25-Hydroxyvitamin D Status of Healthy, Low-Income, Minority Children in Atlanta, Georgia

Emory University School of Medicine, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, 2015 Uppergate Dr, Atlanta, GA 30322, USA.
PEDIATRICS (Impact Factor: 5.47). 03/2010; 125(4):633-9. DOI: 10.1542/peds.2009-1928
Source: PubMed


The goals were to determine the prevalence of vitamin D deficiency among minority children in a southern US city, to examine differences in serum 25-hydroxyvitamin D levels between non-Hispanic black and Hispanic children, and to determine dietary sources of vitamin D.
Low-income, minority children (N = 290; mean age: 2.5 +/- 1.2 years) were recruited during well-child clinic visits. Serum 25-hydroxyvitamin D and calcium levels were measured and dietary information was assessed.
The mean 25-hydroxyvitamin D(3) level was 26.2 +/- 7.6 ng/mL, whereas 25-hydroxyvitamin D(2) was not detected. Overall, 22.3% of children had deficient serum 25-hydroxyvitamin D(3) levels (< or =20 ng/mL), 73.6% had less-than-optimal serum 25-hydroxyvitamin D levels (< or =30 ng/mL), and 1.4% had low serum calcium levels (< or =9 mg/dL). A significantly larger proportion of non-Hispanic black children, compared with Hispanic children, had vitamin D deficiency (26% vs 18%; P < .05). Age and season of recruitment were significantly associated with vitamin D deficiency and low serum calcium levels. Older children (> or =3 years) were less likely to have vitamin D deficiency (odds ratio [OR]: 0.89 [95% confidence interval [CI]: 0.81-0.96]; P < .001). Study enrollment during spring and summer reduced the likelihood of vitamin D deficiency by approximately 20% (spring, OR: 0.85 [95% CI: 0.73-0.98]; P = .03; summer, OR: 0.82 [95% CI: 0.73-0.92]; P < .01). Fortified milk provided most dietary vitamin D (62%), with Hispanic children reporting greater intake.
Suboptimal vitamin D status was common among apparently healthy, low-income, minority children. Age and season were significant predictors of vitamin D deficiency.

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    • "One limitation of our study is that it was conducted at a single site in an urban area at a specific solar zenith angle, which typically receives less UV radiation than more equatorial regions of the world. However, it appears that astronomical factors may be less influential in determining vitamin D status, given that studies conducted in latitudes with higher UV radiation (e.g., Costa Rica, Georgia, Arizona) [12,32,33] show surprisingly similar rates of deficiency. Rather, lifestyle and behavioral factors may be more significant in an increasingly urbanized world. "
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    ABSTRACT: Background The inner-city pediatric population in the United States has a disproportionate burden of asthma. Recent attention has focused on the immunomodulatory role of vitamin D, which may be protective against disease morbidity. As the primary determinant of vitamin D status in humans is exposure to sunlight, we aimed to determine if 25-OH vitamin D levels in urban preschool children with asthma were low, influenced by time spent outdoors, and associated with asthma morbidity. Methods Serum 25-OH vitamin D levels were measured at baseline in a cohort of 121 inner-city children ages 2–6 years with asthma in Baltimore, MD. Participants were followed longitudinally at 3 and 6 months to assess time spent outdoors, asthma symptoms through questionnaires and daily diaries, and allergic markers. Results In a predominantly black population of preschool children, the median 25-OH vitamin D level was 28 ng/mL (IQR 21.2-36.9), with 54% of the children below the traditionally sufficient level of 30 ng/mL and 7.4% in the range associated with risk of rickets (< 15 ng/mL). The median time spent outdoors was 3 hours/day (IQR 2–4), and greater time spent outdoors was not associated with higher vitamin D levels. 25-OH vitamin D did not show seasonal variation in our cohort (p = 0.66). Lower 25-OH levels were correlated with higher IgE levels. Conclusions Urban African-American preschool children with asthma have high rates of vitamin D insufficiency, and increased outdoor exposure is unlikely to correct these low 25-OH vitamin D levels. Repletion in this population may require dietary supplementation.
    Nutrition Journal 06/2013; 12(1):81. DOI:10.1186/1475-2891-12-81 · 2.60 Impact Factor
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    • "This is a secondary analysis of data collected in low-income, minority, preschool children between the ages of 1 and 5 years enrolled in larger study (n = 291) between February 2006 and July 2007 [9,10]. A convenience sampling method was used to recruit low-income, minority children attending well-child clinics at the Children’s Healthcare of Atlanta at Hughes Spalding and North Dekalb Grady Satellite Clinic. "
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    ABSTRACT: Background The food group intake patterns of low income Hispanic and African American preschool children are not well documented. The aim of this study was to perform a food group intake analysis of low income minority preschool children and evaluate how macronutrient and micronutrient intake compares to Dietary Reference Intakes (DRI). Methods A cross sectional study design using three-day food diaries analyzed by dietary analysis software (Nutrient Database System for Research) was used. Children were recruited from well-child clinics at Children’s Healthcare of Atlanta at Hughes Spalding and North Dekalb Grady Satellite Clinic, Atlanta, GA. Low-income, African American and Hispanic preschool age children (n = 291) were enrolled. A total of 105 completed and returned the 3-day food diaries. Chi-squared tests were used to assess demographic variables. The mean percentage of intake per day of specific food groups and sub-groups were obtained (servings of given food group/total daily servings). Food intake data and proportion of children meeting DRIs for macro- and micronutrients were stratified by race/ethnicity, nutritional status, and caloric intake, and were compared using t-tests. Regression models controlling for age, BMI and sex were obtained to assess the effect of total caloric intake upon the proportional intake of each studied food group. Results The mean age of African American children was 2.24 ± 1.07 years and Hispanic children 2.84 ± 1.12 years. African Americans consumed more kcal/kg/day than Hispanics (124.7 ± 51 vs. 96.9 ± 33, p < 0.05). Hispanics consumed more fruits (22.0 ± 10.7% vs. 14.7 ± 13.7%, p < 0.05), while African Americans consumed more grains (25.7 ± 7.8% vs. 18.1 ± 6.4%, p < 0.05), meats (20.7 ± 9.0% vs. 15.4 ± 6.1%, p < 0.05), fats (9.8 ± 5.4% vs. 7.0 ± 5.8%, p < 0.05), sweet drinks (58.7 ± 17.1% vs. 41.3 ± 14.8%, p < 0.05) and low-fat dairy products (39.5 ± 19.3% vs. 28.9 ± 12.6%, p < 0.05). Among Hispanics, the proportional intake of fruits, fats and grains varied by total caloric intake, while no difference by total caloric intake was found for the dietary patterns of African Americans. Micronutrient intake also differed significantly between African American and Hispanic children. Conclusions Food group intake patterns among low-income children differ by ethnic group. There is a need for more research to guide program design and target nutritional interventions for this population.
    Nutrition Journal 08/2012; 11(1):62. DOI:10.1186/1475-2891-11-62 · 2.60 Impact Factor
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    • "There is no consensus on the measurement and definition of VDD and its functional outcomes in children24,25). In this study, VDD was defined as serum 25OHD less than 20 ng/mL8,10,26,27); vitamin D insufficiency (VDI) was defined as serum 25OHD between 20 and 30 ng/mL25,27); and vitamin D sufficiency was defined as 25OHD greater than 30 ng/mL. Serum 25OHD levels were measured by a radioimmunoassay kit from DiaSorin (Stillwater, MN, USA). "
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    ABSTRACT: The increasing prevalence of breast feeding has led to concerns about vitamin D deficiency (VDD) and iron deficiency anemia (IDA) in children. We evaluated the prevalence of VDD in a population of Korean children with IDA and assessed the risk factors for VDD in these children. A total of 79 children who were diagnosed with IDA were prospectively surveyed from April 2010 to March 2011. Data were collected by questionnaire, medical assessment, and laboratory tests, including measurement of 25-hydroxyvitamin D (25OHD), hemoglobin, and wrist radiography. The median age was 22 months and 30% of the subjects were female. Over a half of subjects (58%) had subnormal vitamin D level (25OHD<30 ng/mL), and VDD (25OHD<20 ng/mL) was present in 39% of children. There was no difference in serum hemoglobin level between IDA patients with VDD and those without VDD. Most subjects (89%) were currently or had recently been breastfed and almost all subjects (97%) who had VDD received breastfeeding. Children with VDD were more likely to be younger than 2 years, to have been breastfed, and to have been tested in winter or spring. Multivariable analysis indicated seasonal variation was a significant independent risk factor for VDD in our IDA patients. Our results demonstrated that VDD has a high prevalence in Korean children with IDA. Primary care physicians should be aware of the possibility of VDD in children with IDA and should supplement the vitamin D as well as iron.
    Korean Journal of Pediatrics 06/2012; 55(6):206-11. DOI:10.3345/kjp.2012.55.6.206
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