Skip to main content Accessibility help
×
Home

Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle

  • Seema Puri (a1), Raman K. Marwaha (a2), Neha Agarwal (a1), Nikhil Tandon (a3), Rashmi Agarwal (a2), Khushi Grewal (a2), D. H. K. Reddy (a3) and Satveer Singh (a2)...

Abstract

Forty to fifty per cent of skeletal mass, accumulated during childhood and adolescence, is influenced by sunlight exposure, physical activity, lifestyle, endocrine status, nutrition and gender. In view of scarce data on association of nutrition and lifestyle with hypovitaminosis D in Indian children and adolescents, an in-depth study on 3127 apparently healthy Delhi schoolgirls (6–18 years) from the lower (LSES, n 1477) and upper socioeconomic strata (USES, n 1650) was carried out. These girls were subjected to anthropometry and clinical examination for hypovitaminosis D. Girls randomly selected from the two strata (LSES, n 193; USES, n 211) underwent detailed lifestyle, dietary, biochemical and hormonal assessment. Clinical vitamin D deficiency was noted in 11·5 % girls (12·4 % LSES, 10·7 % USES). USES girls had significantly higher BMI than LSES counterparts. Prevalence of biochemical hypovitaminosis D (serum 25-hydroxyvitamin D < 50 nmol/l) was seen in 90·8 % of girls (89·6 % LSES, 91·9 % USES, NS). Mean intake of energy, protein, fat, Ca, vitamin D and milk/milk products was significantly higher in USES than LSES girls. Conversely, carbohydrate, fibre, phytate and cereal intakes were higher in LSES than USES girls. Physical activity and time spent outdoors was significantly higher in LSES girls (92·8 v. 64 %, P = 0·000). Significant correlation between serum 25-hydroxyvitamin D and estimated sun exposure (r 0·185, P = 0·001) and percentage body surface area exposed (r 0·146, P = 0·004) suggests that these lifestyle-related factors may contribute significantly to the vitamin D status of the apparently healthy schoolgirls. Hence, in the absence of vitamin D fortification of foods, diet alone appears to have an insignificant role.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Dr Raman K. Marwaha, fax +98 11 23919509, email marwaha_raman@hotmail.com

References

Hide All
1 Cadogan, J, Blumsohn, A, Barker, ME & Eastell, R (1998) A longitudinal study of bone gain in pubertal girls: anthropometric and biochemical correlates. J Bone Miner Res 13, 16021612.
2 Whiting, SJ & Calvo, MS (2005) Vitamin D insufficiency: a significant risk factor in chronic diseases and potential disease-specific biomarkers of vitamin D sufficiency. J Nutr 135, 301303.
3 Peterlik, M & Cross, HS (2005) Vitamin D and calcium deficits predispose for multiple chronic diseases. Eur J Clin Invest 35, 290304.
4 Lehtonen-Veromaa, M, Mottonen, T, Irjala, K, Karkkainen, M, Lamberg-Allardt, C, Hakola, P & Vikari, J (1999) Vitamin D intake is low and hypovitaminosis D common in healthy 9- to 15-year-old Finnish girls. Eur J Clin Nutr 53, 746751.
5 Outila, Ta, Karkkainen, MU & Lamberg-Allardt, CJ (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr 74, 206210.
6 El-Hajj Fuleihan, G, Nabulsi, M, Choucair, M, Salamoun, M, Hajj Shahine, C, Kizirian, A & Tannous, R (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107, 17.
7 Looker, AC, Dawson-Hughes, B, Calvo, MS, Gunter, EW & Sahyoun, NR (2002) Serum 25- hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30, 771777.
8 Gordon, CM, De Peter, KC, Feldman, HA, Grace, E & Emans, SJ (2004) Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 158, 531537.
9 Rajakumar, K, Fernsttrom, JD, Janosky, JE & Greenspan, SL (2005) Vitamin D insufficiency in preadolescent African-American children. Clin Pediatr 44, 683692.
10 Marwaha, RK, Tandon, N, Reddy, DHK, Aggarwal, R, Singh, R, Sawhney, RC, Saluja, B, Ganie, MA & Singh, S (2005) Vitamin D and bone mineral density status of healthy school children in northern India. Am J Clin Nutr 82, 477482.
11 Goswami, R, Gupta, N, Goswami, D, Marwaha, RK, Tandon, N & Kochupillai, N (2000) Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr 72, 472475.
12 Tandon, N, Marwaha, RK, Kalra, S, Gupta, N, Dudha, A & Kochupillai, N (2003) Bone mineral parameters in healthy young Indian adults with optimal vitamin D availability. Nat Med J India 16, 298301.
13 Cole, TJ, Bellizzi, MC, Flegal, KM & Dietz, WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 320, 12401243.
14 Solomon, L, Warwick, D & Nayagam, S (2001) Apley's System of Orthopedics and Fractures, 8th ed. pp. 449484, London: Arnold.
15 Portale, AA (1997) Blood calcium, phosphorus and magnesium. In Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 2nd ed., pp. 8790 [Favus, MJ, editor]. New York: Raven Press.
16 Lips, P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22, 477501.
17 Khanna, K, Gupta, S, Seth, R, Mahana, R & Rekhi, T (1998) The Art and Science of Cooking, 3rd ed. New Delhi: Phoenix Publishing House.
18 Gopalan, C, Ramasastry, BV & Balasubramaniam, SC (2001) Nutritive Value of Indian Foods. Hyderabad: Indian Council of Medical Research.
19 Indian Council of Medical Research (2004) Nutrient Requirements and Recommended Dietary Allowances for Indians. New Delhi: Indian Council of Medical Research.
20 United States Department of Agriculture (1999) Provisional Table on the Vitamin D Content of Foods. HNIS/PT-108. Washington, DC: Human Nutrition Information Service.
21 Chugh, R & Puri, S (2001) Affluent adolescent girls of Delhi: eating and weight concerns. Br J Nutr 86, 535542.
22 Tyler, M (2004) Burns. In Bailey and Love's Short Practice of Surgery, 24th ed., pp.266278 [Mann, CV, Russel, RCG and Williams, NS, editors]. London: Chapman and Hall.
23 Oliveri, MB, Ladizesky, M, Mautalen, CA, Alonso, A & Martinez, L (1993) Seasonal variations of 25 hydroxyvitamin D and parathyroid hormone in Ushuai (Argentina), the southernmost city of the world. Bone Miner Res 20, 99108.
24 Weaver, CM, Peacock, M & Johnston, CC (1999) Adolescent nutrition in the prevention of postmenopausal osteoporosis. J Clin Endocrinol Metab 84, 18391843.
25 Docio, S, Riancho, JA, Perez, A, Olmos, JM, Amado, JA & Gonzallez-Macias, J (1998) Seasonal deficiency of vitamin D in children: a potential target for osteoporosis preventing strategies. J Bone Miner Res 13, 544548.
26 Guillemant, J, Taupin, P, Le, HT, Taright, N, Allemandou, A, Peres, G & Guillemant, S (1999) Vitamin D status during puberty in French healthy male adolescents. Osteoporos Int 10, 222225.
27 Hatun, S, Islam, O, Cizmecioglu, F, Kara, B, Babaoglu, K, Berk, F & Gokalp, AS (2005) Sub clinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. Am Soc Nutr Sci 135, 218222.
28 Stephens, WP, Klimiuk, PS, Warrington, S & Taylor, JL (1982) Observations on the dietary practices of Asians in the United Kingdom. Hum Nutr Appl Nutr 36, 438444.
29 Solanki, T, Hyatt, RH, Kemm, JR, Hughes, EA & Cowan, RA (1995) Are elderly Asians in Britain at a high risk of vitamin D deficiency and osteomalacia? Age Ageing 24, 103107.
30 Chaturvedi, S, Kapil, U, Gnanasekaran, N, Sachdev, HP, Pandey, RM & Bhanti, T (1996) Nutrient intake amongst adolescent girls belonging to poor socioeconomic group of rural area of Rajasthan. Indian Pediatr 33, 197201.
31 Sharma, AK, Shukla, D & Kannan, AT (2005) Calorie and protein intake and its determinants among adolescent school girls in Delhi. Indian J Comm Med 30, 810.
32 Fleming, KH & Heimbach, JT (1994) Consumption of calcium in the U.S.: food sources and intake levels. J Nutr 124, S1426S1430.
33 Nagi, M, Chawla, S & Sharma, S (1995) A study on the nutritional status of adolescent girls. Plant Foods Hum Nutr 47, 201209.
34 Khader, V (1996) Food intake and nutrient adequacy of rural population of Guntur district (Andhra Pradesh). Indian J Med Sci 50, 3442.
35 Jasminka, ZI, Mario, S, Thomas, H, Baoshe, AN & Velimir Matkovic (1998) Relation of nutrition, body composition and physical activity to skeletal development: a cross-sectional study in preadolescent females. Am J Coll Nutr 17, 136147.
36 Arunabh, S, Pollack, S, Yeh, J & Aloia, JF (2003) Body fat content and 25 hydroxy vitamin D levels in healthy women. J Clin Endocrinol Metab 88, 137161.
37 Parikh, SJ, Edelman, M, Gabriel, I, Uwaifo, Freedman, RJ, Janneh, MS, Reynolds, J & Yanovski, JA (2004) The relationship between obesity and serum 1,25-dihydroxy vitamin D concentration in healthy adults. J Clin Endocrinol Metab 89, 11961199.
38 Wortsman, J, Matsuoka, LY, Chen, TC, Lu, Z & Holick, MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72, 690693.
39 Hu, JF, Zhao, XH, Jia, JB, Parpia, B & Campbell, TC (1993) Dietary calcium and bone density among middle-aged and elderly women in China. Am J Clin Nutr 58, 219227.
40 Harinarayan, CV, Ramalakshmi, T & Venkatprasad, U (2004) High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr 13, 359364.
41 Heaney, RP (1986) Calcium, bone health and osteoporosis. In Bone and Mineral Research, pp. 255301 [Peck, WA, editor]. Amsterdam: Elsevier Science Publishers.
42 Gannage-Yared, MH, Chemali, R, Yaacoub, N & Halaby, G (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. Bone Miner Res 15, 18561862.
43 Das, G, Crocombe, S, McGrath, M, Berry, JL & Mughal, MZ (2006) Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child 91, 569572.
44 Bachrach, LK (2000) Making an impact on pediatric bone health. J Pediatr 136, 137139.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed