The relationship between vitamin D status and lifestyle of children from birth to 5 years old: a multi-center cross-sectional study in Jiangsu Province / 中华临床营养杂志

ABSTRACT

Objective:To explore the relationship between vitamin D status and diet, vitamin D and calcium supplements, and physical activity in children during the first five years of life.Methods:This was a large population-based cross-sectional multicenter study. Children aged 0-5 years were recruited from Children's Health Care Centers through stratified cluster random sampling in 10 cities in Jiangsu Province from April, 2014 to March, 2015. The food frequency method and the physical activity questionnaire were used to investigate the diet and physical activity respectively, and serum 25-hydroxyvitamin D (25-[OH]D) was detected via enzyme-linked immunosorbent assay.Results:A total of 5,289 children were investigated. Factors significantly associated with increased risk of vitamin D deficiency in children included milk consumption < 250 ml/d (odds ratio [OR] = 1.24), meat consumption > 150.0 g/d (OR = 1.46), preferences for meats (OR = 1.34), preferences for sweets (OR = 1.27), no vitamin D supplementation in the last 3 months (OR = 1.47), no calcium supplementation in the last 3 months (OR = 1.39), dose of vitamin D supplementation < 400 IU/d (OR = 1.19), time of sleeping < 10 h/d (OR = 1.38), and time of outdoor activity < 2 h/d (OR = 1.20). Children with these factors showed significantly lower 25-(OH)D levels by 4.43 nmol/L, 9.33 nmol/L, 7.10 nmol/L, 5.21 nmol/L, 8.76 nmol/L, 7.18 nmol/L, 5.40 nmol/L, 5.35 nmol/L, and 3.24 nmol/L respectively. The 25-(OH)D levels in children with breast feeding and preferences for vegetables were significantly lower by 2.46 nmol/L and 5.29 nmol/L, respectively. The 25-(OH)D levels in children with eggs consumption < 60.0 g/d and ≥ 60.0 g were 63.0 nmol/L and 69.0 nmol/L, respectively, showing statistically significant difference ( P = 0.026). Conclusions:Lower intake of milk and eggs, higher intake of meat, sweet foods, breast feeding, no vitamin D and calcium supplements, and less sleep and outdoor activity were associated with lower vitamin D levels in children during the first five years of life. This is an early study focused on the relationship between diet and vitamin D in children during the first five years of life.