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Background <p>Vitamin D deficiency (VDD) is highly prevalent in children in India despite abundant sunlight. Multiple behavioral and dietary factors contribute to inadequate vitamin D status. We estimated the prevalence of vitamin D deficiency and insufficiency among apparently healthy children and explored associated sociodemographic, environmental, and dietary factors.</p> Methods <p>We conducted a cross-sectional study at the Department of Pediatrics, G.G. Hospital, Jamnagar (April 2023–June 2025). Every fourth eligible child aged 9 months–12 years attending the immunization clinic or accompanying as a healthy sibling was enrolled after consent. A structured proforma captured demographics, socioeconomic status, sun exposure (duration/body surface area), sunscreen use, and dietary practices (milk, eggs, vegetarian intake). Serum 25-hydroxyvitamin D [25(OH)D] was measured by chemiluminescent immunoassay. Vitamin D status followed IAP revised cut-offs: deficient &lt; 20 ng/mL; inadequate 20–29 ng/mL; sufficient ≥ 30 ng/mL. Associations were analyzed using Chi-square or Fisher’s exact tests (<i>p</i> &lt; 0.05).</p> Results <p>Of 277 children (mean age 5.9 ± 3.3 years; 55.6% male), 34.7% were vitamin D deficient and 43.0% inadequate; only 22.4% were sufficient. Vitamin D status showed no significant association with age category (<i>p</i> = 0.757), gender (<i>p</i> = 0.652), or religion (<i>p</i> = 0.971). A strong dose–response was observed for sun exposure: &lt;1&#xa0;h/day (deficient 50.0%, sufficient 13.0%), 1–2&#xa0;h/day (deficient 32.7%, sufficient 21.8%), and &gt; 2&#xa0;h/day (deficient 9.1%, sufficient 72.7%) (<i>p</i> &lt; 0.01). Sunscreen use was associated with higher deficiency (50.0% vs. 31.8%, <i>p</i> = 0.018). Regular milk intake correlated with better status (<i>p</i> = 0.008); moderate egg consumption (3–5 days/week) showed the most favorable profile (<i>p</i> &lt; 0.01). Socioeconomic class trended toward association (<i>p</i> = 0.08), with the small upper-class subgroup having highest deficiency.</p> Conclusions <p>Over three-quarters of children exhibited suboptimal vitamin D status. Modifiable correlates—including sun exposure duration, sunscreen use, milk intake, and moderate egg consumption—were significantly associated with 25(OH)D levels. Pragmatic strategies combining safe sun exposure guidance, dietary counseling, food fortification, and targeted supplementation are warranted.</p>

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Prevalence and determinants of vitamin D deficiency among children aged 9 months to 12 years at a tertiary care center in western India: a cross-sectional study

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  • 发表日期：

    2025年12月16日

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  • Sanayaa M. Bhonsle,
  • Namrata K. Makwana,
  • Bhadresh R. Vyas,
  • Manan R. Vaishnav

摘要

Background

Vitamin D deficiency (VDD) is highly prevalent in children in India despite abundant sunlight. Multiple behavioral and dietary factors contribute to inadequate vitamin D status. We estimated the prevalence of vitamin D deficiency and insufficiency among apparently healthy children and explored associated sociodemographic, environmental, and dietary factors.

Methods

We conducted a cross-sectional study at the Department of Pediatrics, G.G. Hospital, Jamnagar (April 2023–June 2025). Every fourth eligible child aged 9 months–12 years attending the immunization clinic or accompanying as a healthy sibling was enrolled after consent. A structured proforma captured demographics, socioeconomic status, sun exposure (duration/body surface area), sunscreen use, and dietary practices (milk, eggs, vegetarian intake). Serum 25-hydroxyvitamin D [25(OH)D] was measured by chemiluminescent immunoassay. Vitamin D status followed IAP revised cut-offs: deficient < 20 ng/mL; inadequate 20–29 ng/mL; sufficient ≥ 30 ng/mL. Associations were analyzed using Chi-square or Fisher’s exact tests (p < 0.05).

Results

Of 277 children (mean age 5.9 ± 3.3 years; 55.6% male), 34.7% were vitamin D deficient and 43.0% inadequate; only 22.4% were sufficient. Vitamin D status showed no significant association with age category (p = 0.757), gender (p = 0.652), or religion (p = 0.971). A strong dose–response was observed for sun exposure: <1 h/day (deficient 50.0%, sufficient 13.0%), 1–2 h/day (deficient 32.7%, sufficient 21.8%), and > 2 h/day (deficient 9.1%, sufficient 72.7%) (p < 0.01). Sunscreen use was associated with higher deficiency (50.0% vs. 31.8%, p = 0.018). Regular milk intake correlated with better status (p = 0.008); moderate egg consumption (3–5 days/week) showed the most favorable profile (p < 0.01). Socioeconomic class trended toward association (p = 0.08), with the small upper-class subgroup having highest deficiency.

Conclusions

Over three-quarters of children exhibited suboptimal vitamin D status. Modifiable correlates—including sun exposure duration, sunscreen use, milk intake, and moderate egg consumption—were significantly associated with 25(OH)D levels. Pragmatic strategies combining safe sun exposure guidance, dietary counseling, food fortification, and targeted supplementation are warranted.