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Vitamin D status of children in Kerala, southern India
Madhava Vijayakumar1, Vijayalakshmi Bhatia2, Biju George3
1Department of Pediatrics, Government Medical College, Kozhikode, Kerala, India.
Insights
Vitamin D deficiency is uncommon in children in Kerala, India, likely due to local fish consumption and sunny conditions. This highlights regional variations in nutritional status and public health needs.
Area of Science:
- Nutritional Science
- Pediatric Health
- Public Health
Background:
- Vitamin D deficiency is a global concern, particularly in children.
- Understanding regional variations in vitamin D status is crucial for targeted public health interventions.
- Kerala, southern India, has unique dietary habits and environmental factors that may influence vitamin D levels.
Purpose of the Study:
- To assess the plasma 25-hydroxyvitamin D (25(OH)D) status in children residing in Kerala, India.
- To investigate the relationship between sociodemographic variables, dietary intake, sun exposure, and 25(OH)D levels.
- To determine the prevalence of vitamin D deficiency in this pediatric population.
Main Methods:
- A cross-sectional observational study was conducted involving 296 children with minor illnesses at a tertiary government hospital.
- Data on sun exposure, calcium (Ca), and vitamin D intake were collected using a 7-day dietary recall.
- Plasma 25(OH)D, serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone (PTH) were measured.
Main Results:
- The prevalence of vitamin D deficiency (plasma 25(OH)D <30 nmol/l) was 11.1%.
- Higher plasma 25(OH)D levels were associated with daily fish consumption, the summer season (March-May), lower age, and higher calcium intake.
- Plasma 25(OH)D showed positive correlations with serum phosphorus and calcium intake, and negative correlations with age and PTH.
Conclusions:
- Vitamin D deficiency is relatively low among children in Kerala.
- The traditional fish-rich diet and geographical latitude of coastal Kerala appear to be protective factors against vitamin D deficiency.
- Public health policies in India should consider regional dietary and environmental diversity when addressing vitamin D status.
Objective:
To study plasma 25-hydroxyvitamin D (25(OH)D) status of children in Kerala, southern India, and its relationship with sociodemographic variables.
Design:
Cross-sectional observational study.
Setting:
Tertiary government hospital.
Participants:
Children (n 296) with trivial acute illness were enrolled. Sun exposure and Ca and vitamin D intakes (7 d dietary recall) were documented. Serum Ca, P, alkaline phosphatase, plasma 25(OH)D and parathyroid hormone (PTH) were measured.
Results:
Prevalence of vitamin D deficiency (plasma 25(OH)D <30 nmol/l) was 11·1% (median, interquartile range (IQR): 52·6, 38·4-65·6 nmol/l). Children who ate fish daily had significantly higher plasma 25(OH)D than those who did not (median, IQR: 52·5, 40·8-68·9 v. 49·1, 36·2-60·7 nmol/l; P = 0·02). Those investigated in the months of March-May showed highest 25(OH)D v. those enrolled during other times (median, IQR: 58·7, 45·6-81·4 v. 45·5, 35·6-57·4 nmol/l; P <0·001). Plasma 25(OH)D correlated positively with serum P (r = 0·24, P <0·001) and Ca intake (r = 0·16, P 0·03), negatively with age (r = -0·13, P 0·03) and PTH (r = -0·22, P <0·001.). On linear regression, summer season (March-May), lower age, daily fish intake and higher Ca intake were independently associated with plasma 25(OH)D.
Conclusions:
Prevalence of vitamin D deficiency is low in Kerala. The natural fish diet of coastal Kerala and the latitude may be protective. Public health policy in India should take account of this geographical diversity.
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