Prevalence and Predictors of Vitamin D Insufficiency in Children: A Great Britain Population Based Study
PLOS Received: May 11, 2011; Accepted: June 17, 2011; Published: July 22, 2011
Michael Absoud1 michaelabsoud at childdemyelination.org.uk
Carole Cummins1, Ming J. Lim2, Evangeline Wassmer3, Nick Shaw4
1 School of Health and Population Sciences, University of Birmingham, Birmingham, United Kingdom,
2 Department of Paediatric Neurology, Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom,
3 Department of Paediatric Neurology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom,
4 Department of Paediatric Endocrinology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom
Objectives: To evaluate the prevalence and predictors of vitamin D insufficiency (VDI) in children In Great Britain.
Design: A nationally representative cross-sectional study survey of children (1102) aged 4–18 years (999 white, 570 male) living in private households (January 1997–1998). Interventions provided information about dietary habits, physical activity, socio-demographics, and blood sample.
Outcome measures were vitamin D insufficiency (<50 nmol/L). (20 ng)
Results: Vitamin D levels (mean = 62.1 nmol/L, 95%CI 60.4–63.7) were insufficient in 35%, and decreased with age in both sexes (p<0.001).
Young People living between 53–59 degrees latitude had lower levels (compared with 50–53 degrees, p = 0.045).
Dietary intake and gender had no effect on vitamin D status. A logistic regression model showed increased risk of VDI in the following: adolescents (14–18 years old),
- odds ratio (OR) = 3.6 (95%CI 1.8–7.2) compared with younger children (4–8 years);
- non white children (OR = 37 (95%CI 15–90));
- blood levels taken December-May (OR = 6.5 (95%CI 4.3–10.1));
- on income support (OR = 2.2 (95%CI 1.3–3.9));
- not taking vitamin D supplementation (OR = 3.7 (95%CI 1.4–9.8));
- being overweight (OR 1.6 (95%CI 1.0–2.5));
- <1/2 hour outdoor exercise/day/week (OR = 1.5 (95%CI 1.0–2.3));
- watched >2.5 hours of TV/day/week (OR = 1.6(95%CI 1.0–2.4)).
Conclusion: We confirm a previously under-recognised risk of VDI in adolescents. The marked higher risk for VDI in non-white children suggests they should be targeted in any preventative strategies. The association of higher risk of VDI among children who exercised less outdoors, watched more TV and were overweight highlights potentially modifiable risk factors. Clearer guidelines and an increased awareness especially in adolescents are needed, as there are no recommendations for vitamin D supplementation in older children.
Funding: The National Diet and Nutrition Survey (NDNS) was commissioned jointly by the Ministry of Agriculture, Fisheries and Food (MAFF) and the Department of Health (DH). The NDNS was carried out by the Medical Research Council (MRC), Office for National Statistics, and the Dental Schools of the Universities of Birmingham, Newcastle, Dundee and Wales. The MRC component of the work was conducted by the Micronutrient Status Laboratory, Cambridge, initially at MRC Dunn Nutrition Unit (DNU) and more recently at MRC Human Nutrition Research (HNR). Data analysis and interpretation was done by the authors independently of the funding sources based on the available dataset provided by the UK Data Archive. No additional funding has been received in support for the data analysis for this study. The Medical Research Council, Office for National Statistics, Ministry of Agriculture, Fisheries and Food Department of Health, Food Standards Agency, Department of Health, UK Data Archive bear no responsibility for the analysis or interpretation of data.
Competing interests: MA, CC, MJL, and EW are contributors to a prospective study of childhood CNS inflammatory demyelination funded by the MS Society and Action Medical Research (UK). The authors confirm that this does not alter adherence to all the PLoS ONE policies on sharing data and material
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