title: Modifiable determinants of serum 25-hydroxyvitamin D status in early childhood: opportunities for prevention.
abstract: OBJECTIVES To determine the effect of modifiable dietary intake variables (current vitamin D supplementation and daily cow's milk intake) on 25-hydroxyvitamin D level in early childhood and to evaluate the relationship between these modifiable dietary factors and other largely nonmodifiable determinants of vitamin D status including skin pigmentation and season. DESIGN Cross-sectional study. SETTING Primary care pediatric and family medicine practices participating in the TARGet Kids! practice-based research network in Toronto, Ontario, Canada. PARTICIPANTS From December 2008 to June 2011, healthy children 1 to 5 years of age were recruited during a routine physician's visit. INTERVENTIONS Survey, anthropometric measurements, and laboratory data were collected. A multivariable linear regression model was developed to examine the independent effects of vitamin D supplementation and daily volume of cow's milk on 25-hydroxyvitamin D level. MAIN OUTCOME MEASURES 25-Hydroxyvitamin D level. RESULTS Blood was obtained in 1898 children. Two modifiable dietary intake variables, vitamin D supplementation and cow's milk, increased 25-hydroxyvitamin D level by 3.4 ng/mL (95% CI, 2-4 ng/mL) and 1.6 ng/mL per 250-mL cup per day (95% CI, 1-2 ng/mL), respectively. Two nonmodifiable variables reflecting cutaneous vitamin D synthesis (skin pigmentation and season) were also strongly associated with 25-hydroxyvitamin D status but accounted for a much smaller proportion of the explained variation in 25-hydroxyvitamin D level. The effect of vitamin D supplementation and milk intake on 25-hydroxyvitamin D level appeared similar regardless of skin pigmentation or season. CONCLUSION Two modifiable dietary intake variables (vitamin D supplementation and cow's milk intake) are the most important determinants of 25-hydroxyvitamin D status in early childhood.
authors: Department of Pediatrics, St Michael’s Hospital, 30 Bond St, 15-014 Cardinal Carter, Toronto, Ontario, Canada. jonathon.maguire@utoronto.ca
authors: Jonathon L
authors: JL
authors: Maguire
authors: Catherine S
authors: CS
authors: Birken
authors: Marina
authors: M
authors: Khovratovich
authors: Julie
authors: J
authors: Degroot
authors: Sarah
authors: S
authors: Carsley
authors: Kevin E
authors: KE
authors: Thorpe
authors: Muhammad
authors: M
authors: Mamdani
authors: Patricia C
authors: PC
authors: Parkin
mesh_terms: D000818:Animals; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D008892:Milk; D009864:Ontario; D011446:Prospective Studies; D012621:Seasons; D012880:Skin Pigmentation; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000209:etiology / Q000517:prevention & control
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D