Bárbara H Lourenço1, Lara Ls Silva1,2, Wafaie W Fawzi3, Marly A Cardoso1. 1. Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP 01246-904, Brazil. 2. Department of Public Health, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil. 3. Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
OBJECTIVE: To assess sociodemographic, nutritional and health conditions associated with vitamin D sufficiency among young Brazilian children living at different latitudes. DESIGN: Cross-sectional analysis with a four-level model of inflammation to correct micronutrient concentrations. Prevalence ratios (PR; 95 % CI) were estimated for factors associated with vitamin D sufficiency (≥50 nmol/l), adjusting for child's sex, age, skin colour, stunting and vitamin A+D supplementation. SETTING: Primary health-care units in four Brazilian cities located at lower (7°59'26·9016″S and 9°58'31·3864″S) and higher latitudes (16°41'12·7752″S and 30°2'4·7292″S). PARTICIPANTS: In total 468 children aged 11-15 months were included in the analysis. RESULTS: Only 31·8 % of children were vitamin D sufficient (concentration <30 nmol/l and <50 nmol/l among 32·9 and 68·2 %, respectively). Living at higher latitudes was associated with reduced prevalence of vitamin D sufficiency compared with lower latitudes (PR = 0·65; 95 % CI 0·49, 0·85). Maternal education ≥9 years positively influenced a sufficient vitamin D status in children. After correction for inflammatory status, each increase of 1 µmol/l in vitamin A concentration was associated with a 1·38-fold higher prevalence of vitamin D sufficiency (95 % CI 1·18, 1·61). Progressive decline in the prevalence of vitamin D sufficiency was associated with marginal and deficient status of vitamin A (Ptrend = 0·001). CONCLUSIONS: Lower latitude, higher maternal education and vitamin A concentration were positively associated with vitamin D sufficiency in young Brazilian children. These findings are relevant for planning public health strategies for improving vitamin D status starting in early infancy.
OBJECTIVE: To assess sociodemographic, nutritional and health conditions associated with vitamin D sufficiency among young Brazilian children living at different latitudes. DESIGN: Cross-sectional analysis with a four-level model of inflammation to correct micronutrient concentrations. Prevalence ratios (PR; 95 % CI) were estimated for factors associated with vitamin D sufficiency (≥50 nmol/l), adjusting for child's sex, age, skin colour, stunting and vitamin A+D supplementation. SETTING: Primary health-care units in four Brazilian cities located at lower (7°59'26·9016″S and 9°58'31·3864″S) and higher latitudes (16°41'12·7752″S and 30°2'4·7292″S). PARTICIPANTS: In total 468 children aged 11-15 months were included in the analysis. RESULTS: Only 31·8 % of children were vitamin D sufficient (concentration <30 nmol/l and <50 nmol/l among 32·9 and 68·2 %, respectively). Living at higher latitudes was associated with reduced prevalence of vitamin D sufficiency compared with lower latitudes (PR = 0·65; 95 % CI 0·49, 0·85). Maternal education ≥9 years positively influenced a sufficient vitamin D status in children. After correction for inflammatory status, each increase of 1 µmol/l in vitamin A concentration was associated with a 1·38-fold higher prevalence of vitamin D sufficiency (95 % CI 1·18, 1·61). Progressive decline in the prevalence of vitamin D sufficiency was associated with marginal and deficient status of vitamin A (Ptrend = 0·001). CONCLUSIONS: Lower latitude, higher maternal education and vitamin A concentration were positively associated with vitamin D sufficiency in young Brazilian children. These findings are relevant for planning public health strategies for improving vitamin D status starting in early infancy.
Entities:
Keywords:
Developing countries; Inflammation; Latitude; Vitamin A; Vitamin D; Young children