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Articles by J. Mindell
Total Records ( 3 ) for J. Mindell
  V Hirani , K Tull , A Ali and J. Mindell

Background: the importance of vitamin D for bone health is well known, but emerging evidence also suggests that adequate vitamin D status may also be protective against non-communicable diseases. In the UK, government initiatives highlighting the importance of adequate vitamin D among older people have been in place since 1998.

Objectives: the aim of this analysis is to assess vitamin D status in people aged ≥65, living in private households in England, 2005 and make comparisons with the Health Survey for England (HSE) 2000 and the National Diet and Nutrition Survey (NDNS), 1994. We also examine associations of hypovitaminosis D [serum 25(OH)D <50 nmol/l] with demographic, geographic, lifestyle and health risk factors.

Design and setting: a nationally representative sample of older people living in England in 2005.

Participants: 2,070 adults aged ≥65, living in private households taking part in the HSE 2005.

Results: in the HSE 2005, mean serum 25(OH)D levels were 53 and 49 nmol/l in men and women, respectively, these levels are significantly lower than currently recommended at ≥75 nmol/l. Prevalence of vitamin D deficiency [25(OH)D <25 nmol/l] in people aged ≥65 in 2005 was 13% in women and 8% in men. Nearly two thirds (57%) of women and half of men (49%) had serum 25(OH)D <50 nmol/l. Only 16% of men and 13% of women aged ≥65 years had serum 25(OH)D levels ≥75 nmol/l. There is no improvement in vitamin D status in 2005 compared to 2000 and a significant decline in vitamin D status among men in 2005 in comparison to the 1994/1995 NDNS results. The odds of hypovitaminosis D increased by age group from those aged 75–79 to aged ≥85. Season of taking a blood sample, obesity, dark skin pigmentation, not taking vitamin supplements, cigarette smoking, poor general health and longstanding illness were all significant predictors (P < 0.05) of serum 25(OH)D status in adjusted regression models.

Conclusions: poor vitamin D status of older people continues to be a public health problem in England. Hypovitaminosis D is associated with many risk factors and poor health outcomes. There is now an urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people to prevent poor vitamin D status and its negative consequences.

  M. B. Pierce , P. Zaninotto , N. Steel and J. Mindell
  Aims  Diabetes UK estimates a quarter of UK cases of diabetes are undiagnosed; 750 000 people have undiagnosed diabetes in addition to 2.25 million with known diabetes, but research studies examining this are contradictory. The aim was to determine the prevalence of, and risk factors for, undiagnosed diabetes in the population of England aged > 50 years and to calculate the percentage of cases of undiagnosed diabetes.

Methods  This was a cross-sectional study in a nationally representative sample of 6739 people aged 52-79 years from the English Longitudinal Study of Ageing (ELSA) 2004/2005. Diabetes cases were ascertained by self-reported doctor diagnosis of diabetes. A fasting plasma glucose measurement after a minimum of 8-h fast was available for 2387 (38% of the participants without diabetes). Undiagnosed diabetes cases were based on a fasting plasma glucose ≥ 7.0 mmol/l.

Results  The overall weighted prevalence of diabetes was 9.1%; 502 people (7.5%) had self-reported diabetes (9.0% of men and 6.0% of women); 36 (1.7%) had undiagnosed diabetes (2.6% of men and 0.8% of women). Of cases of diabetes, 18.5% were undiagnosed (22% in men, 12% in women). Significant risk factors for undiagnosed diabetes were male sex, higher body mass index, waist circumference, systolic blood pressure and triglycerides.

Conclusions  In 2004 the prevalence of undiagnosed diabetes, and the proportion of cases of diabetes that were undiagnosed, appear smaller than in previous studies. This is likely to be due to increased awareness of diabetes and improved clinical care resulting in many of those with previously undetected disease having been diagnosed.

  M. A Roth , A Aitsi Selmi , H Wardle and J. Mindell

This study investigates the prevalence of under-reported use of tobacco among Bangladeshi women and the characteristics of this group.


The 1999 and 2004 Health Survey for England included 996 Bangladeshi women aged 16 years and above, 302 with a valid saliva sample and 694 without. The main outcome measure was the prevalence of under-reported tobacco use.


Fifteen per cent of Bangladeshi women with a saliva sample under-reported their personal tobacco use. Under-reporters were very similar to self-reported users except for being much more likely to report chewing paan without tobacco (47% versus 9%, P < 0.001). Under-reporters differed significantly from cotinine-validated non-users in most respects. Regression analyses confirmed that under-reporters and self-reported users were similar in age, education level and exposure to passive smoking. Under-reporters were older and less educated than cotinine-validated non-users. Both self-reported users [odds ratio (OR): 0.11, 95% confidence interval (CI): 0.04–0.30] and cotinine-validated non-users (OR: 0.42, 95% CI: 0.20–0.89) were far less likely to report chewing paan without tobacco compared with under-reporters.


Contrary to our a priori hypothesis, under-reporters were not young, British-born, English-speaking women likely to be concealing smoking but resembled self-reported tobacco users except for being much more likely to report chewing paan without tobacco.

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