Abstract
Objective
Vitamin D intake in childhood is primarily for the prevention of rickets. Inconsistent evidence has associated adequate blood concentrations with a decreased risk of certain health conditions. Further, obese individuals may have lower vitamin D status. The estimated average requirement (EAR) for children recently doubled to 400 IU/day. Our aim was to examine dietary intake of vitamin D in different body mass index (BMI) categories, in addition to assessing determinants.
Methods
Data from two provincial surveys of grade 5 children, including a food frequency questionnaire and measured BMI, were used. Rao-Scott chi-square statistic tested the bivariate association between provinces and adequate dietary vitamin D intake. Key correlates were examined using multilevel logistic regression.
Results
Those below the EAR differed between Alberta (78%) and Nova Scotia (81 %). Those drinking <2 glasses of milk/day had 0.02 times the odds of meeting the EAR (95% CI: 0.01 -0.02) compared to those drinking more. No significant difference was observed for BMI, though those consuming <1 glass of milk/day were more likely to be obese than those consuming >-2 glasses/day. Income and physical activity were negatively correlated with meeting the EAR.
Conclusion
Many children did not meet the EAR for vitamin D from dietary sources and milk consumption was an important determinant. Given trends towards a more sedentary lifestyle and limited sun exposure, we recommend prioritizing public health efforts to support dietary vitamin D intake alongside interventions to increase physical activity and reduce sedentary behaviour. Further investigation is required to determine the need for targeted strategies for obese children.
Key Words: Vitamin D, children, dietary reference intake, obesity, health behaviour, intake
Résumé
Objectif
L’apport en vitamine D durant l’enfance sert principalement à prévenir le rachitisme. Bien que les données probantes divergent, des études associent des concentrations sanguines adéquates à un moindre risque de contracter certains troubles médicaux. De plus, les personnes obèses pourraient avoir un statut plus faible en vitamine D. Le besoin moyen estimatif (BME) en vitamine D des enfants a récemment été doublé à 400 Ul/jour. Notre but était d’examiner l’apport alimentaire en vitamine D dans différentes catégories de l’indice de masse corporelle (IMC), en plus d’en évaluer les déterminants.
Méthode
Nous avons utilisé les données de deux enquêtes provinciales auprès d’élèves de 5e année comportant un questionnaire sur la fréquence de consommation des produits alimentaires et des mesures de l’IMC des élèves. Le test du khi-carré de Rao-Scott a analysé l’association bivariée entre les deux provinces et la suffisance de l’apport alimentaire en vitamine D. Les principaux corrélats ont été examinés par régression logistique multiniveau.
Résultats
La proportion d’enfants dont l’apport est en-deçà du BME était différente en Alberta (78 %) et en Nouvelle-Écosse (81 %). Les enfants qui buvaient <2 verres de lait/jour avaient 0,02 fois la probabilité d’avoir un apport supérieur ou égal au BME (IC de 95 %: 0,01 -0,02) que ceux qui en buvaient plus. Aucun écart significatif n’a été observé pour l’IMC, mais les enfants qui consommaient <1 verre de lait/jour étaient plus susceptibles d’être obèses que ceux qui en consommaient >-2 verres/jour. Le revenu et l’activité physique présentaient des corrélations négatives avec le statut par rapport au BME.
Conclusion
De nombreux enfants avaient un apport en vitamine D de sources alimentaires en-deçà du BME, et la consommation de lait en était un important déterminant. Étant donné la tendance à la sédentarisation des modes de vie et l’exposition limitée au soleil, nous recommandons de privilégier les efforts de santé publique qui appuient l’apport alimentaire en vitamine D en plus des interventions pour accroître l’activité physique et réduire les comportements sédentaires. Il est nécessaire de pousser la recherche pour déterminer s’il faudrait des stratégies ciblant les enfants obèses.
Mots Clés: vitamine D, enfant, apports nutritionnels de référence, obésité, comportement en matière de santé, apport
Footnotes
Funding sources: CLASS was funded through an operating grant from the Canadian Institutes of Health Research (CIHR [FRN: 93680]), and REAL Kids Alberta through a contract with Alberta Health. All interpretations and opinions in this article are those of the authors. Sara Kirk acknowledges support from a CIHR Canada Research Chair (CRC) in Health Services Research and an IWK Scholar Award. Paul Veugelers acknowledges his support through a CIHR CRC in Population Health, an Alberta Research Chair in Nutrition and Disease Prevention, and an Alberta Innovates Health Scholarship. Cynthia Colapinto is supported by a CIHR-Quebec Training Network in Perinatal Research postdoctoral fellowship.
Acknowledgements: The authors thank students, parents, schools and school jurisdictions in Nova Scotia and Alberta for their participation in and support for this research. We also thank the CLASS and REAL Kids Alberta coordinators, evaluation assistants and others involved in the data collection, as well as Connie Lu for data validation and management.
Conflict of Interest: None to declare.
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