. 1491-1492 AMER SOCIETY NUTRITIONAL SCIENCE
Darling AL, Millward DJ, Torgerson DJ, Hewitt CE, Lanham-New SA (2009) Dietary protein and bone health: a systematic review and meta-analysis, AMERICAN JOURNAL OF CLINICAL NUTRITION 90 (6) pp. 1674-1692 AMER SOC CLINICAL NUTRITION
Aldayel TS, Hampton SM, Lanham-New SA, Williams P, Brown JE (2014) An evaluation of serum cytokine levels in overweight women consuming a cinnamon supplement for 8 weeks, IMMUNOLOGY 143 pp. 184-185 WILEY-BLACKWELL
Darling AL, Hart KH, Skene DJ, Arber S, Lanham-New SA (2014) Vitamin D status, functional ability and muscle strength in older South Asian and Caucasian women in the UK, PROCEEDINGS OF THE NUTRITION SOCIETY 73 (OCE1) pp. E23-E23 CAMBRIDGE UNIV PRESS
Mendes MM, Darling AL, Meira L, Lanham-New SA (2014) Vitamin D status and body composition in UK Caucasian and South Asian postmenopausal women: results from the DFINES II study, PROCEEDINGS OF THE NUTRITION SOCIETY 73 (OCE1) pp. E40-E40 CAMBRIDGE UNIV PRESS
Darling AL, Berry JL, Gossiel F, Hannon R, Eastell R, Lanham-New SA (2010) Evidence of an association between seasonal cycling of 25(OH)D and markers of bone health in UK South Asian but not Caucasian women living at 51oN,
Aim: This study aimed to assess whether seasonal cycling of 25(OH)D (25-dihydroxy vitamin D) is associated with bone health. Method: A subgroup of 65 South Asian and Caucasian women who took part in the 2006-2007 D-FINES study was analysed. During this study they had blood drawn in four seasons for determination of 25(OH)D and serum c-telopeptide (sCTX)and in autumn and spring they had a DEXA scan (Hologic). Cycling of 25(OH)D was assessed by calculating the difference between the winter (nadir) and summer (peak) 25(OH)D and for ease of interpretation, expressing all change as positive values. Dependent variables analysed were absolute values for autumn femoral neck and lumbar spine BMD, BMC and bone area, and absolute sCTX in each season. Also, change in sCTX from summer to winter and change in the DEXA bone indices from autumn to spring were analysed. Results: ANCOVA, controlling for summer and winter 25(OH)D status, age, BMI, socioeconomic status, physical activity, and dietary calcium showed no statistically significant association (p>0.05) between quartile of cycling of 25(OH)D and any bone measurement in either ethnic group except in the Asians for absolute autumn CTX (F=5.925, p=0.01, fig 1) and change in FNBMC (F=3.111, p=0.05, see fig.3). Also, in Asians only, absolute autumn lumbar spine BMD approached significance (F =2.780, p=0.07, see fig 2). Conclusions: It has been suggested that some findings of increased risk of some cancers in countries with high 25(OH)D could be due to slow adaption of CYP27B1 and CYP24 to fluctuating 25(OH)D (1). This begs the question as to whether seasonal cycling of 25(OH)D could be detrimental to bone. Indeed, a recent review discussed a correlation between 25(OH)D and bone indices (2). The lack of an association between cycling and most bone indices found here does not support this view that 25(OH)D cycling is detrimental to bone. However, in Asians only, the loss of femoral neck BMC during the year in the top and bottom quartiles but gain in the 3rd quartile, and the increased autumn sCTX in the third quartile warrants further investigation.
Hakim OA, Darling A, Hart K, Berry JL, Lanham-New SA (2012) VOLUMETRIC BONE MINERAL DENSITY (VBMD) AT RADIUS SITE AND VITAMIN D STATUS IN PREMENOPAUSAL SOUTH ASIAN AND CAUCASIAN WOMEN, OSTEOPOROSIS INTERNATIONAL 23 pp. S336-S337 SPRINGER LONDON LTD
Darling AL, Hakim OA, Hart KH, Lanham-New SA (2011) Vitamin D intakes in UK South Asian and Caucasian postmenopausal women: a novel longitudinal analysis from 2006-2010, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E349-E349 CAMBRIDGE UNIV PRESS
Darling AL, Gossiel F, Hannon R, Skene DJ, Berry JL, Eastell R, Lanham-New SA (2010) Evidence for an Association Between Seasonal Fluctuation of 25(OH)D and Serum C-telopeptide (CTx): Preliminary Evidence from the D-FINES study.,
The purpose of this study was to assess whether there is a difference in bone resorption by degree of seasonal change in 25(OH)D and whether this varies by ethnicity. In the recent D-FINES study, (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England, 2006-2007), a subset of n=65 from the 293 participants (South Asian (n 30) and Caucasian (n 35)) had blood taken in four seasons for determination of 25(OH)D and serum c-telopeptide (sCTX). sCTX was measured using an electrochemiluminescent immunoassay (Roche cobas e411). Seasonal fluctuation of 25(OH)D was assessed by calculating differences between the winter (nadir) and summer (peak) 25(OH)D. For ease of interpretation these changes were expressed as positive values. This enabled investigation of the absolute change in 25(OH)D but not its direction. This variable was then split into quartiles within ethnicity. The dependent variables were absolute concentration of sCTX in each season as well as summer to winter change in sCTX. ANCOVA was run with absolute summer and winter 25(OH)D status, age, BMI, socioeconomic status, physical activity, and dietary calcium as covariates. In the Asian group there was no clear trend between degree of seasonal fluctuation and absolute sCTX. Indeed, only the autumn data was statistically significant (F=5.93; p= 0.01) and with no consistent pattern among the quartiles. No data were significant for change in summer to winter sCTX in Asians or Caucasians despite a trend in both ethnic groups for lower sCTX in the middle quartiles relative to the highest and lowest. Last, in Caucasians, there was a non-statistically significant (p.0.05) inverse trend between cycling of 25(OH)D and absolute serum C-telopeptide levels. These data suggest lower bone resorption in all seasons in Caucasians with increased cycling, and a reduction in sCTX between summer and winter in both ethnic groups in the middle quartile relative to the other quartiles. As the values were covariate adjusted, these findings are not likely to be due to other variables. However, it must be borne in mind that these results are only trends, which is likely due to the small numbers of subjects. Further research is required to analyse banked urine samples from the D-FINES study (n 293) which would enable us to see if these results are statistically significant with increased statistical power.
The D-FINES study was funded by the UK Food Standards Agency. All views are those of the authors alone
Darling AL, Lanham-New SA (2010) Dietary Protein and Bone Health: The Urgent Need for Large-Scale Supplementation Studies, NUTRITIONAL INFLUENCES ON BONE HEALTH pp. 17-26 SPRINGER-VERLAG BERLIN
Fallowfield JL, Delves SK, Hill NE, Cobley R, Brown P, Lanham-New SA, Frost G, Brett SJ, Murphy KG, Montain SJ, Nicholson C, Stacey M, Ardley C, Shaw A, Bentley C, Wilson DR, Allsopp AJ (2014) Energy expenditure, nutritional status, body composition and physical fitness of Royal Marines during a 6-month operational deployment in Afghanistan., Br J Nutr 112 (5) pp. 821-829
Understanding the nutritional demands on serving military personnel is critical to inform training schedules and dietary provision. Troops deployed to Afghanistan face austere living and working environments. Observations from the military and those reported in the British and US media indicated possible physical degradation of personnel deployed to Afghanistan. Therefore, the present study aimed to investigate the changes in body composition and nutritional status of military personnel deployed to Afghanistan and how these were related to physical fitness. In a cohort of British Royal Marines (n 249) deployed to Afghanistan for 6 months, body size and body composition were estimated from body mass, height, girth and skinfold measurements. Energy intake (EI) was estimated from food diaries and energy expenditure measured using the doubly labelled water method in a representative subgroup. Strength and aerobic fitness were assessed. The mean body mass of volunteers decreased over the first half of the deployment ( - 4·6 (sd 3·7) %), predominately reflecting fat loss. Body mass partially recovered (mean +2·2 (sd 2·9) %) between the mid- and post-deployment periods (P
Davey T, Delves SK, Lanham-New SA, Allsopp AJ, Fallowfield JL (2011) Body composition of Royal Marine recruits during 32 weeks of military training, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE4) pp. E150-E150 CAMBRIDGE UNIV PRESS
Duinartheray EW, Lanham-New SA, Whittamore DR, Krieg M, Burckhardt P (2007) Low estimates of pral (nutritional acid load) correlates with bone ultrasound measurements in elderly fractured women, CALCIFIED TISSUE INTERNATIONAL 80 pp. S172-S173 SPRINGER
Al-Ghamdi MA, Lanham-New SA, Kahn JA (2012) Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health., Public Health Nutr 15 (10) pp. 1845-1853
Few data exist looking at vitamin D status and bone health in school-aged boys and girls from Saudi Arabia. The present study aimed to determine the extent of poor vitamin D status in school boys and girls aged 6-18 years and to examine if there was any difference in status with age, physical activity and veiling and concomitant effects on bone.
Lanham-New SA, Lambert H, Frassetto L (2012) Potassium., Adv Nutr 3 (6) pp. 820-821
Bachtiar NS, Hussain R, Lanham-New SA, Horton K (2011) Infant Feeding Practices in The Klang Valley, Malaysia, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E359-E359 CAMBRIDGE UNIV PRESS
Darling AL, Gossiel F, Hannon R, Eastell R, Lanham-New SA (2010) PRELIMINARY EVIDENCE FOR MENOPAUSAL BUT NOT ETHNIC OR SEASONAL DIFFERENCES IN BONE RESORPTION AS MEASURED BY SERUM C-TELOPEPTIDE: EARLY RESULTS OF THE D-FINES STUDY, OSTEOPOROSIS INTERNATIONAL 21 pp. 84-84 SPRINGER LONDON LTD
Tripkovic L, Wilson L, Hart K, Lanham-New S (2013) Associations between dietary intake and volumetric bone mineral density in South Asian and Caucasian women: preliminary analysis of the D2-D3 Study, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E216-E216 CAMBRIDGE UNIV PRESS
Wadsworth J, Darling AL, Shearer M, Gibbs MA, Adamson J, Torgerson D, Lanham-New SA (2010) Vitamin K and Bone Health: An Updated Systematic Review
and Meta-analysis,
Previous research suggests vitamin K may increase bone mass, prevent loss of bone mineral density (BMD), and possibly reduce fracture incidence. The purpose of this study was to update the systematic review and meta-analysis of the effect of both vitamin K1 and vitamin K2 (menaquinone-4 and menaquinone-7) on bone turnover, BMD and fracture risk that we published in 2007 in the light of key vitamin K supplementation studies completed in the last 30 months. The Cochrane Library (1994-2009) and EMBASE (1980-2009) databases were searched for relevant cross sectional, longitudinal and intervention studies. Thirty three studies were included in the systematic review and seven in the meta-analysis. Results from the systematic review for vitamin K1 suggested a significant negative correlation with undercarboxylated osteocalcin (ucOC), but mixed results for total OC, bone resorption markers and fracture, and no association with BMD. The meta analysis supported these results, showing a significant effect of vitamin K1 supplementation on reducing ucOC (p,0.00001, Z=15.59, weighted mean difference=-21.23 95% CI (-23.90 to-18.57)), but no significant effect on BMD at any site (P=0.78, Z=0.28, weighted mean difference=0.00, 95%CI (0.00 to 0.01)). There was insufficient data to analyse fracture incidence, bone resorption or OC in the K1 metaanalysis.
Results from the systematic review of K2 studies showed a significant negative association of K2 on ucOC in intervention studies. The intervention studies, but not cross-sectional studies, independently associated vitamin K2 with fracture risk. No effect of vitamin K2 supplementation on bone resorption was found for any study type, but the intervention studies were associated with increased BMD. This was supported by results from the vitamin K2 meta-analysis for a reduction in ucOC (p,0.00001, Z=8.75, weighted mean difference=95% CI (-68.54 to-43.45)) and increased BMD from combined sites (p=0.004, Z=3.86, weighted mean difference= 95% CI (1.24-6.48)).
These findings suggest vitamin K; especially K2, may be beneficial for bone health, as ucOC is an independent risk factor for osteoporotic fracture. In this analysis, K2, but not K1 supplementation, was associated with increased BMD. However, overall the results from the studies were too conflicting to recommend routine supplementation. Further, higher quality and more homogenous studies are needed before any clear conclusions can be made about vitamin K and bone health.
Wynn E, Krieg MA, Lanham-New SA, Burckhard P (2010) Positive influence of nutritional alkalinity on bone health, PROCEEDINGS OF THE NUTRITION SOCIETY 69 (1) pp. 166-173 CAMBRIDGE UNIV PRESS
Wilson L, Hart K, Lanham-New S, Tripkovic L (2013) Vitamin D intakes and blood pressure in Caucasian and South Asian women aged 20-64 years - baseline analysis of the D2-D3 study, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E189-E189 CAMBRIDGE UNIV PRESS
Davey T, Lanham-New SA, Allsopp AJ, Taylor P, Cooper C, Fallowfield JL (2012) LUMBAR SPINE AND HIP BONE MINERAL DENSITY ARE IMPORTANT RISK FACTORS FOR STRESS FRACTURE IN ROYAL MARINE RECRUITS, OSTEOPOROSIS INTERNATIONAL 23 pp. S533-S533 SPRINGER LONDON LTD
Darling AL, Gossiel F, Robertson F, Hill T, Berry JL, Johnsen S, Eastell R, Lanham-New SA (2014) GREATER SEASONAL FLUCTUATION OR 'CYCLING' OF 25-HYDROXYVITAMIN D IS ASSOCIATED WITH INCREASED BONE RESORPTION, OSTEOPOROSIS INTERNATIONAL 25 pp. S669-S669 SPRINGER LONDON LTD
Khojah SO, Khan JA, Balamesh KS, Berry JL, Gibbs M, Lanham-New SA, Dehlawi FMA (2013) Extensive hypovitaminosis d in partly veiled Saudi Arabian premenopausal and postmenopausal women: Influence on bone health, Life Science Journal 10 (4) pp. 3496-3503
The link between vitamin D and bone health is well established. However, little is known about the bone health, vitamin D status, and lifestyle characteristics of women living in Saudi Arabia. To characterize: i) bone health indices; ii) vitamin D status; iii) potential influential of sunlight exposure and physical activity level. A total of 100 premenopausal aged 20-30 years and 112 postmenopausal aged 45-60 years were included. Bone mineral density was determined at the lumbar spine and femoral neck. Serum levels of 25-hydroxyvitamin D, intact parathyroid hormone, and ionized calcium and phosphorus were measured. The subjects interviewed about their physical activity levels and lifestyle. Using the WHO criteria, 37% of the premenopausal and 52% of the postmenopausal were osteopenic at the lumbar spine. Vitamin D deficiency was highly prevalent in Saudi women, with 98% of women being below the IOM recommended level of 50nmol/L. There was a significant correlation between duration of sunlight exposure (min/day) and axial BMD and calcaneal bone mass in partly veiled women. These data indicate that younger and older Saudi Arabian women had poor bone health and that their vitamin D status and lifestyle factors do not promote skeletal integrity.
Darling AL, Hart KH, Lanham-New SA (2011) Increased dietary protein is strongly associated with reduced bone mineral density and bone mineral content at the femoral neck and lumbar spine in UK dwelling South Asian and Caucasian postmenopausal women, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE4) pp. E123-E123 CAMBRIDGE UNIV PRESS
Darling AL, Hakim OA, Hart KH, Berry JL, Lanham-New SA (2012) POSTMENOPAUSAL SOUTH ASIAN WOMEN SHOW ADAPTATIONS IN TIBIAL CORTICAL THICKNESS AND VOLUMETRIC BONE MINERAL DENSITY TO COMPENSATE FOR SMALL OVERALL BONE SIZE, OSTEOPOROSIS INTERNATIONAL 23 pp. S584-S584 SPRINGER LONDON LTD
Lanham-New SA (2011) Preface, Nutrition and Metabolism: Second Edition
Dumartheray EW, Krieg M-A, Cornuz J, Whittamore DR, Lanham-New SA, Burckhardt P (2006) Energy and nutrient intake of Swiss women aged 75-87 years, JOURNAL OF HUMAN NUTRITION AND DIETETICS 19 (6) pp. 431-435 WILEY-BLACKWELL
Davey T, Lanham-New SA, Shaw AM, Hale B, Cobley R, Berry JL, Roch M, Allsopp AJ, Fallowfield JL (2015) Low serum 25-hydroxyvitamin D is associated with increased risk of stress fracture during Royal Marine recruit training, OSTEOPOROSIS INTERNATIONAL 27 (1) pp. 171-179 SPRINGER LONDON LTD
Darling AL, Hart KH, Skene DJ, Arber S, Lanham-New SA (2013) Vitamin D, sunlight exposure, sleep disturbances and musculoskeletal health of older South Asian women in the UK: biological and social influences, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E187-E187 CAMBRIDGE UNIV PRESS
Lambert H, Frassetto L, Moore JB, Torgerson D, Gannon R, Burckhardt P, Lanham-New S (2015) The effect of supplementation with alkaline potassium salts on bone metabolism: a meta-analysis, OSTEOPOROSIS INTERNATIONAL 26 (4) pp. 1311-1318 SPRINGER LONDON LTD
Ghayour-Mobarhan M, Yaghootkar H, Lanham-New SA, Lamb DJ, Ferns GA (2007) Association between serum CRP concentrations with dietary intake in healthy and dyslipidaemic patients, ASIA PACIFIC JOURNAL OF CLINICAL NUTRITION 16 (2) pp. 262-268 H E C PRESS, HEALTHY EATING CLUB PTY LTD
Darling AL, Berry JL, Gossiel F, Hannon R, Eastell R, Lanham-New SA (2010) EVIDENCE OF AN ASSOCIATION BETWEEN SEASONAL CYCLING OF 25(OH)D AND MARKERS OF BONE HEALTH IN UK SOUTH ASIAN BUT NOT CAUCASIAN WOMEN LIVING AT 51ON, OSTEOPOROSIS INTERNATIONAL 21 pp. 84-85 SPRINGER LONDON LTD
Lanham-New SA (2010) DO VEGETARIANS HAVE A NORMAL BONE MASS?, OSTEOPOROSIS INTERNATIONAL 21 pp. 391-391 SPRINGER LONDON LTD
Darling AL, Lee PA, Hanjra FK, Osborn A, Starkey S, David D, Berry JL, Patel S, Duckworth A, Cardew P, Gray R, Nurmi-Lawton J, Lee WTK, Lanham-New SA (2010) Differences in Indices of Bone Health in UK Caucasian and Asian Premenopausal women: Results of the D-FINES study,
Hussein KS, Al Kadi HA, Lanham-New SA, Ardawi MSM (2012) Extent of obesity in Saudi women and the association between vitamin D status and different measures of adiposity, BONE 50 pp. S138-S138 ELSEVIER SCIENCE INC
Hakim OA, Shojaee-Moradie F, Hart K, Berry JL, Eastell R, Gossiel F, Hannon R, Umpleby AM, Griffin BA, Lanham-New SA (2011) Vitamin D deficiency, poor bone health and the risk of CVD in Caucasian and South Asian women: analysis from the D-FINES study, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE3) pp. E100-E100 CAMBRIDGE UNIV PRESS
Darling AL, Torgerson DJ, Hewitt CE, Millward DJ, Lanham-New SA (2009) (YOUNG INVESTIGATOR AWARD) DIETARY PROTEIN AND BONE HEALTH: A SYSTEMATIC REVIEW AND META-ANALYSIS, OSTEOPOROSIS INTERNATIONAL 20 pp. S262-S262 SPRINGER LONDON LTD
Lanham-New SA (2009) Role of calcium and vitamin D in the prevention (and treatment) of osteoporotic fracture, Surgery 27 (2) pp. 47-54
The skeleton requires optimum development and maintenance of its integrity to prevent fracture throughout the life cycle. It is now generally accepted that bones break because the loads placed on them exceed their ability to absorb the energy involved. Current figures for the UK suggest that 1 in 3 women and 1 in 12 men over the age of 55 years will suffer from osteoporosis in their lifetime, at a cost of £1.7 billion per annum to the NHS. The pathogenesis of osteoporosis is multifactorial. Both the development of peak bone mass and the rate of bone loss are determined by key endogenous and exogenous factors. Re-defining vitamin D requirements in the UK is urgently needed because there is evidence of extensive hypovitaminosis D in men and women, which is especially prevalent in Asian population groups. Low vitamin D status is associated with an increased risk of falling and a variety of other health outcomes, and is an area that requires urgent attention. Calcium supplementation seems to have little effect on bone mineral density in younger post-menopausal women ( 5 years post-menopause), particularly in those with low habitual calcium intake (
Mavroeidi A, O'Neill F, Lee PA, Darling AL, Fraser WD, Berry JL, Lee WT, Reid DM, Lanham-New SA, Macdonald HM (2010) Seasonal 25-hydroxyvitamin D changes in British postmenopausal women at 57 degrees N and 51 degrees N: A longitudinal study, JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY 121 (1-2) pp. 459-461 PERGAMON-ELSEVIER SCIENCE LTD
Huggett C, Gannon RHT, Truby H, Hiscutt R, Lambert H, Fraser WD, Lanham-New SA (2012) An assessment of the Atkins diet on skeletal health in contrast to diets rich in alkaline-forming fruits and vegetables, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E221-E221 CAMBRIDGE UNIV PRESS
Lanham-New SA, Thompson RL, More J, Brooke-wavell K, Hunking P, Medici E (2007) Importance of vitamin D, calcium and exercise to bone health with specific reference to children and adolescents, Nutrition Bulletin 32 (4) pp. 364-377
The optimisation of skeletal health during the life cycle is critical, especially if we are to reduce the continuing rise in osteoporosis -1 in 2 women and 1 in 5 men over the age of 50 years will suffer an osteoporotic fracture. The foundations of adult bone health are laid down in the early years; therefore, optimisation of bone health in the young is fundamental. Although genetics play a major role, accounting for 70-75% of bone strength, other lifestyle and nutrition factors are known to be highly influential. Calcium (Ca) and vitamin D play critical roles in bone mineralisation as well as generally being key nutrients in health. All living cells require Ca to survive, with the majority (99%) of Ca being found in bones and teeth and the remainder in soft tissues and body fluids. Vitamin D is the generic term for two molecules: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). The former is derived by ultraviolet (UV) irradiation of ergosterol, which is distributed in plants and fungi. The latter is formed from the effect of UV irradiation on the skin. The principal role of vitamin D is to support the serum Ca concentration within narrow limits. Vitamin D is crucial for maximising gut absorption of calcium via vitamin D dependent Ca receptors. It is estimated that adequate vitamin D status increases Ca absorption to 30-40% of intake compared with only 10-15% absorption without adequate vitamin D. Intakes of Ca are a concern among certain groups of the population, for example a high proportion (>12%) of teenage boys and girls fail to meet the lower reference nutrient intake for Ca. For vitamin D, there are no dietary reference values for the age group 4-64 years as it is considered that UV exposure provides sufficient quantities of vitamin D, but there is now mounting evidence of widespread vitamin D insufficiency in the population. Weight-bearing physical activity is beneficial to the skeleton but clarification is needed of the exact type, intensity and duration required for optimal bone mass. The role of othermicronutrients on bone metabolism remains to be fully quantified. This review investigates the current evidence of the impact of dietary and lifestyle factors on bone health, with specific reference to children and adolescents and with a focus on vitamin D, Ca and weight-bearing exercise. © 2007 The Authors; Journal compilation © 2007 British Nutrition Foundation.
Hussein KS, Al Kadi HA, Lanham-New SA, Ardawi MS (2012) EXTENT OF OBESITY IN SAUDI WOMEN AND THE ASSOCIATION BETWEEN VITAMIN D STATUS AND DIFFERENT MEASURES OF ADIPOSITY, OSTEOPOROSIS INTERNATIONAL 23 pp. S597-S598 SPRINGER LONDON LTD
Tripkovic L, Wilson L, Hart K, Lanham-New S (2012) Comparison of vitamin D-2 and vitamin D-3 supplementation in increasing serum 25-hydroxyvitamin D status: a systematic review and meta-analysis Reply, AMERICAN JOURNAL OF CLINICAL NUTRITION 96 (5) pp. 1153-1154 AMER SOC NUTRITION-ASN
Lanham-New SA, Buttriss JL, Miles LM, Ashwell M, Berry JL, Boucher BJ, Cashman KD, Cooper C, Darling AL, Francis RM (2011) Proceedings of the Rank Forum on Vitamin D., Br J Nutr 105 (1) pp. 144-156
The Rank Forum on Vitamin D was held on 2nd and 3rd July 2009 at the University of Surrey, Guildford, UK. The workshop consisted of a series of scene-setting presentations to address the current issues and challenges concerning vitamin D and health, and included an open discussion focusing on the identification of the concentrations of serum 25-hydroxyvitamin D (25(OH)D) (a marker of vitamin D status) that may be regarded as optimal, and the implications this process may have in the setting of future dietary reference values for vitamin D in the UK. The Forum was in agreement with the fact that it is desirable for all of the population to have a serum 25(OH)D concentration above 25 nmol/l, but it discussed some uncertainty about the strength of evidence for the need to aim for substantially higher concentrations (25(OH)D concentrations>75 nmol/l). Any discussion of 'optimal' concentration of serum 25(OH)D needs to define 'optimal' with care since it is important to consider the normal distribution of requirements and the vitamin D needs for a wide range of outcomes. Current UK reference values concentrate on the requirements of particular subgroups of the population; this differs from the approaches used in other European countries where a wider range of age groups tend to be covered. With the re-emergence of rickets and the public health burden of low vitamin D status being already apparent, there is a need for urgent action from policy makers and risk managers. The Forum highlighted concerns regarding the failure of implementation of existing strategies in the UK for achieving current vitamin D recommendations.
Alyahya K, AlMazeed Z, Morgan JB, Lanham-New SA, Berry JL (2006) Extent of vitamin D deficiency in Kuwait adolescent females aged 10-18 years: Implications for peak bone mass attainment., JOURNAL OF BONE AND MINERAL RESEARCH 21 pp. S327-S327 AMER SOC BONE & MINERAL RES
Lanham-New SA (2006) Fruit and vegetables: the unexpected natural answer to the question of osteoporosis prevention?, AMERICAN JOURNAL OF CLINICAL NUTRITION 83 (6) pp. 1254-1255 AMER SOC CLINICAL NUTRITION
Aldayel T, Hampton SM, Lanham-New SA, Brown JE (2013) Acute effects of cinnamon on glucose response in vivo to a standard carbohydrate-rich food, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E203-E203 CAMBRIDGE UNIV PRESS
Lanham-New SA (2008) The balance bone health: Tipping the scales on favor of potassium-rich, bicarbonate-rich foods, JOURNAL OF NUTRITION 138 (1) pp. 172S-177S AMER SOC NUTRITIONAL SCIENCE
Lanham-New SA (2008) Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment, PROCEEDINGS OF THE NUTRITION SOCIETY 67 (2) pp. 163-176 CAMBRIDGE UNIV PRESS
Hussein KS, Al Kadi HA, Lanham-New SA, Ardawi MSM (2012) PREVALENCE OF VITAMIN D DEFICIENCY IN PRE- AND POSTMENOPAUSAL SAUDI WOMEN- A CROSS SECTIONAL STUDY, OSTEOPOROSIS INTERNATIONAL 23 pp. S593-S594 SPRINGER LONDON LTD
Lee PA, Siu KYK, Hipgrave R, David D, Lee WTK, Lovell DP, Kiely M, Cashman K, Berry JL, Lanham-New SA (2007) Associations between dietary intake of calcium and vitamin D, anthropometry measures and indices of bone health in Caucasian women: preliminary results from the D-FINES study, PROCEEDINGS OF THE NUTRITION SOCIETY 66 pp. 83A-83A CAMBRIDGE UNIV PRESS
Khoja SO, Khan JA, Maimani ARA, Berry JL, Lanham-New SA (2007) Influence of diet on bone health in Saudi Arabian women, International Congress Series 1297 pp. 296-302
Few data exist on the effect of dietary and lifestyle factors on indices of bone health in women living in Middle Eastern countries. As part of our on-going bone health study in 212 Saudi Arabian women, a total of 100 premenopausal and 112 postmenopausal women living in the city of Jeddah were studied. They were aged 20-30 years and 45-60 years, respectively. Measurements were made on weight and height as well as spine, hip and calcaneal bone mass. All subjects were interviewed concerning their habitual dietary intake, physical activity levels and general lifestyle. Prevalence of osteopenia and osteoporosis was common amongst postmenopausal women. Vitamin D deficiency was extensive in both the pre- and postmenopausal women Saudi women. Further analysis of the dataset are required to examine extensively the effect of diet on bone health in Middle Eastern women, but these data are a cause for concern regarding the extent of vitamin D deficiency. © 2007 Elsevier B.V. All rights reserved.
Lanham-New SA (2009) Is "vegetarianism" a serious risk factor for osteoporotic fracture?, AMERICAN JOURNAL OF CLINICAL NUTRITION 90 (4) pp. 910-911 AMER SOC CLINICAL NUTRITION
Macdonald HM, Black AJ, Aucott L, Duthie G, Duthie S, Sandison R, Hardcastle AC, New SAL, Fraser WD, Reid DM (2008) Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial, AMERICAN JOURNAL OF CLINICAL NUTRITION 88 (2) pp. 465-474 AMER SOC CLINICAL NUTRITION
Davey T, Dziubak A, Cobley R, Lanham-New SA, Allsopp AJ, Fallowfield JL (2012) THE INFLUENCE OF PAST DIET ON BONE QUALITY AND STRESS FRACTURE RISK IN ROYAL MARINE RECRUITS, OSTEOPOROSIS INTERNATIONAL 23 pp. S556-S557 SPRINGER LONDON LTD
Berry JL, Pattison DP, Woolf AD, Lanham-New SA (2007) Extent of vitamin D insufficiency in young British women: Influence on bone health, JOURNAL OF BONE AND MINERAL RESEARCH 22 (7) pp. 1132-1132 AMER SOC BONE & MINERAL RES
Darling AL, Lee PA, Hanjra FK, Osborn A, Patel S, Duckworth A, Cardew P, Gray R, Berry JL, Lanham-New SA (2009) POOR VITAMIN D STATUS IS ASSOCIATED WITH A DETRIMENTAL EFFECT ON MUSCULOSKELETAL HEALTH: RESULTS OF THE D-FINES STUDY,
There is a considerable lack of data examining poor vitamin D status on bone health and muscle function in different UK ethnic groups. The D-FINES study examined 373 Surrey-dwelling Caucasian (C) and Asian (A) women in four seasons of the year for diet, sunlight exposure, 25-hydroxyvitamin D (25(OH)D) and grip strength (GS). In the autumn season, lumbar spine bone mineral density (LSBMD) was also measured. The aim of this work was to examine differences in LSBMD and GS in A and C pre and postmenopausal women according to 25(OH)D. When women were grouped by 25(OH)D (75nmol/l. For GS, controlling for lean arm mass, a statistically significant difference between the four ethnic/menopausal groups (F=24.851, p0.05). Overall, LS BMD was significantly higher in individuals with 25(OH)D >75nmol/l compared to those with
Dumartheray EW, Krieg M-A, Cornuz J, Whittamore DR, Lovell DP, Burckhardt P, Lanham-New SA (2006) Validation and reproducibility of a semi-quantitative Food Frequency Questionnaire for use in elderly Swiss women, JOURNAL OF HUMAN NUTRITION AND DIETETICS 19 (5) pp. 321-330 BLACKWELL PUBLISHING
Lanham-New SA, MacDonald IA, Roche HM (2011) Nutrition and Metabolism: Second Edition, Nutrition and Metabolism: Second Edition
In this second edition of the second title in the acclaimed Nutrition Society Textbook Series, Nutrition and Metabolism has been revised and updated to meet the needs of the contemporary student. Groundbreaking in their scope and approach, the titles in the series: Provide students with the required scientific basics of nutrition in the context of a systems and health approach. Enable teachers and students to explore the core principles of nutrition, to apply these throughout their training, and to foster critical thinking at all times. Throughout, key areas of knowledge are identified. Are fully peer reviewed, to ensure completeness and clarity of content, as well as to ensure that each book takes a global perspective. Nutrition and Metabolism is an essential purchase for students of nutrition and dietetics, and also for those students who major in other subjects that have a nutrition component, such as food science, medicine, pharmacy and nursing. Professionals in nutrition, dietetics, food science, medicine, health sciences and many related areas will also find much of great value within its covers. © 2011 The Nutrition Society.
Berry JL, Darling AL, Lanham-New SA (2010) ASIAN AND CAUCASIAN UK WOMEN WITH LOW VITAMIN D STATUS EXHIBIT POORER INDICES OFMUSCULOSKELETAL HEALTH: RESULTS OF THE D-FINES STUDY,
More data is urgently required examining the link between poor vitamin D status on bone health and muscle
function in different UK ethnic groups. The D-FINES study examined a total of 373 Surrey-dwelling Caucasian (C) and
Asian (A) women in four seasons of the year for diet, sunlight exposure, 25-hydroxyvitamin D (25(OH)D) and grip
strength (GS). In the autumn season, lumbar spine bone mineral density (LSBMD) was also measured. The specific aim
of this work was to examine differences in LSBMD and GS in A and C pre and postmenopausal women according to
25(OH)D. When women were grouped by 25(OH)D ( adjusting for BMI showed a significant difference in LS BMD between the groups for summer (p=0.042), autumn
(p=0.002) winter (p=0.028) and spring (p=0.019) 25(OH)D. The 25(OH)D significantly lower LS BMD than those with >75nmol/l. For GS, controlling for lean arm mass, a statistically significant
difference between the four ethnic/menopausal groups (F=24.851, p effect of season (F= 0.503, p=0.681) and no significant interaction between season and ethnic/menopausal group
(F=0.303, p=0.974). Significant positive partial correlations were found for all women (p 25(OH)D and GS. For all C as one group, significant positive correlations were found between 25(OH)D and GS in
summer (r=0.307), autumn (r=0.223), winter (r=0.222) and spring (r=0.242), with p was not found for the A groups combined, or for the four groups separately (p>0.05). In summary, LS BMD was found to
be significantly higher in individuals with 25(OH)D >75nmol/l compared to those with that poor 25(OH)D is associated with a detrimental effect on bone health. If maintained, these findings could potentially
translate into increased fracture risk long-term. Furthermore, 25(OH)D was positively correlated with GS in all women in
all seasons, indicating low 25(OH)D may decrease GS, most likely via poorer muscle function. These findings are a
cause for public health concern.
This work was funded by the UK Foods Standards Agency (NO5064). The views expressed are those of the authors
alone.
Gannon RHT, Millward DJ, Brown JE, Macdonald HM, Lovell DP, Frassetto LA, Remer T, Lanham-New SA (2008) Estimates of daily net endogenous acid production in the elderly UK population: analysis of the National Diet and Nutrition Survey (NDNS) of British adults aged 65 years and over, BRITISH JOURNAL OF NUTRITION 100 (3) pp. 615-623 CAMBRIDGE UNIV PRESS
Macdonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Erratum to: Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern?, Osteoporos Int
Davey T, Delves SK, Lanham-New SA, Allsopp AJ, Fallowfield JL (2011) Energy intake of Royal Marine recruits relative to training outcomes, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE4) pp. E149-E149 CAMBRIDGE UNIV PRESS
Al-Mana NM, Lanham-New SA, Robertson MD (2012) The acute effects of calcium supplementation on appetite and satiety in overweight women, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E215-E215 CAMBRIDGE UNIV PRESS
Lanham-New SA, Lambert H, Tripkovic L, Smith CP, Bucca G, Hart K, Penson S, Chope G, Hyppoenen E, Berry JL, Vieth R (2011) Vitamin D-2 v. vitamin D-3 supplementation in raising 25OHD status: preliminary findings of a meta-analysis, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE3) pp. E94-E94 CAMBRIDGE UNIV PRESS
Lanham-New SA, Lee WTK, Torgerson DJ, Millward DJ (2007) Is vegetable protein more beneficial to bone than animal protein?, International Congress Series 1297 pp. 310-318
The aim of this presentation was to assess the impact of a 'vegetarian diet' on indices of skeletal integrity. Analyses of existing literature were assessed in relation to bone health for: lacto-ovo-vegetarian and vegan diets vs. omnivorous; predominantly meat diets; consumption of animal vs. vegetable protein; fruit and vegetable consumption. The key findings include: (i) no differences in bone health indices between lacto-ovo-vegetarians and omnivores; (ii) conflicting data for protein effects on bone, with high and low protein intake being detrimental to the skeleton; (iii) growing support for a beneficial effect of fruit and vegetable intake on bone, with mechanisms of action currently remaining unclarified. © 2007 Elsevier B.V. All rights reserved.
Darling AL, Lanham-New S (2014) Food Groups and Bone Health, In: Holick M, Nieves J (eds.), Nutrition and Bone Health 18 pp. 277-290 Humana Press
This newly revised edition contains updated versions of all of the topics that were in the first edition and has been substantially expanded with an additional 5 chapters.
Vitamin D deficiency is a major public health concern in the UK. As the natural sources of vitamin D in the UK are limited, supplementation or food fortification are possible strategies for achieving the dietary recommendations of 10 ¼g/d that will be introduced in 2016 for the whole population.
However, there is controversy as to whether vitamin D2 and vitamin D3 are equally effective at raising vitamin D status (25OHD concentration). The primary and secondary aims of this PhD project were: to investigate the effects of both these forms of vitamin D independently on vitamin D status, markers of bone and cardiovascular health, and gene expression; as well as to examine whether common genetic variants affect response to either form of vitamin D.
A cohort of 90 South Asian and 245 Caucasian women were recruited onto a randomised-controlled trial; the D2-D3 Study. Participants were given either 15 µg/d of vitamin D2, 15 µg/d of vitamin D3 or placebo, in fortified foods, for 12 weeks.
At baseline, serum total 25OHD concentrations were significantly lower in the South Asian women (27.6 nmol/L) than the Caucasian women (60.3 nmol/L). In both the South Asian and Caucasian women, 25OHD concentrations significantly decreased in the placebo intervention (-5% and -15% respectively, p Interestingly, whole blood transcriptome analysis indicated that the vitamin D2 and D3 interventions triggered a difference in expression of entirely different genes, and predicted therefore a difference in the activity of the respective metabolic and cellular pathways. The associations between genetic polymorphisms and change in 25OHD concentration in response to vitamin D also appear to differ depending on the form of vitamin D taken, although baseline 25OHD concentration ma
Mortensen C, Damsgaard C, Hauger H, Ritz C, Lanham-New S, Smith T, Hennessy A, Dowling K, Cashman K, Kiely M, Mølgaard C (2016) Estimation of the dietary requirement for vitamin D in white children aged 4?8 y: a randomized, controlled, dose-response trial, American Journal of Clinical Nutrition 104 (5) pp. 1310-1317 American Society for Nutrition
Background: Children in northern latitudes are at high risk of vitamin D deficiency during winter because of negligible dermal vitamin D3 production. However, to our knowledge, the dietary requirement for maintaining the nutritional adequacy of vitamin D in young children has not been investigated. Objective: We aimed to establish the distribution of vitamin D intakes required to maintain winter serum 25-hydroxyvitamin D [25(OH)D] concentrations above the proposed cutoffs (25, 30, 40, and 50 nmol/L) in white Danish children aged 4?8 y living at 55°N. Design: In a double-blind, randomized, controlled trial 119 children (mean age: 6.7 y) were assigned to 0 (placebo), 10, or 20 ¼g vitamin D3/d supplementation for 20 wk. We measured anthropometry, dietary vitamin D, and serum 25(OH)D with liquid chromatography?tandem mass spectrometry at baseline and endpoint. Results: The mean ± SD baseline serum 25(OH)D was 56.7 ± 12.3 nmol/L (range: 28.7?101.4 nmol/L). Serum 25(OH)D increased by a mean ± SE of 4.9 ± 1.3 and 17.7 ± 1.8 nmol/L in the groups receiving 10 and 20 ¼g vitamin D3/d, respectively, and decreased by 24.1 ± 1.2 nmol/L in the placebo group (P 30 (avoiding deficiency) and >50 nmol/L (ensuring adequacy) in 97.5% of participants were 8.3 and 19.5 ¼g/d, respectively, and 4.4 ¼g/d was required to maintain serum 25(OH)D >40 nmol/L in 50% of participants. Conclusions: Vitamin D intakes between 8 and 20 ¼g/d are required by white 4- to 8-y-olds during winter in northern latitudes to maintain serum 25(OH)D >30?50 nmol/L depending on chosen serum 25(OH)D threshold. This trial was registered at clinicaltrials.gov as NCT02145195.
Darling A, Hart K, Gossiel F, Robertson F, Hunt J, Hill T, Johnsen S, Berry J, Eastell R, Vieth R, Lanham-New S (2017) Higher bone resorption excretion in South Asian women vs White Caucasians and increased bone loss with higher seasonal cycling of vitamin D:  results from the D-FINES cohort study, Bone 98 pp. 47-53 Elsevier
Few data exist on bone turnover in South Asian women and it is not well elucidated as to whether Western dwelling South Asian women have different bone resorption levels to that of women from European ethnic backgrounds. This study assessed bone resorption levels in UK dwelling South Asian and Caucasian women as well as evaluating whether seasonal variation in 25-hydroxyvitamin D [25(OH)D] is associated with bone resorption in either ethnic group. Data for seasonal measures of urinary N-telopeptide of collagen (uNTX) and serum 25(OH)D were analysed from n=373 women (four groups; South Asian postmenopausal n=44, South Asian premenopausal n=50, Caucasian postmenopausal n=144, Caucasian premenopausal n =135) (mean (± SD) age 48 (14) years; age range 18-79 years) who participated in the longitudinal D-FINES (Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England) cohort study (2006-2007). A mixed between-within subjects ANOVA (n=192) showed a between subjects effect of the four groups (P
Darling Andrea, Rayman Margaret, Steer Colin D., Golding Jean, Lanham-New Susan, Bath Sarah (2017) Association between maternal vitamin D status in pregnancy and neurodevelopmental outcomes in childhood; results from the Avon Longitudinal Study of Parents and Children, British Journal of Nutrition 117 (12) pp. 1682-1692 Cambridge University Press
Seafood intake in pregnancy has been positively associated with childhood cognitive outcomes which could potentially relate to the high vitamin-D content of oily fish. However, whether higher maternal vitamin D status [serum 25-hydroxy-vitamin D, 25(OH)D] in pregnancy is associated with a reduced risk of offspring suboptimal neurodevelopmental outcomes is unclear. A total of 7065 mother-child pairs were studied from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort who had data for both serum total 25(OH)D concentration in pregnancy and at least one measure of offspring neurodevelopment (pre-school development at 6?42 months; ?Strengths and Difficulties Questionnaire? scores at 7 years; IQ at 8 years; reading ability at 9 years). After adjustment for confounders, children of vitamin-D deficient mothers (
Darling Andrea, Hart Kathryn, Macdonald HM, Horton K, Kang?ombe AR, Berry JL, Lanham-New Susan (2012) Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women, Osteoporosis International Springer Verlag
This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern.
Introduction
There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D.
Methods
This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51° N), aged 20?55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry.
Results
Serum 25(OH)D Conclusions
Year-round vitamin D deficiency was extremely common in South Asian women. These findings pose great health threats regarding the adverse effects of vitamin D deficiency in pregnancy and warrant urgent vitamin D public health policy and action.
Darling Andrea, Hart Kathryn, Lanham-New Susan, MacDonald HM, Horton K, Kang'Ombe AR, Berry JL (2013) Vitamin D deficiency in UK South Asian Women of childbearing age: A comparative longitudinal investigation with UK Caucasian women, Osteoporosis International 24 (2) pp. 477-488 Springer Verlag
This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern. Introduction: There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D. Methods: This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51 N), aged 20-55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry. Results: Serum 25(OH)D
Vitamin D deficiency and inadequacy are worldwide public health concerns and occur across all age, sex and ethnic groups, with significant implications for human health. Adolescents are a population group at high risk of low vitamin D status, yet the evidence base for establishing vitamin D requirements remains weak.
The primary aim of this Thesis was to estimate the dietary vitamin D intakes required to maintain serum 25-hydroxyvitamin D [25(OH)D] concentrations above specific cut-off thresholds (25, 30, 40 and 50 nmol/l) during the winter-time in white Caucasian adolescents residing in the UK (51°N). Secondary aims were to: 1) investigate vitamin D status in relation to musculoskeletal and cardiometabolic health outcomes and; 2) explore familial associations in vitamin D status, dietary intakes and musculoskeletal health in mother-child pairs. This was achieved via a dose-response trial in 110 adolescents (14-18 years), who were randomly allocated to receive 0 (placebo), 10 or 20 ¼g vitamin D3 daily for 20 weeks during the winter-time. A final aim of this Thesis was to assess the vitamin D status and prevalence of vitamin D deficiency in a small study of African Caribbean and South Asian adolescent and young adult females (16-25 years) in comparison to their white Caucasian counterparts.
It was estimated that vitamin D intakes of 10.1, 13.1, 23.3 and ~30 ¼g/day would maintain serum 25(OH)D concentrations > 25, 30, 40 and 50 nmol/l respectively in 97.5% of the adolescents. Adolescents with serum 25(OH)D concentrations below 50 nmol/l had significantly lower radial trabecular volumetric bone mineral density and presented with a poorer cardiometabolic profile, with greater waist circumference and higher triglyceride and glucose concentrations than their more replete counterparts. However cardiometabolic risk was lost after controlling for potential confounders. Positive, sex-specific associations were found for serum 25(OH)D concentrations and radial mass, total area and cortical volumetric bone mineral density in mother-child pairs, but not for dietary vitamin D and calcium intakes. A high prevalence of vitamin D deficiency was found in African Caribbean and South Asian females (serum 25(OH)D In conclusion, dietary vi
Tripkovic Laura, Wilson LR, Hart Kathryn, Johnsen Sigurd, de Lusignan Simon, Smith CP, Bucca G, Penson S, Chope G, Elliott Ruan, Hypponen E, Berry J L, Lanham-New Susan (2017) Daily supplementation with 15 mg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial, American Journal of Clinical Nutrition 106 (2) pp. 481-490 American Society for Nutrition
Background: There are conflicting views in the literature as to whether vitamin D2 and vitamin D3 are equally effective in increasing and maintaining serum concentrations of 25-hydroxyvitamin D [25(OH)D], particularly at lower doses of vitamin D.

Objective: We aimed to investigate whether vitamin D2 or vitamin D3 fortified in juice or food, at a relatively low dose of 15 ¼g/d, was effective in increasing serum total 25(OH)D and to compare their respective efficacy in South Asian and white European women over the winter months within the setting of a large randomized controlled trial.

Design: A randomized, double-blind, placebo-controlled food-fortification trial was conducted in healthy South Asian and white European women aged 20?64 y (n = 335; Surrey, United Kingdom) who consumed placebo, juice supplemented with 15 ¼g vitamin D2, biscuit supplemented with 15 ¼g vitamin D2, juice supplemented with 15 ¼g vitamin D3, or biscuit supplemented with 15 ¼g vitamin D3 daily for 12 wk. Serum 25(OH)D was measured by liquid chromatography?tandem mass spectrometry at baseline and at weeks 6 and 12 of the study.

Results: Postintervention in the 2 ethnic groups combined, both the vitamin D3 biscuit and the vitamin D3 juice groups showed a significantly greater absolute incremental change (”) in total 25(OH)D when compared with the vitamin D2 biscuit group [” (95% CI): 15.3 nmol/L (7.4, 23.3 nmol/L) (P

Conclusions: With the use of a daily dose of vitamin D relevant to public health recommendations (15 ¼g) and in vehicles relevant to food-fortification strategies, vitamin D3 was more effective than vitamin D2 in increasing serum 25(OH)D in the wintertime. Vitamin D3 may therefore be a preferential form to optimize vitamin D status within the general population. This trial was registered at www.controlled-trials.com as ISRCTN23421591.

Smith Taryn, Tripkovic Laura, Lanham-New Susan, Hart Kathryn (2017) Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy, Proceedings of the Nutrition Society. 77 (3) pp. 292-301 Cambridge University Press
Vitamin D is a unique nutrient. Firstly, it acts as a pro-hormone and secondly, the requirement for
vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This
complicates the determination of dietary requirements for vitamin D, which along with the
definition of optimal vitamin D status, have been highly controversial and much debated over recent
years. Adolescents are a population group at high risk of low vitamin D status, which is concerning
given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and
attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations
are important from a public health perspective in helping to avoid deficiency and optimise vitamin
D status for health. However limited experimental data from winter-based dose-response
randomised trials in adolescents has hindered the development of evidence-based dietary
requirements for vitamin D in this population group. This review will highlight how specifically
designed randomised trials and the approach adopted for estimating such requirements can lead to
improved recommendations. Such data indicates that vitamin D intakes of between 10 and ~30
µg/day may be required to avoid deficiency and ensure adequacy in adolescents, considerably
greater than the current recommendations of 10-15 µg/day. Finally this review will consider the
implications of this on public health policy, in terms of future refinements of vitamin D requirement
recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency
Gibson Philippa S., Quaglia Alberto, Dhawan Anil, Wu Huihai, Lanham-New Sue, Hart Kath, Fitzpatrick Emer, Moore J. Bernadette (2018) Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non-alcoholic fatty liver disease, Pediatric Obesity 13 (7) pp. 433-441 Wiley
Background: Vitamin D deficiency has been associated with non-alcoholic fatty liver disease (NAFLD). However, the role of polymorphisms determining vitamin D status remains unknown.

Objectives: To determine in UK children with biopsy-proven NAFLD: (i) vitamin D status throughout a 12-month period; (ii) interactions between key vitamin D-related genetic variants (NADSYN1/DHCR7, VDR, GC, CYP2R1) and disease severity.

Methods: In 103 pediatric patients with NAFLD, serum 25-hydroxyvitamin D (25OHD) levels and genotypes were determined contemporaneously to liver biopsy and examined in relation to NAFLD activity score and fibrosis stage.

Results: Only 19.2% of children had adequate vitamin D status; most had mean 25OHD levels considered deficient (

Conclusions: Children with NAFLD in the UK have particularly low winter vitamin D status; with vitamin D insufficiency prevalent throughout the year. Polymorphisms in the vitamin D metabolic pathway are associated with histological severity of pediatric NAFLD.

Smith Taryn J, Tripkovic Laura, Hauger Hanne, Damsgaard Camilla T, Mølgaard Christian, Lanham-New Susan, Hart Kathryn H (2018) Winter Cholecalciferol Supplementation at 51°N Has No Effect on Markers of Cardiometabolic Risk in Healthy Adolescents Aged 14-18 Years, The Journal of Nutrition 148 (8) pp. 1269-1275 American Society for Nutrition

Background: Epidemiological studies have supported inverse associations between low serum 25-hydroxyvitamin D [25(OH)D] and cardiometabolic risk markers, but few randomized trials have investigated the effect of vitamin D supplementation on these markers in adolescents.

Objective: The objective of this study was to investigate the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk markers in white, healthy 14-18 year-old adolescents in the UK (51°N) as part of the ODIN Project.

Methods: In a dose-response trial, 110 adolescents (15.9±1.4 years; 43% male; 81% normal weight) were randomly assigned to receive 0, 10 or 20 ¼g/day vitamin D3 for 20 weeks (October-March). Cardiometabolic risk markers including BMI-for-age z-score (BMIz), waist circumference, systolic and diastolic blood pressure, fasting plasma triglycerides, cholesterol (total, HDL, LDL and total:HDL) and glucose were measured at baseline and endpoint as secondary outcomes, together with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at endpoint, adjusted for the baseline value of the outcome variable and additionally for age, sex, Tanner stage, BMIz and baseline serum 25(OH)D.

Results: Mean±SD baseline serum 25(OH)D was 49.1±12.3 nmol/L and differed between groups at endpoint with concentrations of 30.7±8.6, 56.6±12.4 and 63.9±10.6 nmol/L in the 0, 10 and 20 ¼g/day groups respectively (Pd0.001). Vitamin D3 supplementation had no effect on any of the cardiometabolic risk markers (all P>0.05), except for lower HDL (-0.12 mmol/L, 95% CI -0.21, 0.04, P=0.003) and total cholesterol (-0.21 mmol/L, 95% CI -0.42, 0.00, P=0.05) in the 20 compared to the 10 ¼g/day group, which disappeared in the fully adjusted analysis (P=0.27 and P=0.30 respectively).

Conclusions: Supplementation with vitamin D3 at 10 and 20 ¼g/25 day, which increased serum 25(OH)D concentrations during the winter-time, had no effect on markers of cardiometabolic risk in healthy 14-18 year-old adolescents. This trial was registered at clinicaltrials.gov as NCT02150122.

Darling Andrea L., Blackbourn David J., Ahmadi Kourosh R., Lanham-New Susan A. (2018) Vitamin D supplement use and associated demographic, dietary and lifestyle factors in South Asians (n 8024) aged 40-69 years: analysis of the UK Biobank Cohort, Public Health Nutrition 21 (14) pp. 2678-2688 Cambridge University Press

Objective: Vitamin D deficiency (serum 25-hydroxyvitamin DÂ25nmol/L) is extremely common in western-dwelling South Asians but evidence regarding vitamin D supplement usage in this group is very limited. This work identifies demographic, dietary and lifestyle predictors associated with vitamin D supplement use.

Design: Cross-sectional analysis of baseline vitamin D supplement use data.

Setting: UK Biobank cohort.

Subjects: In total, n 8024 South Asians (Bangladeshi, Indian, Pakistani), aged 40-69 years.

Results: Twenty-three % of men and 39% of women (PÂ0.001) [22% of Bangladeshis, 32% of Indians, 25% of Pakistanis (PÂ0.001)] took a vitamin D containing supplement. Median vitamin D intakes from diet were low at 1.0-3.0 micrograms per day, being highest in Bangladeshis and lowest in Indians (PÂ0.001). Logistic regression modelling showed that females had a higher odds of vitamin D supplement use than males (odds ratio (OR) = 2.02; 95% confidence interval (CI) 1.79 to 2.28). A lower supplement usage was seen in younger persons (40-60 years) (OR=0.75; 95% CI 0.65 to 0.86 reference= Ã60 years), and those living outside of Greater London (OR=0.53 to 0.77), with borderline trends for a lower body mass index, higher oily fish intake and higher household income associated with increased odds of vitamin D supplement use.

Conclusions: Vitamin D supplements were not used by most South Asians and intakes from diet alone are likely to be insufficient to maintain adequate vitamin D status. Public health strategies are now urgently required to promote the use of vitamin D supplements in these specific UK South Asian sub-groups.

Hauger Hanne, Mølgaard Christian, Mortensen Charlotte, Ritz Christian, Frøkiær Hanne, Smith Taryn J, Hart Kath, Lanham-New Susan, Damsgaard Camilla T (2018) Winter Cholecalciferol Supplementation
at 55°N Has No Effect on Markers of
Cardiometabolic Risk in Healthy Children
Aged 4?8 Years,
The Journal of Nutrition 148 (8) pp. 1261-1268 Oxford University Press
Background: Low serum 25-hydroxyvitamin D [25(OH)D] has been associated with unfavorable cardiometabolic risk
profiles in many observational studies in children, but very few randomized controlled trials have investigated this.
Objective: We explored the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk
markers in young, white, 4- to 8-y-old healthy Danish children (55°N) as part of the pan-European ODIN project.
Methods: In the ODIN Junior double-blind, placebo-controlled, dose-response trial, 119 children (mean ± SD age:
6.7 ± 1.5 y; 36% male; 82% normal weight) were randomly allocated to 0, 10 or 20 ¼g/d of vitamin D3 for 20 wk
(October?March). Cardiometabolic risk markers including BMI-for-age z score (BMIz), waist circumference, systolic and
diastolic blood pressure, serum triglycerides and cholesterol (total, LDL, HDL, and total:HDL), plasma glucose and insulin,
and whole-blood glycated hemoglobin were measured at baseline and endpoint as secondary outcomes together
with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at
endpoint adjusted for baseline value of the outcome, and additionally for age, sex, baseline serum 25(OH)D, BMIz, time
since breakfast, and breakfast content.
Results: Mean ± SD serum 25(OH)D was 56.7 ± 12.3 nmol/L at baseline and differed between groups at endpoint
with concentrations of 31.1 ± 7.5, 61.8 ± 10.6, and 75.8 ± 11.5 nmol/L in the 0-, 10-, and 20 ¼g/d groups, respectively
(P for baseline value of the outcome (all P e 0.05), and additional covariate adjustment did not change the results notably.
Conclusions: Preventing the winter decline in serum 25(OH)D with daily vitamin D3 supplementation of 10 or 20 ¼g had
no cardiometabolic effects in healthy 4- to 8-y-old Danish children. This trial was registered at www.clinicaltrials.gov as
NCT02145195.
Wilson Louise, Tripkovic Laura, Hart Kath, Lanham-New Susan (2017) Vitamin D deficiency as a public health issue: using vitamin D2 or vitamin D3 in future fortification strategies, Proceedings of the Nutrition Society 76 (3) pp. 392-399 Cambridge University Press
The role of vitamin D in supporting the growth and maintenance of the skeleton is robust;
with recent research also suggesting a beneficial link between vitamin D and other nonskeletal
health outcomes, including immune function, cardiovascular health and cancer.
Despite this, vitamin D deficiency remains a global public health issue, with a renewed
focus in the UK following the publication of Public Health England?s new Dietary
Vitamin D Requirements. Natural sources of vitamin D (dietary and UVB exposure) are
limited, and thus mechanisms are needed to allow individuals to achieve the new dietary
recommendations. Mandatory or voluntary vitamin D food fortification may be one of
the mechanisms to increase dietary vitamin D intakes and subsequently improve vitamin
D status. However, for the food industry and public to make informed decisions, clarity
is needed as to whether vitamins D2 and D3 are equally effective at raising total 25-hydroxyvitamin
D (25(OH)D) concentrations as the evidence thus far is inconsistent. This review
summarises the evidence to date behind the comparative efficacy of vitamins D2 and D3 at
raising 25(OH)D concentrations, and the potential role of vitamin D food fortification as a
public health policy to support attainment of dietary recommendations in the UK. The comparative
efficacy of vitamins D2 and D3 has been investigated in several intervention trials,
with most indicating that vitamin D3 is more effective at raising 25(OH)D concentrations.
However, flaws in study designs (predominantly under powering) mean there remains a
need for a large, robust randomised-controlled trial to provide conclusive evidence, which
the future publication of the D2?D3 Study should provide (BBSRC DRINC funded: BB/
I006192/1). This review also highlights outstanding questions and gaps in the research
that need to be addressed to ensure the most efficacious and safe vitamin D food fortification
practices are put in place. This further research, alongside cost, availability and ethical considerations
(vitamin D3 is not suitable for vegans), will be instrumental in supporting government,
decision-makers, industry and consumers in making informed choices about
potential future vitamin D policy and practice.
Smith Taryn J, Lanham-New Susan, Hart Kath (2017) Vitamin D in adolescents: Are current recommendations enough?, The Journal of Steroid Biochemistry and Molecular Biology 173 pp. 265-272 Elsevier
Vitamin D is essential for bone development during adolescence and low vitamin D status during this critical period of growth may impact bone mineralization, potentially reducing peak bone mass and consequently increasing the risk of osteoporosis in adulthood. Therefore, the high prevalence of vitamin D inadequacy and deficiency in adolescent populations is of great concern. However, there is currently a lack of consensus on the 25-hydroxyvitamin D [25(OH)D] concentration, the widely accepted biomarker of vitamin D status, that defines adequacy, and the vitamin D intake requirements to maintain various 25(OH)D thresholds are not well established. While the current intake recommendations of 10?15 ¼g/day may be sufficient to prevent vitamin D deficiency (25(OH)D 50 nmol/l). This review will address these concerns and consider if the current dietary recommendations for vitamin D in adolescents are sufficient.
Mendes Marcela M., Darling Andrea L., Hart Kathryn H., Morse Stephen, Murphy Richard, Lanham-New Susan A. (2019) Impact of high latitude, urban living and ethnicity on 25-hydroxyvitamin D status: A need for multidisciplinary action?, The Journal of Steroid Biochemistry and Molecular Biology 188 pp. pp 95-102 Elsevier

The effects of urban living on health are becoming increasingly important, due to an increasing global population residing in urban areas. Concomitantly, due to immigration, there is a growing number of ethnic minority individuals (African, Asian or Middle Eastern descent) living in westernised Higher Latitude Countries (HLC) (e.g. Europe, Canada, New Zealand). Of concern is the fact that there is already a clear vitamin D deficiency epidemic in HLC, a problem which is likely to grow as the ethnic minority population in these countries increases. This is because 25-hydroxyvitamin D (25(OH)D) status of ethnic groups is significantly lower compared to native populations.

Environmental factors contribute to a high prevalence of vitamin D deficiency in HLC, particularly during the winter months when there is no sunlight of appropriate wavelength for vitamin D synthesis via the skin. Also, climatic factors such as cloud cover may reduce vitamin D status even in the summer. This may be further worsened by factors related to urban living, including air pollution, which reduces UVB exposure to the skin, and less occupational sun exposure (may vary by individual HLC). Tall building height may reduce sun exposure by making areas more shaded. In addition, there are ethnicity-specific factors which further worsen vitamin D status in HLC urban dwellers, such as low dietary intake of vitamin D from foods, lower production of vitamin D in the skin due to increased melanin and reduced skin exposure to UVB due to cultural dress style and sun avoidance.

A multidisciplinary approach applying knowledge from engineering, skin photobiology, nutrition, town planning and social science is required to prevent vitamin D deficiency in urban areas. Such an approach could include reduction of air pollution, modification of sun exposure advice to emphasise spending time each day in non-shaded urban areas (e.g. parks, away from tall buildings), and advice to ethnic minority groups to increase sun exposure, take vitamin D supplements and/or increase consumption of vitamin D rich foods in a way that is safe and culturally acceptable. This review hopes to stimulate further research to assess the impact of high latitude, urban environment and ethnicity on the risk of vitamin D deficiency.

Darling A.L., Hart K.H., Arber S., Berry J.L., Morgan P.L., Middleton B.A., Lanham-New S., Skene D.J. (2019) 25-Hydroxyvitamin D status, light exposure and sleep quality in UK dwelling South Asian and Caucasian postmenopausal women, The Journal of Steroid Biochemistry and Molecular Biology 189 pp. pp 265-273 Elsevier

There is a lack of research into 25-hydroxyvitamin D (25(OH)D) status, light exposure and sleep patterns in South Asian populations. In addition, results of research studies are conflicting as to whether there is an association between 25(OH)D status and sleep quality.

We investigated 25(OH)D status, self-reported and actigraphic sleep quality in n = 35 UK dwelling postmenopausal women (n = 13 South Asians, n = 22 Caucasians), who kept daily sleep diaries and wore wrist-worn actiwatch (AWL-L) devices for 14 days. A subset of n = 27 women (n = 11 South Asian and n = 16 Caucasian) also wore a neck-worn AWL-L device to measure their light exposure.

For 25(OH)D concentration, South Asians had a median ± IQR of 43.8 ± 28.2 nmol/L, which was significantly lower than Caucasians (68.7 ± 37.4 nmol/L)(P = 0.001). Similarly, there was a higher sleep fragmentation in the South Asians (mean ± SD 36.9 ± 8.9) compared with the Caucasians (24.7 ± 7.1)(P = 0.002). Non-parametric circadian rhythm analysis of rest/activity patterns showed a higher night-time activity (L5) (22.6 ± 14.0 vs. 10.5 ± 4.4; P = 0.0008) and lower relative amplitude (0.85 ± 0.07 vs. 0.94 ± 0.02; P Â 0.0001) in the South Asian compared with the Caucasian women. More South Asians (50%) met the criteria for sleep disorders (PSQI score Ã5) than did Caucasians (27%) (P = 0.001, Fishers Exact Test). However, there was no association between 25(OH)D concentration and any sleep parameter measured (P Ã 0.05) in either ethnic group. South Asians spent significantly less time in illuminance levels over 200 lx (P = 0.009) than did Caucasians.

Overall, our results show that postmenopausal South Asian women have lower 25(OH)D concentration than Caucasian women. They also have higher sleep fragmentation, as well as a lower light exposure across the day. This may have detrimental implications for their general health and further research into sleep quality and light exposure in the South Asian ethnic group is warranted.

Darling A. L., Manders R. J. F., Sahni S., Zhu K., Hewitt C. E., Prince R. L., Millward D. J., Lanham-New S. A. (2019) Dietary protein and bone health across the life-course: an updated systematic review and meta-analysis over 40 years, Osteoporosis International 30 (4) pp. 741-761 Springer London
We undertook a systematic review and meta-analysis of published papers assessing dietary protein and bone health. We found little benefit of increasing protein intake for bone health in healthy adults but no indication of any detrimental effect, at least within the protein intakes of the populations studied. This systematic review and meta-analysis analysed the relationship between dietary protein and bone health across the life-course. The PubMed database was searched for all relevant human studies from the 1st January 1976 to 22nd January 2016, including all bone outcomes except calcium metabolism. The searches identified 127 papers for inclusion, including 74 correlational studies, 23 fracture or osteoporosis risk studies and 30 supplementation trials. Protein intake accounted for 0?4% of areal BMC and areal BMD variance in adults and 0?14% of areal BMC variance in children and adolescents. However, when confounder adjusted (5 studies) adult lumbar spine and femoral neck BMD associations were not statistically significant. There was no association between protein intake and relative risk (RR) of osteoporotic fractures for total (RR(random) = 0.94; 0.72 to 1.23, I2 = 32%), animal (RR (random) = 0.98; 0.76 to 1.27, I2 = 46%) or vegetable protein (RR (fixed) = 0.97 (0.89 to 1.09, I2 = 15%). In total protein supplementation studies, pooled effect sizes were not statistically significant for LSBMD (total n = 255, MD(fixed) = 0.04 g/cm2 (0.00 to 0.08, P = 0.07), I2 = 0%) or FNBMD (total n = 435, MD(random) = 0.01 g/cm2 (?0.03 to 0.05, P = 0.59), I2 = 68%). There appears to be little benefit of increasing protein intake for bone health in healthy adults but there is also clearly no indication of any detrimental effect, at least within the protein intakes of the populations studied (around 0.8?1.3 g/Kg/day). More studies are urgently required on the association between protein intake and bone health in children and adolescents.
Lewis Rebecca, Gomez Alvarez Constanza B., Rayman Margaret, Lanham-New Susan, Woolf Anthony, Mobasheri Ali (2019) Strategies for optimising musculoskeletal health in the 21st century, BMC Musculoskeletal Disorders 20 164 pp. 1-15 BMC

We live in a world with an ever-increasing ageing population. Studying healthy ageing and reducing the socioeconomic impact of age-related diseases is a key research priority for the industrialised and developing countries, along with a better mechanistic understanding of the physiology and pathophysiology of ageing that occurs in a number of age-related musculoskeletal disorders. Arthritis and musculoskeletal disorders constitute a major cause of disability and morbidity globally and result in enormous costs for our health and social-care systems.

By gaining a better understanding of healthy musculoskeletal ageing and the risk factors associated with premature ageing and senescence, we can provide better care and develop new and better-targeted therapies for common musculoskeletal disorders. This review is the outcome of a two-day multidisciplinary, international workshop sponsored by the Institute of Advanced Studies entitled ?Musculoskeletal Health in the 21st Century? and held at the University of Surrey from 30th June-1st July 2015.

The aim of this narrative review is to summarise current knowledge of musculoskeletal health, ageing and disease and highlight strategies for prevention and reducing the impact of common musculoskeletal diseases.

There is still limited data on the association between 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and bone health in healthy younger adults, particularly in Latin America. This cross-sectional analysis aimed to investigate the associations of 25(OH)D and plasma PTH concentrations with bone parameters, and potential confounders, in women living in a high (England) or low (Brazil) latitude country. Bone was assessed by either peripheral quantitative computed tomography (pQCT) (England) or dual-energy x-ray absorptiometry (DXA) scan (Brazil), serum 25(OH)D concentrations by high performance liquid chromatography tandem mass spectrometry (HPLC-MS) and PTH by the chemiluminescent method. In participants living in England, total volumetric bone mineral density (vBMD) was significantly higher in women
Hattangdi-Haridas Sonal R., Lanham-New Susan A., Wong Wilfred Hing Sang, Ho Marco Hok Kung, Darling Andrea L. (2019) Vitamin D deficiency and effects of vitamin D supplementation on disease severity in patients with Atopic Dermatitis: a systematic review and meta-analysis in adults and children, Nutrients 11 (8) 1854 pp. 1-19 MDPI
Research has investigated 25-hydroxyvitamin D (25(OH)D) levels in the Atopic Dermatitis (AD) population, as well as changes in AD severity after vitamin D (VitD) supplementation. We performed an up-to-date systematic review and meta-analysis of these findings. Electronic searches of MEDLINE, EMBASE and COCHRANE up to February 2018 were performed. Observational studies comparing 25(OH)D between AD patients and controls, as well as trials documenting baseline serum 25(OH)D levels and clinical severity by either SCORAD/EASI scores, were included. Of 1085 articles retrieved, sixteen were included. A meta-analysis of eleven studies of AD patients vs. healthy controls (HC) found a mean difference of -14 nmol/L (95%CI -25 to -2) for all studies and -16 nmol/L (95% CI -31 to -1) for the paediatric studies alone. A meta-analysis of three VitD supplementation trials found lower SCORAD by -11 points (95% CI -13 to -9) (p Â0·00001). This surpasses the Minimal Clinical Important Difference for AD of 9.0 points (by 22%). There were greater improvements in trials lasting three months and the mean weighted dose of all trials was 1500-1600U/day. Overall, the AD population, especially the paediatric subset, may be at high-risk for lower serum 25(OH)D. Supplementation with around 1600IU/d results in a clinically meaningful AD severity reduction.
Risco D, Salguero Bodes F.J., Cerrato R., Gutierrez Merino J., Lanham-New S., Barquero-Pérez O., Hermoso de Mendoza J., Fernández Llario P. (2016) Association between vitamin D supplementation and severity of tuberculosis in wild boar and red deer, Research in Veterinary Science 108 pp. 116-119 Elsevier
Tuberculosis (TB) is a chronic disease affecting humans and other mammal species. Severity of TB caused by Mycobacterium tuberculosis in humans seems to be influenced by nutritional factors like vitamin D3 intake. However, this relationship has been scarcely studied in cattle and other mammals infected with Mycobacterium bovis. The aim of this work was to assess if wildlife reservoirs of M. bovis show different levels of TB severity depending on the level of vitamin D found in serum after supplementation with vitamin D3. Forty hunted wildlife mammals were included in this study: 20 wild boar and 20 red deer. Ten wild boar and ten red deer had been supplemented with a vitamin D3-enriched food, whereas the remaining animals had received no supplementation. TB diagnosis was carried out in each animal based on microbiological isolation of M. bovis. Animals infected with M. bovis were then classified as animals with localized or generalized TB depending on the location and dissemination of the lesions. Furthermore, serum levels of vitamin D2 and D3 were determined in each animal to evaluate differences not only between supplemented and non-supplemented animals but also between those with localized and generalized TB. Levels of vitamin D3 found in both, supplemented wild boar and red deer, were significantly higher than those found in the non-supplemented animals. Interestingly, higher levels of vitamin D3 were observed in animals suffering localized TB when compared to animals with generalized TB suggesting that vitamin D3 concentration correlates negatively with TB severity in these wildlife reservoirs.

Vitamin D deficiency (Â25nmol/L) and insufficiency (Â50nmol/L) has become an increasingly popular topic. Current research focusses upon the potential ergogenic effects of vitamin D (vitD) in sporting performance; however, the relationship between vitD (dietary intake and nutritional status) and bone health within a University athlete cohort remains under-investigated. Therefore, the aims of this Thesis were to (1) examine vitD status longitudinally across the University competitive seasons and; (2) examine the implications that vitD deficiency/ insufficiency may have upon physical performance parameters or bone health.

In the first study, fifty-seven competitive University level- athletes from varied sports were observed from autumn to spring. Radial bone mineral density (BMD) and physical performance parameters were investigated; for the analysis of vitD and parathyroid hormone, blood samples were collected. Within the cohort 7% presented with deficiency during the autumn; increasing to 44% during spring. However, this did not have a significant effect upon physical performance and bone health despite an average status of 31.5±16.4 nmol/L in spring.

In the second study, 34 University athletes and sixteen sedentary students were recruited and followed from spring to summer. Whole body, hip and tibial scans were conducted to determine BMD and bone mineral content (BMC). Physical performance parameters including jump height, aerobic fitness, muscular strength and blood biochemistry were also collected. During the summer term, 26% of the cohort were vitD insufficient. Moreover, an insufficient vitD status was associated with a lowered jump height (p=0.015) but not aerobic fitness (p=0.07). There was also a significant positive relationship between vitD status, femoral neck BMC (r=0.685; pÂ0.02) and BMD (r=0.679; pÂ0.02). Our results show that BMD was higher in weight bearing athletes. The final study found that racket sport athletes had a significantly superior bone profile in their dominant arm when contrasted to controls.

Overall, these findings suggest that an insufficient vitD status was associated with lower indices of muscular power and aerobic fitness in University students. Therefore, being vitD replete may not only play an important role in musculoskeletal health but could also be a key determining factor in athletic performance.