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Sun protective behaviors and vitamin D levels in the US population: NHANES 2003-2006.

ABSTRACT: Sun protection is recommended for skin cancer prevention, yet little is known about the role of sun protection on vitamin D levels. Our aim was to investigate the relationship between different types of sun protective behaviors and serum 25(OH)D levels in the general US population.Cross-sectional, nationally representative survey of 5,920 adults aged 18-60 years in the US National Health and Nutrition Examination Survey 2003-2006. We analyzed questionnaire responses on sun protective behaviors: staying in the shade, wearing long sleeves, wearing a hat, using sunscreen and SPF level. Analyses were adjusted for multiple confounders of 25(OH)D levels and stratified by race. Our primary outcome measures were serum 25(OH)D levels (ng/ml) measured by radioimmunoassay and vitamin D deficiency, defined as 25(OH)D levels <20 ng/ml.Staying in the shade and wearing long sleeves were significantly associated with lower 25(OH)D levels. Subjects who reported frequent use of shade on a sunny day had -3.5 ng/ml (p (trend) < 0.001) lower 25(OH)D levels compared to subjects who reported rare use. Subjects who reported frequent use of long sleeves had -2.2 ng/ml (p (trend) = 0.001) lower 25(OH)D levels. These associations were strongest for whites, and did not reach statistical significance among Hispanics or blacks. White participants who reported frequently staying in the shade or wearing long sleeves had double the odds of vitamin D deficiency compared with those who rarely did so. Neither wearing a hat nor using sunscreen was associated with low 25(OH)D levels or vitamin D deficiency.White individuals who protect themselves from the sun by seeking shade or wearing long sleeves may have lower 25(OH)D levels and be at risk for vitamin D deficiency. Frequent sunscreen use does not appear to be linked to vitamin D deficiency in this population.

SUBMITTER: Linos E

PROVIDER: S-EPMC3718293 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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Sun protective behaviors and vitamin D levels in the US population: NHANES 2003-2006.

Linos Eleni E Keiser Elizabeth E Kanzler Matthew M Sainani Kristin L KL Lee Wayne W Vittinghoff Eric E Chren Mary-Margaret MM Tang Jean Y JY

Cancer causes & control : CCC 20111102 1

<h4>Background</h4>Sun protection is recommended for skin cancer prevention, yet little is known about the role of sun protection on vitamin D levels. Our aim was to investigate the relationship between different types of sun protective behaviors and serum 25(OH)D levels in the general US population.<h4>Methods</h4>Cross-sectional, nationally representative survey of 5,920 adults aged 18-60 years in the US National Health and Nutrition Examination Survey 2003-2006. We analyzed questionnaire resp ...[more]

PMID: 22045154

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Project description:BACKGROUND:We propose a method for estimating the timing of in-bed intervals using objective data in a large representative US sample, and quantify the association between these intervals and age, sex, and day of the week. METHODS:The study included 11,951 participants 6 years and older from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, who wore accelerometers to measure physical activity for seven consecutive days. Participants were instructed to remove the device just before the nighttime sleep period and put it back on immediately after. This nighttime period of non-wear was defined in this paper as the objective bedtime (OBT), an objectively estimated record of the in-bed interval. For each night of the week, we estimated two measures: the duration of the OBT (OBT-D) and, as a measure of the chronotype, the midpoint of the OBT (OBT-M). We estimated day-of-the-week-specific OBT-D and OBT-M using gender-specific population percentile curves. Differences in OBT-M (chronotype) and OBT-D (the amount of time spent in bed) by age and sex were estimated using regression models. RESULTS:The estimates of OBT-M and their differences among age groups were consistent with the estimates of chronotype obtained via self-report in European populations. The average OBT-M varied significantly by age, while OBT-D was less variable with age. In the reference group (females, aged 17-22 years), the average OBT-M across 7 days was 4:19 AM (SD = 30 min) and the average OBT-D was 9 h 19 min (SD = 12 min). In the same age group the average OBT-D was 18 minutes shorter for males than for females, while the average OBT-M was not significantly different between males and females. The most pronounced differences were observed between OBT-M of weekday and weekend nights. In the reference group, compared to the average OBT-M of 3:50 am on Monday through Thursday nights, there was a 57-minute delay in OBT-M on Friday nights (entering the weekend), a 69-minute delay on Saturday nights (staying in the weekend), and a 23-minute delay on Sunday night (leaving the weekend). For both OBT-M and OBT-D, in most age groups and for most days of the week, there were no statistically significant differences between males and females, except for OBT-D on Wednesdays and Thursdays, with males having 31 (p-value < 0.05) and 45 (p-value < 0.05) minutes shorter OBT-D, respectively. CONCLUSIONS:The proposed measures, OBT-D and OBT-M, provide useful information of time in bed and chronotype in NHANES 2003-2006. They identify within-week patterns of bedtime and can be used to study associations between the bedtime and the large number of health outcomes collected in NHANES 2003-2006.

Dataset Information

Sun protective behaviors and vitamin D levels in the US population: NHANES 2003-2006.

Publications

Sun protective behaviors and vitamin D levels in the US population: NHANES 2003-2006.

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