title: Body mass but not vitamin D status is associated with bone mineral content and density in young school children in northern Sweden.
abstract: BACKGROUND
  High latitude of residence where sun exposure is limited affects vitamin D status. Although vitamin D levels have been associated with poor bone health, cut-off values for optimising bone health are yet to be decided.
  
  
  OBJECTIVE
  To assess vitamin D intake and status among young school children living at latitude 63-64 °N, in northern Sweden and to examine the association between vitamin D status and bone mineral content (BMC) and bone mineral density (BMD).
  
  
  METHODS
  In a cross-sectional study, diet was assessed by a 4-day food diary and a food frequency questionnaire in 8- to 9-year-old children (n=120). Energy, vitamin D, and calcium intakes were calculated. Physical activity was assessed using a pedometer for 7 days. Serum 25-hydroxyvitamin D (S-25[OH]D) levels were analysed by high-pressure liquid chromatography-atmospheric pressure chemical ionisation-mass spectrometry (n=113). BMC and BMD were assessed by dual energy X-ray absorptiometry scan. Height and weight were measured by standard procedures and BMI z-score was calculated using WHO AnthroPlus programme.
  
  
  RESULTS
  The majority of children, 91%, did not reach the recommended vitamin D intake of 7.5 µg/day and 50% had insufficient S-25[OH]D levels defined as <50 nmol/l. The highest concentrations of S-25[OH]D were observed during the summer months (p=0.01). Body mass (p<0.01) but not S-25[OH]D was associated with measures of BMC and BMD. Furthermore, boys had higher total BMC (p=0.01), total body less head BMC (p=0.02), fat free mass (p<0.01), and a higher degree of physical activity (p=0.01) compared to girls.
  
  
  CONCLUSIONS
  Body mass was related to BMC and BMD measures in a population of prepubertal school children living at high latitudes in Sweden. Despite insufficient S-25[OH]D levels and low vitamin D intake, this did not appear to affect bone parameters. Prospective studies with repeated assessment of vitamin D status are needed to examine cut-off values for optimising bone health.
authors.affiliation: Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden; frida.karlsson@umu.se.
authors.forename: Frida K
authors.initials: FK
authors.lastname: Videhult
authors.affiliation: Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Öhlund
authors.affiliation: Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Hernell
authors.affiliation: Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden.
authors.forename: Christina E
authors.initials: CE
authors.lastname: West
keywords: calcium; diet; dual energy X-ray absorptiometry (DXA); latitude; season; serum 25-hydroxyvitamin D