Hypovitaminosis D in healthy toddlers and preschool children from Western Saudi Arabia

Abstract

Background: Vitamin D deficiency is common in Saudi Arabia. No sufficient data are available on the vitamin D status of preschool children. Aims: To i nv e s t i g a te the vitamin D status amo n g toddlers and pr e s c hool c hi l dr e n and to evaluate the factors associated with hypovitaminosis D in Western Saudi Arabia. Methods: A c ross- s ec t i on a l s t u d y w a s c ondu c t e d on 503 pr e s c hool children in Makkah. The c hi l dr e n w e r e divided into two a ge ca tego r ies: 1 - 3 y ea rs (toddlers) a nd 3 - 6 y e a rs (preschool). Sociodemographic factors, life-st yle f actors, ea ting habits, body mass index (BMI), 25- (OH)- vit amin D 3 , parath yroid hormone, calcium, phosphorous, and alkaline phosphatase con centr ations were de t ermined. Results: Sixty-three % of children had a vi t a m i n D d e fic i e n c y. Vitamin D in todd l e r s w as sign i fica nt l y high e r than in p r e s c hool c hi l d r e n. Vitamin D lev e ls were negatively correlated with B M I (r = - 0.419, P < 0.001), and d u r a t i on of b r e a st fe e ding (r = - 0.270, P = 0.027), but a sign i fica nt positive c or r e lation with vitamin D intake (r = 0.335, P = 0.021), calcium intake (r = 0.25, P = 0.029) , dur a t i on of fo r mu l a f e e ding (r = 0.354, P = 0.019), and outdoor phy sical a ctivity (r = 0.381, P = 0.011) was found. Multivariable predictors of hypovitaminosis D were preschool age (OR = 11, [95 % CI: 2.78 - 43.57], P < 0.001), outdoor physical inactivity (OR = 2.44, [95 % CI: 0.93 - 14.12], P < 0.001), obesity (OR = 2.3, [95 % CI: 1.25 - 7.08], P = 0.008), overweight (OR = 2.16, [95 % CI: 1.18 - 6.01], P = 0.039), inadequate vitamin D intake (OR = 1.65, [95 % CI: 1.12 - 2.53], P = 0.012), exclusive formula feeding (OR = 0.53, [95 % CI: 0.41 - 0.72], P < 0.001), and breast and formula feeding (OR = 0.62 [95 % CI: 0.39 - 0.88], P = 0.002). Conclusion: Hypovitaminosis D is a public health concern, especially in preschool children. Possible determinants of low vitamin D status in preschool children in the Makkah region could be related to age, high BMI, inadequate vitamin D intake, exclusive breastfeeding, and outdoor physical inactivity.