Prevalence and Risk Factors of Vitamin D Deficiency in Children Aged 6-12 Years: A Cross-Sectional Study
The Burden of Vitamin D Deficiency in Children
Keywords:
Children, Determinants, Vitamin D, Vitamin D DeficiencyAbstract
Background: Vitamin D deficiency has become a common public health problem, especially in children. Globally, vitamin D deficiency is an important public health concern, especially in regions with sun exposure limited by climatic and other cultural practices or lifestyle habits. This study aims to determine the prevalence of vitamin D deficiency among children and explore the associated determinants, including sunlight exposure, dietary habits, socioeconomic status, parental education, and body weight.
Methods: This cross-sectional survey was conducted from January 2023 to July 2024 at Lahore General Hospital, Lahore, Pakistan. Four hundred and seventeen children visiting the pediatric outpatient department were recruited via convenience sampling technique. A health camp was established within the hospital premises to facilitate data collection. A structured questionnaire in English and Urdu was used to collect demographic details (age, gender, and socioeconomic status), dietary intake, sun exposure, and clinical history. Data were entered into SPSS version 22.0 for analysis. The chi-square test was applied to determine associations between Vitamin D deficiency and determinants.
Results: The average age for participants was 8.1±2.9 years. The children included in the study were predominantly boys (61.15% males), while 38.84% were females. Vitamin D deficiency (<20 ng/mL) was detected in 244 children out of 417. Among the 69 responders (16.54%), vitamin D insufficiency was defined, while 104 (24.9%) children were in normal vitamin D levels (>30 ng/mL).
Conclusion: The findings highlight the need for multi-faceted interventions, including public health campaigns promoting adequate sun exposure, dietary modifications, and potential fortification programs.
References
Bikle DD. Vitamin D regulation of immune function. Current osteoporosis reports. 2022 Jun;20(3):186-93. DOI: https://doi.org/10.1007/s11914-022-00732-z
Wimalawansa SJ. Controlling chronic diseases and acute infections with vitamin D sufficiency. Nutrients. 2023 Aug 18;15(16):3623. DOI: https://doi.org/10.3390/nu15163623
de Santana KV, Oliver SL, Mendes MM, Lanham-New S, Charlton KE, Ribeiro H. Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health. EClinicalMedicine. 2022 May 1;47. DOI: https://doi.org/10.1016/j.eclinm.2022.101400
Cui A, Zhang T, Xiao P, Fan Z, Wang H, Zhuang Y. Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants. Frontiers in Nutrition. 2023 Mar 17;10:1070808. DOI: https://doi.org/10.3389/fnut.2023.1070808
Arshad S, Zaidi SJ. Vitamin D levels among children, adolescents, adults, and elders in Pakistani population: a cross-sectional study. BMC Public Health. 2022 Nov 8;22(1):2040. DOI: https://doi.org/10.1186/s12889-022-14526-6
Mahar B, Shah T, Sadiq N, Mangi R, Warsi J, Abbas Q. Vitamin D Deficiency Prevalence in Pakistan: Common, Important, and Neglected: A Comprehensive Meta-Analysis. Journal of Diabetology. 2024 Oct 1;15(4):335-48. DOI: https://doi.org/10.4103/jod.jod_61_24
Demay MB, Pittas AG, Bikle DD, Diab DL, Kiely ME, Lazaretti-Castro M, Lips P, Mitchell DM, Murad MH, Powers S, Rao SD. Vitamin D for the prevention of disease: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2024 Aug;109(8):1907-47. DOI: https://doi.org/10.1210/clinem/dgae290
Shah VP, Nayfeh T, Alsawaf Y, Saadi S, Farah M, Zhu Y, Firwana M, Seisa M, Wang Z, Scragg R, Kiely ME. A systematic review supporting the endocrine society clinical practice guidelines on vitamin D. The Journal of Clinical Endocrinology & Metabolism. 2024 Jun 3:dgae312. DOI: https://doi.org/10.1210/clinem/dgae312
Mahajan C, Singla N, Jain D. High Incidence of Vitamin D Deficiency (VDD) Among Indoor Workers: Association with Dietary and Lifestyle Factors. Ecology of Food and Nutrition. 2024 Mar 3;63(2):40-62. DOI: https://doi.org/10.1080/03670244.2024.2306386
Normando P, de Castro IR, Bezerra FF, Berti TL, Bertoni N, de Aquino Lacerda EM, Alves-Santos NH, de Freitas MB, Kac G. Prevalence and predictors of vitamin D insufficiency in Brazilian children under 5 years of age: Brazilian National Survey on Child Nutrition (ENANI-2019). British Journal of Nutrition. 2024 Jan;131(2):312-20.
Chen J, Wang J, Qi Z, Liu S, Zhao L, Zhang B, Dong K, Du L, Yang J, Zou H, He X. Smartwatch measures of outdoor exposure and myopia in children. JAMA Network Open. 2024 Aug 1;7(8):e2424595. DOI: https://doi.org/10.1001/jamanetworkopen.2024.24595
Weiler HA, Rana H, McCrea J, Loukine L, Bonvalot Y, Nguyen L, Hopperton K, Cooper M, Bertinato J, Vercammen K, Luo W. Adherence to Vitamin D Supplementation Recommendations for Breastfed Infants and Young Children: An Analysis of Canadian Community Health Survey Data Cycles From 2015 to 2018. The Journal of Nutrition. 2024 May 1;154(5):1665-75. DOI: https://doi.org/10.1016/j.tjnut.2024.03.016
Mogire RM, Morovat A, Muriuki JM, Mentzer AJ, Webb EL, Kimita W, Ndungu FM, Macharia AW, Cutland CL, Sirima SB, Diarra A. Prevalence and predictors of vitamin D deficiency in young African children. BMC medicine. 2021 Dec;19:1-4. DOI: https://doi.org/10.1186/s12916-021-01985-8
Nyakundi PN, Némethné Kontár Z, Kovács A, Járomi L, Zand A, Lohner S. Fortification of staple foods for household use with vitamin D: an overview of systematic reviews. Nutrients. 2023 Aug 26;15(17):3742. DOI: https://doi.org/10.3390/nu15173742
Cashman KD, Kiely M. Vitamin D and food fortification. Feldman and Pike's Vitamin D. 2024 Jan 1:135-60. DOI: https://doi.org/10.1016/B978-0-323-91338-6.00008-2
Stoica AB, Săsăran MO, Suciu LM, Huțanu A, Mărginean C. Vitamin D Status in Roma Mothers and Newborns: Socioeconomic Factors and Impact on Neonatal Outcome. Nutrients. 2024 Dec 18;16(24):4361. DOI: https://doi.org/10.3390/nu16244361
Turgeon O’Brien H, Gagné D, Blanchet R, Vézina C. Prevalence and determinants of insufficient vitamin D status in young Canadian Inuit children from Nunavik. Nutrition and Health. 2024 Jan 31. DOI: https://doi.org/10.1177/02601060231207664
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Copyright (c) 2025 Muhammad Asim Zahoor, Iqra Aslam, Shumaila Fatima, Zulfiqar Ali, Hafiz Muhammad Usman, Farhan Rasheed
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