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Canadian Journal of Public Health

, Volume 96, Issue 6, pp 443–449 | Cite as

Are National Vitamin D Guidelines Sufficient to Maintain Adequate Blood Levels in Children?

  • Daniel E. Roth
  • Pat Martz
  • Rochelle Yeo
  • Connie Prosser
  • Melissa Bell
  • Adrian B. Jones
Article

Abstract

Background: Vitamin D insufficiency (defined as 25-hydroxyvitamin D [25(OH)D] concentrations <40 nmol/L) may be associated with subclinical adverse effects on bone mineralization. The current vitamin D status of children and adolescents in Canada has not been described. The purpose of this study was to describe the association between 25(OH)D serum concentration and dietary vitamin D intake, and other potential determinants of vitamin D status, among a sample of children and adolescents aged 2–16 years presenting to a pediatric emergency department in Edmonton, Alberta (latitude 52°N) at the end of winter.

Methods: In early April 2003, 90 patients between the ages of 2 and 16 years who presented to the pediatric emergency department in Edmonton volunteered to participate. All participants and/or parents or guardians completed questionnaires regarding potential risk factors for vitamin D insufficiency, detailed dietary assessments, and anthropometric measurements. Serum 25(OH)D concentrations were measured in 68 of 90 participants.

Results: The mean serum 25(OH)D concentration was 47.2 nmol/L (95% CI 43.8–50.8 nmol/L). 34% of participants had vitamin D insufficiency (<40 nmol/L) and 6% were deficient (<25 nmol/L). Boys and girls aged 9–16 years had a prevalence of insufficiency of 69% and 35% respectively, while boys and girls 2–8 years old had a prevalence of insufficiency of 22% and 8% respectively. Dietary vitamin D intake per kilogram body weight was the most important independent determinant of 25(OH)D concentration (r = 0.446, p<0.001). Vitamin D intake, age and male sex best predicted insufficiency. No subject was insufficient if they had an intake >0.45 mcg/kg/day.

Interpretation: Vitamin D insufficiency may be common among children and adolescents at the beginning of spring. The risk may be highest among older children because vitamin D intake does not adequately rise in proportion with increases in body mass. Further studies are needed to assess whether Canadian dietary vitamin D recommendations should be changed.

MeSH terms

Vitamin D nutrition disorders Canada child adolescent vitamin D deficiency 

Résumé

Contexte: L’insuffisance en vitamine D (définie dans cette étude comme les concentrations de 25-hydroxyvitamine D [25(OH)D] inférieures à 40 nmol/L) peut être associée à des effets subcliniques indésirables sur la minéralisation osseuse. Comme le statut actuel en vitamine D des enfants et des adolescents au Canada n’a pas encore été décrit, nous avons cherché à déterminer l’association entre la concentration sérique en 25(OH)D et l’apport en vitamine D dans l’alimentation, ainsi que d’autres déterminants possibles du statut en vitamine D, au sein d’un échantillon d’enfants et d’adolescents de 2 à 16 ans s’étant présentés au service d’urgences pédiatriques d’Edmonton (Alberta) (latitude 52°N) à la fin de l’hiver.

Méthode: Quatre-vingt-dix patients âgés de 2 à 16 ans s’étant présentés au service d’urgences pédiatriques d’Edmonton au début d’avril 2003 ont participé bénévolement à l’étude. Tous les participants et/ou leurs parents ou tuteurs ont rempli des questionnaires portant sur les facteurs de risque d’insuffisance en vitamine D et se sont soumis à des évaluations approfondies de leur alimentation et à des mesures anthropométriques. Les concentrations sériques en 25(OH)D ont été mesurées chez 68 des 90 participants.

Résultats: La concentration sérique moyenne en 25(OH)D était de 47,2 nmol/L (IC de 95 % =43,8–50,8 nmol/L). Trente-quatre p. cent des participants avaient une insuffisance en vitamine D (<40 nmol/L), et 6 % étaient carencés (<25 nmol/L). Les garçons et les filles de 9 à 16 ans affichaient des taux d’insuffisance de 69 % et de 35 % respectivement, contre 22 % et 8 % respectivement pour les garçons et les filles de 2 à 8 ans. L’apport alimentaire en vitamine D par kilogramme de poids était le principal déterminant indépendant de la concentration en 25(OH)D (r=0,446, p<0,001). L’apport en vitamine D, l’âge et le sexe masculin étaient les meilleurs prédicteurs d’insuffisance. Aucun sujet ayant un apport supérieur à 0,45 mcg/kg/jour n’a été considéré comme présentant une insuffisance.

Interprétation: L’insuffisance en vitamine D pourrait être commune chez les enfants et les adolescents au début du printemps. Les enfants pourraient présenter le risque le plus élevé, car leur apport en vitamine D n’augmente pas suffisamment en proportion de la croissance de leur masse corporelle. D’autres études sont nécessaires pour déterminer s’il faut modifier les recommandations canadiennes concernant l’apport alimentaire en vitamine D.

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Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Daniel E. Roth
    • 1
  • Pat Martz
    • 2
  • Rochelle Yeo
    • 2
  • Connie Prosser
    • 3
  • Melissa Bell
    • 2
  • Adrian B. Jones
    • 1
  1. 1.Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics and Child Health, Faculty of Medicine, 2C3.76 Walter C. Mackenzie Health Science CentreEdmontonCanada
  2. 2.Nutrition and Food ServicesCapital Health AuthorityEdmontonCanada
  3. 3.Department of Laboratory Medicine and Pathology, Faculty of MedicineUniversity of AlbertaCanada

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