Canadian newcomer children’s bone health and vitamin D status

Abstract

Adequate calcium intake and supply of vitamin D during childhood play important roles in ensuring adequate bone mass gain to achieve optimal peak bone mass. The Healthy Immigrant Children study employed a mixed-method cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. This paper presents bone mineral content and vitamin D status data along with qualitative data that deepen the understanding of newcomer bone health status. A significantly higher percentage of refugee children (72.3%) had insufficient (<50 nmol/L) or deficient (<30 nmol/L) serum vitamin D compared with immigrants (53.2%). Vitamin D deficiency was most common among ethnic minority girls. Newcomer children with higher intakes of vitamin D, younger newcomer children, and those from western Europe or the United States had higher serum vitamin D levels. Immigrants had significantly higher mean total body bone mineral content compared with refugees. Total body fat, serum vitamin D, calcium intake, height, height by calcium intake, total body fat by calcium intake, and total body fat by height predicted total body bone mineral content levels. Vitamin D deficiency among newcomer children may be related to lack of knowledge regarding children’s vitamin D requirements in the Canadian environment, dietary habits established in country of origin, low income that limits healthy dietary choices, and lifestyle habits that limit exposure to sunlight. Results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency and support early intervention.

Hypovitaminosis D in Migrant Children in Switzerland: a Retrospective Study

“…We found 75% of su cient values in children from the region of the Americas but had a limited number of patients (n = 8). Similar results for geographic distribution of hypovitaminosis D were found in a Canadian study [29]. Another Norwegian study [31] had comparable results, except for a lower prevalence of de cit in the East Asian region (approximately our Western Paci c region), but the analysed countries were different and they included adults.…”

“…Gender differences in activities are also possible, with girls spending more time indoors than boys. Another Canadian study also found that Middle East, Asian and African female were particularly at risk of hypovitaminosis D [29]. Similar results were found in a Norwegian study, with a greater risk of hypovitaminosis D in females, especially if adolescent [31].…”

“…Highest prevalence of de cit (86%) and severe de cit (41%) were found in children older than 10 years old. Other studies found concordant results in Italy [30] and Canada [29], with better vitamin D status in younger patients.…”

“…It is consistent with other studies, although reference values for de cit can vary between authors. For example, 72.3% of refugees in Canada were de cient (< 50 nmol/L) [29] and 77.4% in Italy (< 75 nmol/L) [30]. Supplementation is needed to prevent impact on bone health [1][2][3][4].…”

Vitamin D in Toddlers, Preschool Children, and Adolescents

“…Other populations at increased risk for vitamin D deficiency include immigrant/refugee children moving to higher-latitude countries [23,24], children with chronic disease that decreases fat absorption, children receiving anti-epileptic medications, and obese children [25][26][27]. For children with diseases with impaired fat absorption, such as cystic fibrosis, higher supplementation of this fat-soluble vitamin likely is required [25].…”