Vitamin D levels in prepubertal children in Southern Tasmania: prevalence and determinants

Abstract
Objective: To describe the prevalence and determinants of 25-hydroxy D3(25(OH)D) in children. Design: Cross-sectional study. Setting: Southern Tasmania between June and November 1997. Subjects: Two hundred and one 8-y old male and female children taking part in a cohort study whose principal endpoints were blood pressure and high-density lipoprotein (HDL) cholesterol. Results: The mean 25(OH)D level was 79 nmol/l (s.d. 29.5, median 73, range 12–222). Boys had higher levels than girls (82.1 vs 72.8 nmol/l, P=0.02). 25(OH)D was associated with sunlight exposure in winter school holidays (r=0.20, P=0.005) and winter weekends (r=0.16, P=0.02), the month after school holidays (87.5 vs 69.5 nmol, Pr=−0.23, P=0.001). Dietary intake of vitamin D was low (mean 40 IU/day, range 5.2–384) and was not associated with 25(OH)D levels (r=0.01, P=0.91). Variation in skin melanin density was weakly associated with 25(OH)D (r=0.09, P=0.19). Conclusions: Sunlight is the major determinant of vitamin D stores in our population. Neither variation in skin type within Caucasians nor diet modified this association to any significant extent. Extrapolation of these findings to sunlight bone mass associations in a very similar population suggests that a minimum level of around 50 nmol/l in the population is required for optimal bone development in prepubertal children but this needs to be confirmed with further controlled trials of vitamin D supplementation and bone mass. Sponsorship: Arthritis Foundation of Australia, Roche Pharmaceuticals.