| Literature DB >> 35267264 |
Anna Haug1, Cees Vermeer2, Lene Ruud3, Milena Monfort-Pires3, Vladana Grabež3, Bjørg Egelandsdal3.
Abstract
Bovine meat provides healthy nutrients but has also been negatively linked to greenhouse gases and non-communicable diseases. A double-blind intervention study was carried out to compare beef meat from bulls fed with feed supplemented with selenium, vitamin D, E, K (SeDEK-feed), and n-3, or REGULAR feed. Thirty-four young healthy women (19-29 years old) consumed 300 g of these beef types per day for 6 days in a cross-over design. Diet registrations, blood samples, anthropometric measurements, and clinical data were collected four times. Both beef diets were higher than their habitual diet in protein, fat, saturated fat, and several micronutrients; contained more vegetables and fewer carbohydrates and were followed by a higher feeling of satiety. The SeDEK beef had higher amounts of selenium, vitamin 25-hydroxyvitamin D3 (25(OH)D3), E, and K (MK4), and increased serum selenium and 25(OH)D3 from the participants' normal values if they were below 85 µg/L of selenium and 30 nmol of 25(OH)D3/L, respectively. Our study showed that optimized beef increased serum selenium in young women having moderate selenium levels and improved blood 25(OH)D3 in a woman having low to normal 25(OH)D3. Meat should be optimized to increase specific consumer groups' needs for selenium and vitamin D.Entities:
Keywords: beef meat; human intervention; selenium; vitamin D; young women
Year: 2022 PMID: 35267264 PMCID: PMC8909616 DOI: 10.3390/foods11050631
Source DB: PubMed Journal: Foods ISSN: 2304-8158
Figure 1Timeline for the experimental design of the cross-over double-blind study.
Measured nutrient contents in minced beef meat; control bulls (REGULAR) and bulls fed nutrient optimized composite feed (SeDEK) [39]. Reproduced with permission from Kaveri Thakuria, Meat Science, Elsevier, 2022.
| In 100 g a | REGULAR | SeDEK |
|---|---|---|
| N = 6 Bulls | N = 6 Bulls | |
| Selenium, µg | 10.0 | 12.6 |
| Myoglobin b, g | 0.38 | 0.45 |
| Alpha-tocopherol, mg | 0.16 | 0.65 |
| K1, µg | 2.1 | 2.0 |
| MK4, µg | 9.1 | 20.3 |
| Vit D3, µg | <0.01 | 0.04 |
| 25(OH)D3, µg | 0.10 | 0.29 |
| Cholesterol, mg | 73.0 | 57.5 |
| Fat, g | 13.6 | 14.9 |
| C14:0, g | 0.36 | 0.39 |
| C16:0, g | 3.35 | 3.48 |
| C16:1 | 0.37 | 0.42 |
| C18:0, g | 2.59 | 2.82 |
| C18:1 | 5.01 | 5.56 |
| C18:1 trans, g | 0.43 | 0.47 |
| C18:2 | 0.27 | 0.25 |
| C18:3 | 0.059 | 0.070 |
| C20:4 | 0.032 | 0.029 |
| C20:5 | 0.006 | 0.006 |
| C22:5 | 0.017 | 0.019 |
| 3.6 | 2.9 |
a Analytical measurement errors are given in [35]. b hemin-based determination.
Baseline characteristics of 34 participants; anthropometric values and serum analyses, mean values at baseline, standard deviations (SD), min and max values and reference ranges.
| N = 34 | Baseline | Min | Max | Ref Values |
|---|---|---|---|---|
| Mean ± SD | ||||
| Age, years | 21.4 ± 2.0 | 19 | 29 | |
| Height, cm | 170 ± 6 | 157 | 180 | |
| Body weight, kg | 66.1 ± 8.5 | 50 | 88 | |
| BMI, kg/m2 | 22.9 ± 2.7 | 18 | 29 | |
| Systolic BP | 113 ± 8 | 94 | 132 | 90–130 |
| Diastolic BP | 70 ± 7 | 54 | 84 | 60–85 |
| Heart rate | 74 ± 13 | 48 | 102 | 60–100 |
| Blood glucose, mmol/L, blood | 5.0 ± 0.5 | 3.9 | 6.6 | 3.8–6.1 |
| Insulin, pmol/L serum | 72.6 ± 31 | 24 | 150 | 18–173 |
| C-peptide, pmol/L serum | 476 ± 146 | 205 | 850 | 270–1290 |
| Selenium µg/L serum | 84.9 ± 15.1 | 65.4 | 151.8 | 47–142 |
| AST, U/L serum | 18.3 ± 4.5 | 10 | 27 | <35 |
| ALT, U/L serum | 14.7± 5.7 | 8 | 35 | <45 |
| IL-6, ng/L plasma | 3.6 ± 0.8 | 2.2 | 6.8 | <7 a |
| IL-8, ng/L plasma | 21.5 ± 1.2 | 19.4 | 23.6 | <16 b |
| IL-1β, ng/L plasma | 12.3 ± 2.6 | 9.9 | 19.6 | <12 c,d |
| Hb, g/100 mL blood | 13.3 ± 1.0 | 11.4 | 15.6 | 11.5–16 |
| Triglycerides, mmol/L serum | 0.93 ± 0.28 | 0.5 | 1.6 | <2.6 |
| LDL-cholesterol, mmol/L serum | 2.7 ± 0.81 | 0.9 | 4.8 | 1.2–4.3 |
| HDL-cholesterol, mmol/L serum | 1.6 ± 0.41 | 1.2 | 3.0 | 1.0–2.7 |
| Phylloquinone, µg/L plasma | 0.35 ± 0.22 | nd | 0.8 | 0.2–0.8 e,f,g,h |
| MK4, µg/L plasma | n.d | n.d. | n.d. | <0.3 i |
| MK7, µg/L plasma | 0.18 ± 0.14 | nd | 0.82 | <0.8 j,k |
| MK8, µg/L plasma | 0.13± 0.18 | nd | 0.48 | <0.45 k |
| 25(OH)D3, nmol/L serum | 54.6 l ± 19.6 | 11.8 | 91.7 | 50–150 |
a [49]; b [50]; c,d [51,52]; e [53]; f [54]; g [55]; h [56]; i [57]; j [58]; k [59]; l Only 6 samples out of 34 reached detection level for vitamin D3, and the vitamin D3 values are not presented.
The calculated (databases and own values) nutrient intake of 34 participants, after the 3-day food registrations, mean values, and standard deviations (SD). The ‘habitual diet’ represents the mean nutrient intakes at baseline, and the washout period, the ‘300 g beef’ represents the mean nutrient intakes when consuming SeDEK beef and REGULAR beef.
| N = 34 | Habitual Diet | ‘300 g Beef’ |
| SeDEK-Beef | REGULAR Beef |
|
|---|---|---|---|---|---|---|
| Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |||
| Energy, kcal | 1848 ± 336 | 1971 ± 306 | 0.117 | 1894 ± 313 | 2049 ± 383 | 0.071 |
| Higher satiety, % of participants | 3 | 77 | <0.001 | - | - | - |
| Intake of beef, g | 12.7 ± 2.3 | 312.2 ± 8.4 | <0.001 | - | - | - |
| Intake of all meat, g | 84.8 ± 17.8 | 391.0 ± 28.8 | <0.001 | - | - | - |
| Intake of vegetables, g | 221 ± 145 | 314 ± 176 | 0.020 | - | - | - |
| Intake of cereals, g | 222 ± 80 | 186 ± 86 | 0.080 | - | - | - |
| Fat E% | 36.33 ± 6.01 | 42.73 ± 4.55 | <0.001 | 42.26 ± 5.2 | 43.53 ± 6.6 | 0.385 |
| Saturated fat E% | 12.53 ± 3.10 | 17.60 ± 2.69 | <0.001 | 17.65 ± 3.3 | 17.56 ± 3.7 | 0.918 |
| Trans unsaturated E% | 0.08 ± 0.18 | 0.45 ± 0.42 | <0.001 | 0.44 ± 0.56 | 0.46 ± 0.50 | 0.909 |
| Monounsaturated E% | 13.21 ± 3.20 | 15.71 ± 2.53 | <0.001 | 14.97 ± 3.2 | 16.44 ± 3.2 | 0.062 |
| Polyunsaturated fat E% | 6.40 ± 1.89 | 4.56 ± 1.53 | 0.007 | 4.24 ± 1.5 | 4.88 ± 1.7 | 0.107 |
| Carbohydrate (incl. fiber) E% | 45.68 ± 7.11 | 35.54 ± 5.13 | <0.001 | 36.15 ± 5.8 | 34.94 ± 6.7 | 0.429 |
| Added sugar E% | 5.65 ± 4.98 | 3.97 ± 3.34 | 0.105 | 4.03 ± 4.4 | 3.88 ± 3.7 | 0.881 |
| Protein E% | 18.12 ± 3.67 | 21.37 ± 2.30 | <0.001 | 21.53 ± 3.0 | 21.21 ± 2.3 | 0.620 |
| Fat, g | 73.7 ± 21.1 | 91.5 ± 15.8 | <0.001 | 90.0 ± 15.9 | 95.0 ± 21.1 | 0.128 |
| Saturated fat, g | 25.08 ± 8.41 | 37.05 ± 6.05 | <0.001 | 36.1 ± 6.5 | 38.0 ± 9.2 | 0.333 |
| Trans unsaturated fat, g | 0.51 ± 0.33 | 1.07 ± 0.25 | <0.001 | 1.01 ± 0.3 | 1.14 ± 0.4 | 0.095 |
| Monounsaturated fat, g | 26.85 ± 8.73 | 34.62 ± 6.27 | <0.001 | 31.91 ± 6.0 | 35.92 ± 9.2 | 0.036 |
| Polyunsaturated fat, g | 13.39 ± 5.71 | 10.07 ± 3.98 | 0.007 | 9.07 ± 3.8 | 11.10 ± 4.8 | 0.055 |
| 2.43 ± 1.99 | 1.76 ± 1.82 | 0.151 | 1.63 ± 1.9 | 1.94 ± 1.9 | 0.599 | |
| 9.51 ± 3.35 | 7.46 ± 2.78 | 0.008 | 6.65 ± 2.4 | 8.28 ± 3.5 | 0.032 | |
| 5.86 ± 3.02 | 5.64 ± 1.80 | 0.722 | 5.29 ± 1.9 | 5.99 ± 2.7 | 0.220 | |
| Cholesterol, mg | 281 ± 134 | 262 ± 97 | 0.514 | 249 ± 107 | 276 ± 123 | 0.341 |
| Carbohydrate (incl. fiber) g | 219 ± 47.8 | 185.3 ± 46.9 | 0.005 | 178 ± 51 | 193 ± 60 | 0.263 |
| Starch, g | 108.5 ± 29.7 | 95.3 ± 33.4 | 0.089 | 91.6 ± 35 | 99.0 ± 45 | 0.458 |
| Mono- and disaccharides, g | 76.2 ± 35.0 | 62.0 ± 24.3 | 0.057 | 60.8 ± 25 | 63.3 ± 31 | 0.714 |
| Sugar, added, g | 26.6 ± 25.1 | 18.1 ± 15.3 | 0.094 | 16.63 ± 16 | 19.49 ± 17 | 0.498 |
| Fiber, g | 26.7 ± 10.8 | 23.1 ± 9.8 | 0.149 | 22.33±10 | 23.83 ± 11 | 0.560 |
| Protein, g | 81.4 ± 21.0 | 104.9 ± 14.9 | <0.001 | 102 ± 18 | 108 ± 16 | 0.214 |
| Salt, g | 6.07 ± 2.11 | 6.18 ± 2.47 | 0.843 | 6.66 ± 3.2 | 5.69 ± 2.7 | 0.175 |
| Vitamin A, (RAE) | 1227 ± 1327 | 634 ± 349 | 0.014 | 593 ± 436 | 675 ± 491 | 0.469 |
| Retinol, µg | 648 ± 1007 | 250 ± 210 | 0.028 | 217 ± 205 | 283 ± 383 | 0.379 |
| Beta-carotene, µg | 4217 ± 3562 | 3885 ± 3589 | 0.704 | 3858 ± 4350 | 3913 ± 4252 | 0.957 |
| Vitamin D a, µg | 4.91 ± 3.26 | 5.20 ± 1.78 | 0.650 | 6.39 ± 1.7 | 4.01 ± 2.9 | <0.001 |
| Vitamin E, αTE | 13.16 ± 4.75 | 11.49±3.70 | 0.112 | 11.38 ± 3.3 | 11.61 ± 5.0 | 0.821 |
| Vitamin K (total) b µg | 100.71 ± 83.5 | 157.7 ± 88.0 | 0.008 | 155.6 ± 94 | 159.9 ± 119 | 0.869 |
| MK4, µg | 10.57 ± 7.05 | 54.15 ± 5.63 | <0.001 | 69.29 ± 2.8 | 39.00 ± 10.2 | <0.001 |
| Thiamin, mg | 1.53 ± 0.46 | 1.26 ± 0.49 | 0.022 | 1.29 ± 0.6 | 1.23 ± 0.5 | 0.648 |
| Riboflavin, mg | 1.50 ± 0.42 | 1.50 ± 0.34 | 0.923 | 1.45 ± 0.4 | 1.55 ± 0.4 | 0.288 |
| Niacin, mg | 18.28 ± 6.05 | 22.15 ± 3.91 | 0.003 | 21.38 ± 3.8 | 22.92 ± 4.7 | 0.141 |
| Vitamin B6, mg | 1.80 ± 0.57 | 1.72 ± 0.49 | 0.527 | 1.64 ± 0.5 | 1.79 ± 0.6 | 0.243 |
| Folate, µg | 309 ± 127 | 282 ± 107 | 0.336 | 261 ± 91 | 302 ± 144 | 0.173 |
| Vitamin B12, µg | 5.16 ± 2.22 | 7.10 ± 1.31 | <0.001 | 6.96 ± 1.5 | 7.24 ± 1.7 | 0.480 |
| Vitamin C, mg | 104.4 ± 67.1 | 119.5 ± 70.8 | 0.370 | 120.5 ± 95 | 118.6 ± 72 | 0.929 |
| Calcium, mg | 835 ± 328 | 737 ± 254 | 0.169 | 726 ± 357 | 748 ± 327 | 0.793 |
| Iron, mg | 10.77 ± 3.20 | 14.08 ± 2.90 | <0.001 | 13.88 ± 3.0 | 14.28 ± 3.5 | 0.616 |
| Sodium, mg | 2405 ± 871 | 2454 ± 1016 | 0.833 | 2644 ± 1297 | 2263 ± 1074 | 0.192 |
| Potassium, mg | 3210 ± 1071 | 3440 ± 979 | 0.358 | 3382 ± 913 | 3499 ± 1242 | 0.662 |
| Magnesium, mg | 337 ± 115 | 326 ± 103 | 0.693 | 313 ± 99 | 340 ± 123 | 0.316 |
| Zinc, mg | 9.76 ± 2.16 | 20.55 ± 2.08 | <0.001 | 20.11 ± 2.5 | 20.98 ± 2.6 | 0.162 |
| Selenium, µg | 49.12 ± 25.69 | 61.61 ± 28.54 | 0.023 | 66.82 ± 37.9 | 56.41 ± 12.8 | 0.134 |
| Copper, mg | 1.31 ± 0.53 | 1.30 ± 0.42 | 0.955 | 1.24 ± 0.4 | 1.36 ± 0.5 | 0.330 |
| Phosphorous, mg | 1509 ± 350 | 1573 ± 307 | 0.424 | 1527 ± 334 | 1620 ± 389 | 0.296 |
| Iodine, µg | 76.38 ± 34.81 | 55.72 ± 27.45 | 0.008 | 51.33 ± 29 | 60.10 ± 37 | 0.283 |
a The vitamin D concentration in SeDEK and REGULAR beef is the sum of analyzed values for D3 + (25(OH)D3 × 5). In the NFCD [45], only vitamin D is given. b Vitamin K and MK4 are not given in the NFCD (Matvaretabellen.no) and the intake was estimated using values from ‘the Danish Food Composition Database [38] and from the US Food Composition databases [46]. Total K is the sum of K1 + MK4.
Participant characteristics, anthropometric values, and serum analyses of 34 participants. Part I shows habitual and the ‘300 g beef’ meat diets. Part II shows the 2 different meat diets in absolute values (upper part of cell) and as changes (lower part of cell). Part III tests for an effect of the 2 meat products’ sequence.
| Part I | Part II | Part III | |||||
|---|---|---|---|---|---|---|---|
| Variable (N = 34) | Habitual Diet | 300 g Beef | SeDEK-Beef | REGULAR-Beef |
| Cross Over | |
| Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | ||||
| Body weight, kg | 66.35 ± 8.58 | 66.64 ± 8.64 | 0.895 | 66.45 ± 8.71 | 66.47 ± 8.83 | 0.991 | 0.372 |
| 0.001 c ± 0.011 | 0.002 ± 0.010 | 0.681 | |||||
| BMI | 22.99 ± 2.75 | 23.04 ± 2.79 | 0.944 | 23.03 ± 2.80 | 23.04 ± 2.82 | 0.993 | 0.839 |
| 0.001 ± 0.010 | 0.002 ± 0.010 | 0.666 | |||||
| Systolic BP | 113.3 ± 7.16 | 115.8 ± 7.17 | 0.153 | 116.4 ± 9.02 | 115.4 ± 7.32 | 0.617 | 0.204 |
| 0.035 ** ± 0.081 | 0.018 ± 0.076 | 0.372 | |||||
| Diastolic PB | 70.4 ± 5.46 | 71.3 ± 5.88 | 0.544 | 71.3 ± 7.49 | 71.4 ± 5.95 | 0.957 | 0.175 |
| 0.011 ± 0.120 | 0.025 * ± 0.072 | 0.543 | |||||
| Pulse | 74.18 ± 9.87 | 75.29 ± 8.88 | 0.625 | 76.50 ± 11.46 | 74.35 ± 10.26 | 0.419 | 0.378 |
| 0.030 ± 0.162 | 0.025 ± 0.146 | 0.884 | |||||
| Blood glucose, mmol/L blood | 5.19 ± 0.52 | 5.39 ± 0.42 | 0.078 | 5.47 ± 0.58 | 5.31 ± 0.41 | 0.190 | 0.125 |
| 0.058 ** ± 0.127 | 0.039 ± 0.122 | 0.538 | |||||
| Insulin, pmol/L serum | 70.10 ± 25.17 | 74.02 ± 30.24 | 0.564 | 74.75 ± 31.65 | 75.44 ± 30.44 | 0.928 | 0.038 |
| 0.113 ± 0.435 | 0.274 ± 0.610 | 0.221 | |||||
| C-peptide, pmol/L serum | 459 ± 111 | 471 ± 138 | 0.687 | 492 ± 156 | 462 ± 124 | 0.386 | 0.413 |
| 0.078 ± 0.290 | 0.085 ± 0.318 | 0.921 | |||||
| AST, U/L serum | 19.13 ± 5.23 | 17.59 ± 4.86 | 0.212 | 17.62 ± 5.10 | 18.03 ± 5.79 | 0.758 | 0.007 |
| 0.047 ± 0.212 | 0.052 ± 0.207 | 0.914 | |||||
| ALT, U/L serum | 15.41 ± 6.64 | 15.50 ± 6.41 | 0.955 | 15.53 ± 6.45 | 15.91 ± 8.16 | 0.833 | 0.171 |
| 0.023 ± 0.191 | 0.040 ± 0.215 | 0.741 | |||||
| AST/ALT | 1.31 ± 0.26 | 1.22 ± 0.26 | 0.139 | 1.22 ± 0.34 | 1.21 ± 0.25 | 0.905 | 0.030 |
| −0.059 ± 0.195 | 0.076 ± 0.178 | 0.702 | |||||
| IL-1β, ng/L plasma | 11.3 ± 2.7 | 10.5 ± 3.0 | 0.085 | 10.7 ± 3.6 | 10.3 ± 2.2 | 0.511 | 0.514 |
| −0.065 ± 0.245 | 0.089 *** ± 0.141 | 0.638 | |||||
| IL-6, ng/L plasma | 3.6 ± 0.8 | 4.1 ± 1.3 | 0.038 | 4.2 ± 1.4 | 4.0 ± 1.2 | 0.556 | 0.455 |
| 0.119 * ± 0.296 | 0.051 ± 0.220 | 0.294 | |||||
| IL-8, ng/L plasma | 22.3 ± 2.0 | 23.2 ± 2.5 | 0.037 | 23.4 ± 2.8 | 23.0 ± 2.2 | 0.519 | 0.252 |
| 0.049 *** ± 0.074 | 0.027 * ± 0.071 | 0.221 | |||||
| IL-1β/IL-6 | 3.3 ± 1.1 | 2.7 ± 0.7 | 0.001 | 2.8 ± 0.8 | 2.6 ± 0.6 | 0.500 | 0.379 |
| −0.016 ± 0.301 | 0.014 ± 0.220 | 0.972 | |||||
| Hb, g/100 mL blood | 13.17 ± 0.90 | 13.23 ± 0.92 | 0.755 | 13.13 ± 1.14 | 13.32 ± 0.90 | 0.432 | 0.350 |
| −0.016 ± 0.064 | 0.030 * ± 0.078 | 0.010 | |||||
| Triacylglycerol, mmol/L serum | 0.89 ± 0.27 | 0.89 ± 0.29 | 0.945 | 0.89 ± 0.26 | 0.90 ± 0.34 | 0.850 | 0.616 |
| 0.033 ± 0.262 | 0.025 ± 0.220 | 0.892 | |||||
| LDL-cholesterol, mmol/L serum | 2.62 ± 0.78 | 2.74 ± 0.86 | 0.556 | 2.72 ± 0.85 | 2.81 ± 0.85 | 0.638 | 0.021 |
| 0.043 ± 0.169 | 0.069 ** ± 0.135 | 0.492 | |||||
| HDL-cholesterol, mmol/L serum | 1.62 ± 0.37 | 1.63 ± 0.38 | 0.950 | 1.65 ± 0.34 | 1.67 ± 0.41 | 0.864 | 0.227 |
| 0.015 ± 0.098 | 0.043 ** ± 0.072 | 0.192 | |||||
| Selenium, µg/L serum | 83.6 ± 12.8 | 87.0 ± 10.2 | 0.093 | 87.9 ± 9.0 | 86.1 ± 11.4 | 0.472 | 0.410 |
| 0.057 *** ± 0.085 | 0.032 * ± 0.079 | 0.216 | |||||
| Phylloquinone, µg/L plasma | 0.33 ± 0.22 | 0.39 ± 0.32 | 0.410 | 0.40 ± 0.46 | 0.40 ± 0.38 | 0.989 | 0.302 |
| 0.38 ± 1.15 | 0.36 * ± 0.97 | 0.938 | |||||
| MK7, µg/L plasma | 0.19 ± 0.12 | 0.17 ± 0.11 | 0.436 | 0.16 ± 0.11 | 0.18 ± 0.17 | 0.589 | 0.578 |
| −0.125 ± 0.402 | −0.024 ± 0.556 | 0.456 | |||||
| 25(OH)D3, nmol/L serum | 52.0 ± 18.1 | 49.2 ± 16.8 | 0.512 | 50.4 ± 17.2 | 48.4 ± 16.6 | 0.630 | 0.255 |
| −0.012 ± 0.108 | −0.064 ** ± 0.131 | 0.088 d | |||||
a The p represents t-tests; b The crossover p reveals probability of an effect of the presentation order [48]. c The fractional changes from habitual (Hi) to each 300 g beef test diet intervention (Ti) are calculated ((Ti − Hi)/Hi) and the significance (calculated by t-test) is indicated as: * p < 0.05 ** p < 0.01 and *** p < 0.001); d This number was corrected (GLM analysis) for the effect of intervention week.
Figure 2The figure shows the changes in the blood Hb from habitual diet to the intake of 300 g of beef per day. The changes were allocated to three Hb groups Hb according to baseline values (<12.5 mg/100 mL, 12.5–13.5 mg/100 mL, and >13.5 mg/100 mL) where the number in the three groups were 8, 14, and 12, respectively. Mean values with standard errors are given and the p-values were obtained by one-sample Z-analysis indicating probability of obtained values being larger or lower than zero.
Figure 3Mean values with standard errors are shown. The p-values were obtained by one-sample Z-test indicating probability of obtained values being larger or lower than zero. (A) Changes in the absolute serum values for three (<75 µg/ L, 75–85 µg/L, and >85 µg/L) different category groups of initial serum selenium. The average values in the three groups were 72 (N = 8), 80 (N = 13), and 98 (N = 13) µg/L, respectively. (B) Changes in the absolute values for three (<30 nmol/L, 30–50 nmol/L, and >50 nmol/L) different category groups of the initial 25(OH)D3 serum values. The average values in the three groups were 23 (N = 3), 40 (N = 15), and 73 (N = 16) nmol/L, respectively.