Skip to main content
SpringerLink
Log in

Prevalence and Correlates of Vitamin D Deficiency Among Children and Adolescents From a Nationally Representative Survey in India

  • Research Paper
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the prevalence of vitamin D deficiency (VDD) and its correlates among apparently healthy children and adolescents.

Methods

We carried out a secondary analysis of data of Comprehensive National Nutrition Survey 2016–18 to analyze the pre-valence and predictors of VDD among Indian children and adolescents.

Results

The over-all prevalence of VDD in preschool children (1–4 years), school age (5–9 years) children, and adolescents (10–19 years) was 13.7%, 18.2%, and 23.9%, respectively. Age, living in urban area, and winter season were significantly associated with VDD. Vegetarian diet and high-income households were the main risk factors observed in 5–19 years age category. Female sex and less than three hour of physical activity/week were independent risk factors among adolescents.

Conclusion

The prevalence and determinants of VDD across different age-groups are reported, and these should be interpreted and addressed to decrease the burden of VDD in India.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Cashman KD. Vitamin D in childhood and adolescence. Postgrad Med J. 2007;83:230–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Quah SW, Abdul Majid H, Al-Sadat N, et al. Risk factors of vitamin D deficiency among 15-year-old adolescents participating in the Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs). PLoS One. 2018;3:e0200736.

    Article  Google Scholar 

  3. Chan J, Jaceldo-Siegl K, Fraser GE. Serum 25-hydroxy-vitamin D status of vegetarians, partial vegetarians, and nonvegetarians: The Adventist Health Study-2. Am J Clin Nutr. 2009;89:1686S–1692S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Aparna P, Muthathal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Family Med Prim Care. 2018;7:324–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gupta P, Dabas A, Seth A, et al. Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets. Indian Pediatr. 2022;59:142–58.

    Article  PubMed  Google Scholar 

  6. Ministry of Health and Family Welfare (MoHFW), Comprehensive National Nutrition Survey (CNNS) National Report. Government of India. 2019.

  7. Sarna A, Porwal A, Ramesh S, et al. Characterisation of the types of anaemia prevalent among children and adolescents aged 1–19 years in India: A population-based study. Lancet Child Adolesc Health. 2020;4:515–25.

    Article  CAS  PubMed  Google Scholar 

  8. Pullakhadnam R, Agrawal PK, Peter R, et al. Prevalence of low serum zinc concentrations in Indian children and adolescents: Findings from the Comprehensive National Nutrition Survey 2016–18. Am J Clin Nutr 2021;114:638–48.

    Article  Google Scholar 

  9. Ross AC, Taylor CL, Yaktine AL, et al. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press (US); 2011.

  10. World Health Organization, WHO Child Growth Standards 2006. Accessed Dec 1, 2022. Available from: https://www.who.int/childgrowth/standards/bmi_for_age/en/

  11. World Health Organization, Growth reference data for 5–19 years 2007. Accessed Dec 1, 2022. Available from: https://www.who.int/growthref/en/

  12. International Institute for Population Sciences (IIPS), and ICF. National Family Health Survey (NFHS-4), 2015–16: India. IIPS; 2016.

  13. Marwaha RK, Yenamandra VK, Sreenivas V, et al. Regional and seasonal variations in ultraviolet B irradiation and vitamin D synthesis in India. Osteoporos Int. 2016;27:1611–17.

    Article  CAS  PubMed  Google Scholar 

  14. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Khadilkar A, Kajale N, Oza C, et al. Vitamin D status and determinants in Indian children and adolescents: a multi-centre study. Sci Rep. 2022;12:16790

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ayyappan A, Poovat2hinal SA, Viswambharan V, et al. Cross-sectional study reveals a high prevalence of vitamin D deficiency among healthy school children in central Kerala, India. International J Contemporary Pediatrics. 2019:867–71. [online]

  17. Prakasa Rao PV, Siddhartha PV, Yeshwante P. Vitamin D deficiency, the urban epidemic: A cross-sectional study from Bhopal, India. International Journal of Community Medicine and Public Health. 2020;7:4541–60.

    Article  Google Scholar 

  18. Hill TR, Cotter AA, Mitchell S, et al. Vitamin D status and its determinants in adolescents from the Northern Ireland Young Hearts 2000 cohort. Br J Nutr. 2008;99:1061–7.

    Article  CAS  PubMed  Google Scholar 

  19. Goswami R, Gupta N, Goswami D, et al. Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr. 2000;72:472–5.

    Article  CAS  PubMed  Google Scholar 

  20. Fernandes MR, Barreto WDR Jr. Association between physical activity and vitamin D: A narrative literature review. Rev Assoc Med Bras. 2017;63:550–56.

    Article  PubMed  Google Scholar 

Download references

Funding

UNICEF under the CNNS knowledge products project and funded by Aditya and Megha Mittal.

Author information

Authors and Affiliations

  1. Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Garima Rana, Ransi Ann Abraham, Rahul Bharti & Lakshmy Ramakrishnan

  2. Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India

    Harshpal Singh Sachdev

  3. National Institute of Nutrition, Hyderabad, Telangana, India

    K. Madhavan Nair

  4. Institute of Home Economics, University of Delhi, Delhi, India

    Geeta Trilok Kumar

  5. IPE Global Limited, New Delhi, India

    Praween Kumar Agarwal

  6. United Nations Children Funds, Delhi, India

    Robert Johnston & Arjan De Wagt

  7. Population Council, Delhi, India

    Avina Sarna, Rajib Acharya, Akash Porwal, Nizamuddin Khan & Sowmya Ramesh

  8. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    M. Kalaivani

Authors
  1. Garima Rana
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ransi Ann Abraham
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Harshpal Singh Sachdev
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Madhavan Nair
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Geeta Trilok Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Praween Kumar Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Robert Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Arjan De Wagt
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Avina Sarna
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Rajib Acharya
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Akash Porwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Nizamuddin Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Sowmya Ramesh
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Rahul Bharti
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. M. Kalaivani
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Lakshmy Ramakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LR, RAA, GR: conceptualized the manuscript; AS, RA, AP, SR, NK, PKA: survey data analysis; KM,GR,RB: statistical analyses for manuscript; HSS, MN, GTK, RJ, ADW, PKA: provided expert advice for the manuscript; GR: led the writing of the manuscript with inputs from LR, RAA. All authors have reviewed and approved the final version of manuscript, and are accountable for all aspects related to the study.

Corresponding author

Correspondence to Lakshmy Ramakrishnan.

Ethics declarations

Postgraduate Institute for Medical Education and Research, Chandigarh; and the Institutional Review Board of the Population Council.

Additional information

Competing interests

HSS designed the draft protocol of the CNNS with consultancy support from the UNICEF, India and was member of the Technical Advisory Committee of the CNNS, constituted by the Ministry of Health and Family Welfare (MoHFW) of the Government of India (GoI), to oversee its conduct and analysis. He is a member of the World Health Organization Nutrition Guidance Expert Advisory Subgroup on Diet and Health and Guideline Development Group on ‘Use and interpretation of hemoglobin concentrations for assessing anaemia status in individuals and populations’, and member of the National Technical Board on Nutrition of NITI Aayog, and Expert Groups of the MoHFW; GoI on Nutrition and Child Health. GTK designed the draft protocol of the CNNS with consultancy support from the UNICEF, India and was member of the Technical Advisory Committee of the CNNS, constituted by the MoHFW, GoI, to oversee its conduct and analysis. She is also chair of a task force on Balanced and healthy diets of MoHFW, GoI, and member of other governmental expert groups and committees. MN and LR were members of the Technical Advisory Committee of the CNNS, constituted by the MoHFW, GoI, to oversee its conduct and analysis. None of the other authors listed on this manuscript report any competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rana, G., Abraham, R.A., Sachdev, H.S. et al. Prevalence and Correlates of Vitamin D Deficiency Among Children and Adolescents From a Nationally Representative Survey in India. Indian Pediatr 60, 202–206 (2023). https://doi.org/10.1007/s13312-023-2835-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-023-2835-1

Keywords

Search

Navigation