title: Vitamin D status and associated factors of deficiency among Jordanian children of preschool age.
abstract: OBJECTIVE
  Vitamin D deficiency in children remains a global concern. Although literature exists on the vitamin D status and its risk factors among children in the Middle East, findings have yielded mixed results, and large, representative community studies are lacking.
  
  
  METHODS
  In a nationally representative survey of 1077 Jordanian children of preschool age (12-59 months) in Spring 2010, we measured 25(OH)D3 concentrations by liquid chromatography-tandem mass spectrometry and calculated prevalence ratios for deficiency associated with various factors.
  
  
  RESULTS
  RESULTS showed 19.8% (95% confidence interval (CI): 16.4-23.3%) deficiency (<12 ng/ml) and 56.5% (95% CI: 52.0-61.0%) insufficiency (<20 ng/ml). In adjusted models, prevalence of deficiency was higher for females compared with males (prevalence ratio (PR)=1.74, 95% CI: 1.22-2.47, P=0.002) and lower for children 24-35 months of age (PR=0.64, 95% CI: 0.44-0.92, P=0.018) compared with children 12-23 months of age. In rural areas, there was no difference in prevalence of vitamin D deficiency between those whose mothers had/did not have vitamin D deficiency (P=0.312); however, in urban areas, prevalence of vitamin D deficiency was 3.18 times greater among those whose mothers were vitamin D deficient compared with those whose mothers were not deficient (P=0.000).
  
  
  CONCLUSIONS
  Vitamin D deficiency and insufficiency pose significant public health problems in Jordanian children with female children disproportionately affected. Strong associations between vitamin D status in children and urban residency and maternal vitamin D status suggest that the behaviors related to sun exposure in urban mothers likely also affect the sun exposure and thus vitamin D status of their children.
authors.affiliation: Epidemic Intelligence Service assigned to the Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, U.S. Public Health Service, Atlanta, GA, USA.
authors.forename: E K
authors.initials: EK
authors.lastname: Nichols
authors.affiliation: Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
authors.forename: I M D
authors.initials: IM
authors.lastname: Khatib
authors.affiliation: Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Aburto
authors.affiliation: Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Serdula
authors.affiliation: Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Scanlon
authors.affiliation: 1] GroundWork LLC, 1299 Crans-près-Céligny, Nyon, Switzerland [2] Global Alliance for Improved Nutrition, Geneva, Switzerland.
authors.forename: J P
authors.initials: JP
authors.lastname: Wirth
authors.affiliation: 1] Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA [2] Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Sullivan
mesh_terms: D000367:Age Factors; D002112:Calcifediol / Q000097:blood*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007597:Jordan / Q000453:epidemiology; D008297:Male; D009035:Mothers; D009752:Nutritional Status; D012424:Rural Population; D012737:Sex Factors; D013472:Sunlight; D014505:Urban Population; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology*
chemical_list: D002112:Calcifediol