Modifiable Determinants of Serum 25-Hydroxyvitamin D Status in Early Childhood

Maguire, Jonathon L.; Birken, Catherine S.; Khovratovich, Marina; DeGroot, Julie; Carsley, Sarah; Thorpe, Kevin E.; Mamdani, Muhammad; Parkin, Patricia C.

doi:10.1001/2013.jamapediatrics.226

Cited by 34 publications

(22 citation statements)

References 43 publications

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“…A Finnish study assessed the impacts of the initiation of fortification of fluid milk products and margarines with vitamin D and found a higher vitamin D intake and a higher mean serum 25(OH)D concentration after fortification in 4-year-old children (39) . In Canadian and US studies among children, a higher intake of milk fortified with vitamin D has been associated with a higher serum 25(OH)D concentration (40) and with a lower risk of having vitamin D deficiency (41) . A recent British study also concluded that the fortification of food with vitamin D could be the most effective way to improve vitamin D status in children (42) .…”

Section: Risk Factors Of Having Serum 25-hydroxyvitamin D Concentratimentioning

confidence: 99%

Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study

et al. 2016

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We studied vitamin D intake, serum 25-hydroxyvitamin D (S-25(OH)D) concentration, determinants of S-25(OH)D and risk factors for S-25(OH)D <50 nmol/l in a population sample of Finnish children. We studied 184 girls and 190 boys aged 6-8 years, analysed S-25(OH)D by chemiluminescence immunoassay and assessed diet quality using 4-d food records and other lifestyle factors by questionnaires. We analysed the determinants of S-25(OH)D using linear regression and risk factors for S-25(OH)D <50 nmol/l using logistic regression. Mean dietary intake of vitamin D was 5·9 (SD 2·1) µg/d. Altogether, 40·8 % of children used no vitamin D supplements. Of all children, 82·4 % did not meet the recommended total vitamin D intake of 10 µg/d. Milk fortified with vitamin D was the main dietary source of vitamin D, providing 48·7 % of daily intake. S-25(OH)D was <50 nmol/l in 19·5 % of children. Consumption of milk products was the main determinant of S-25(OH)D in all children (standardised regression coefficient β = 0·262; P < 0·001), girls (β = 0·214; P = 0·009) and boys (β = 0·257; P = 0·003) in multivariable models. Vitamin D intake from supplements (β = 0·171; P = 0·035) and age (β = − 0·198; P = 0·015) were associated with S-25(OH)D in girls. Children who drank ≥450 g/d of milk, spent ≥2·2 h/d in physical activity, had ≥13·1 h/d of daylight time or were examined in autumn had reduced risk for S-25(OH)D <50 nmol/l. Insufficient vitamin D intake was common among Finnish children, one-fifth of whom had S-25(OH)D <50 nmol/l. More attention should be paid to the sufficient intake of vitamin D from food and supplements, especially among children who do not use fortified milk products.Key words: Vitamin D: 25-Hydroxyvitamin D: Children: Determinants Vitamin D is a pro-hormone that is converted in the liver to 25-hydroxyvitamin D (25(OH)D) and then in the kidney to 1,25-dihydroxyvitamin D, the active metabolite that regulates Ca, P and bone metabolism (1) . Vitamin D can be obtained from foods and supplements or synthesised endogenously in the skin in response to the UVB radiation of the sun. The major circulating form of vitamin D in serum is 25(OH)D, which is commonly used as an indicator of vitamin D status. Knowledge of the health effects of vitamin D is increasing. In addition to the well-known beneficial effect of vitamin D on bone health, there is some evidence that higher serum levels of 25(OH)D are associated with better muscle strength (2) and decreased risk of several diseases such as type 1 diabetes and other autoimmune diseases, cancer and infections (1) . The recommendations of the Institute of Medicine in the USA for serum 25(OH)D concentration and vitamin D intake are mainly based on the effects of vitamin D on bone health, because evidence on its effects on other outcomes is still not strong enough to inform the recommendations (3) . There is no consensus on the optimal serum level of 25(OH)D. The limit of serum 25(OH)D concentration for vitamin D deficiency varies between 25 and 50 nmol/l, and the lower limit ...

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Section: Risk Factors Of Having Serum 25-hydroxyvitamin D Concentratimentioning

confidence: 99%

Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study

et al. 2016

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“…[4][5][6][7][8] The only other food source with mandatory vitamin D fortification in Canada is margarine, which is required to contain 53 IU per 10 mL (10 g). 5 Fortification of non-cow's milk beverages with vitamin D is also possible, but it is voluntary in both countries.…”

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confidence: 99%

Consumption of non–cow’s milk beverages and serum vitamin D levels in early childhood

Lee

Birken

Parkin

et al. 2014

CMAJ

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“…Although the median 25(OH)D concentration was relatively high in our population and the majority of children had 25(OH)D levels above the American Academy of Pediatrics' cut-off point of 50 nmol/l, other Canadianbased studies including the national Canadian Health Measures Survey have found similar 25(OH)D levels in this age group (69)(70)(71) . There was a low representation of certain ethnic groups in the present study compared with visible minority groups in Toronto; however, this can be partially explained by the higher frequency of mixed ethnicities in our study (72) .…”

Section: Discussionmentioning

confidence: 44%

Non-Western immigrant children have lower 25-hydroxyvitamin D than children from Western families

Omand

Darling

Parkin

et al. 2013

Public Health Nutr.

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Objective: To determine if children aged 1-6 years from non-Western immigrant families have lower serum 25-hydroxyvitamin D (25(OH)D) levels than children from Western-born families and examine which factors influence this relationship. Design: Cross-sectional study. Setting: Toronto, Canada. Subjects: Healthy children (n 1540) recruited through the TARGet Kids! practicebased research network. Serum 25(OH)D concentrations of non-Western immigrants were compared with those of children from Western-born families. Children from non-Western immigrant families were defined as those born, or their parents were born, outside a Western country. Univariate and multiple linear regression analyses were used to identify factors which might influence this relationship. Results: Median age was 36 months, 51 % were male, 86 % had 'light' skin pigmentation, 55 % took vitamin D supplements, mean cow's milk intake was 1?8 cups/d and 27 % were non-Western immigrants. Median serum 25(OH)D concentration was 83 nmol/l, with 5 % having 25(OH)D , 50 nmol/l. Univariable analysis revealed that non-Western immigrant children had serum 25(OH)D lower by 4 (95 % CI 1?3, 8?0) nmol/l (P 5 0?006) and increased odds of 25(OH)D , 50 nmol/l (OR 5 1?9; 95 % CI 1?3, 2?9). After adjustment for known vitamin D determinants the observed difference attenuated to 0?04 (95 % CI 24?8, 4?8) nmol/l (P 5 0?99), with higher cow's milk intake (P , 0?0001), vitamin D supplementation (P , 0?0001), summer season (P 5 0?008) and increased age (P 5 0?04) being statistically significant covariates. Vitamin D supplementation was the strongest explanatory factor of the observed difference. Conclusions: There is an association between non-Western immigration and lower 25(OH)D in early childhood. This difference appears related to known vitamin D determinants, primarily vitamin D supplementation, representing opportunities for intervention.

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Modifiable Determinants of Serum 25-Hydroxyvitamin D Status in Early Childhood

Cited by 34 publications

References 43 publications

Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study

Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study

Consumption of non–cow’s milk beverages and serum vitamin D levels in early childhood

Non-Western immigrant children have lower 25-hydroxyvitamin D than children from Western families

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