title: Vitamin D status of refugees arriving in Canada: findings from the Calgary Refugee Health Program.
abstract: OBJECTIVE
  To determine the 25-hydroxyvitamin D (25[OH]D) serum levels in refugee women of childbearing age and in refugee children; to compare their 25(OH)D levels with the recommended levels in order to determine the prevalence of deficiency; to compare their 25(OH)D levels with those in the general Canadian population in the appropriate age and sex groups; and to investigate the association of vitamin D deficiency with potential risk factors.
  
  
  METHODS
  Cross-sectional chart review.
  
  
  METHODS
  The Calgary Refugee Health Program, an urban family practice that serves newly arrived refugees in Calgary, Alta.
  
  
  METHODS
  A total of 1217 refugee women and children screened between June 2005 and January 2010.
  
  
  METHODS
  Serum 25(OH)D values that were measured during initial screening visits.
  
  
  RESULTS
  Overall, 1217 of the 1768 eligible participants (69%) had 25(OH)D laboratory values recorded. The mean concentration of 25(OH)D was 52.0 nmol/L (95% CI 50.6 to 53.3 nmol/L). Using the Institute of Medicine guideline for adequate serum vitamin D levels (>50 nmol/L), 61% of women and 42% of children had lower-than-desirable 25(OH)D levels. Considering the Osteoporosis Canada guidelines, 88% of women and 81% of children had lower-than-desirable 25(OH)D levels (<75 nmol/L), and 21% of women and 10% of children were vitamin D deficient (<25 nmol/L). Mean levels of 25(OH)D were significantly lower across all age and sex groupings compared with the general Canadian population (P<.001). Women from the Middle East had lower mean 25(OH)D values (24.6 nmol/L, 95% CI 21.7 to 27.5 nmol/L) compared with women from Asia, Africa, or South America (P<.001). Mean values of 25(OH)D were lower during the winter in children (P=.01) but not in women. Female refugees between the ages of 12 and 19 years old had lower mean values of 25(OH)D than male refugees in the same age group did (P=.01).
  
  
  CONCLUSIONS
  Most refugees had lower-than-desirable vitamin D levels. All age groups studied had lower mean 25(OH)D levels compared with the general Canadian population. Health care providers should be aware of this concern and consider vitamin D supplementation among refugees.
authors.affiliation: Calgary Refugee Health Program, 23 McDougall Ct NE, Calgary, AB T2E 8R3. mwaucoin@ucalgary.ca
authors.forename: Michael
authors.initials: M
authors.lastname: Aucoin
authors.forename: Rob
authors.initials: R
authors.lastname: Weaver
authors.forename: Roger
authors.initials: R
authors.lastname: Thomas
authors.forename: Lanice
authors.initials: L
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000704:Analysis of Variance; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000208:ethnology; D015995:Prevalence; D012036:Refugees; D012189:Retrospective Studies; D012621:Seasons; D013020:South America / Q000208:ethnology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000208:ethnology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D