Published online November 1, 2009
PEDIATRICS Vol. 124 No. 5 November 2009, pp. 1404-1410 (doi:10.1542/peds.2008-2041)

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ARTICLE

Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D?

Jonathan M. Mansbach, MD^a, Adit A. Ginde, MD, MPH^b and Carlos A. Camargo, Jr, MD, DrPH^c

^a Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts
^b Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado
^c Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

OBJECTIVE: Single-center studies have suggested that hypovitaminosis D is widespread. Our objective was to determine the serum levels of 25-hydroxyvitamin D (25[OH]D) in a nationally representative sample of US children aged 1 to 11 years.

METHODS: Data were obtained from the 2001–2006 National Health and Nutrition Examination Survey. Serum 25(OH)D levels were determined by radioimmunoassay and categorized as <25, <50, and <75 nmol/L. National estimates were obtained by using assigned patient visit weights and reported with 95% confidence intervals (CIs).

RESULTS: During the 2001–2006 time period, the mean serum 25(OH)D level for US children aged 1 to 11 years was 68 nmol/L (95% CI: 66–70). Children aged 6 to 11 years had lower mean levels of 25(OH)D (66 nmol/L [95% CI: 64–68]) compared with children aged 1 to 5 years (70 nmol/L [95% CI: 68–73]). Overall, the prevalence of levels at <25 nmol/L was 1% (95% CI: 0.7–1.4), <50 nmol/L was 18% (95% CI: 16–21), and <75 nmol/L was 69% (95% CI: 65–73). The prevalence of serum 25(OH)D levels of <75 nmol/L was higher among children aged 6 to 11 years (73%) compared with children aged 1 to 5 years (63%); girls (71%) compared with boys (67%); and non-Hispanic black (92%) and Hispanic (80%) children compared with non-Hispanic white children (59%).

CONCLUSIONS: On the basis of a nationally representative sample of US children aged 1 to 11 years, millions of children may have suboptimal levels of 25(OH)D, especially non-Hispanic black and Hispanic children. More data in children are needed not only to understand better the health implications of specific serum levels of 25(OH)D but also to determine the appropriate vitamin D supplement requirements for children.

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Key Words: vitamin D • deficiency • prevalence • supplementation

Abbreviations: 25(OH)D—25-hydroxyvitamin D • NHANES— National Health and Nutrition Examination Survey • MEC—mobile examination center • CI—confidence interval

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Accepted Feb 24, 2009.

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