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Vitamin D deficiency in early childhood: prevalent in the sunny South Pacific

  • Cameron C Grant (a1) (a2), Clare R Wall (a3), Sue Crengle (a4) and Robert Scragg (a5)



To estimate the prevalence of and risk factors for vitamin D deficiency in young urban children in Auckland, New Zealand, where there is no routine vitamin D supplementation.


A random sample of urban children. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D <27·5 nmol/l (<11 ng/ml). Logistic regression analysis was used to calculate odds ratios and, from these, relative risks (RR) and 95 % confidence intervals were estimated.


Auckland, New Zealand (36°52′S), where the daily vitamin D production by solar irradiation varies between summer and winter at least 10-fold.


Children aged 6 to 23 months enrolled from 1999 to 2002.


Vitamin D deficiency was present in forty-six of 353 (10 %; 95 % CI 7, 13 %). In a multivariate model there was an increased risk of vitamin D deficiency associated with measurement in winter or spring (RR = 7·24, 95 % CI 1·55, 23·58), Pacific ethnicity (RR = 7·60, 95 % CI 1·80, 20·11), not receiving any infant or follow-on formula (RR = 5·69, 95 % CI 2·66, 10·16), not currently receiving vitamin supplements (RR = 5·32, 95 % CI 2·04, 11·85) and living in a more crowded household (RR = 2·36, 95 % CI 1·04, 4·88).


Vitamin D deficiency is prevalent in early childhood in New Zealand. Prevalence varies with season and ethnicity. Dietary factors are important determinants of vitamin D status in this age group. Vitamin D supplementation should be considered as part of New Zealand’s child health policy.

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1.Central Intelligence Agency (2007) The World Factbook – New Zealand. (accessed July 2007).
2.Cancer Society of New Zealand (2003) Position statement: Skin cancer prevention and early detection. (accessed July 2007).
3.Health Sponsorship Council (2005) Position Statement: The Risks and Benefits of Sun Exposure in New Zealand. (accessed May 2007).
4.McKenzie, RL, Bodeker, GE, Keep, DJ, Kotkamp, M & Evans, J (1996) UV radiation in New Zealand: north-to-south differences between two sites and relationship to other latitudes. Weather Climate 16, 1726.
5.McKenzie, RL, Johnston, P & Liley, B (2006) Huge seasonal and latitudinal variability in vitamin-D production from sunlight. N Z Fam Physician 33, 8788.
6.Shaw, NJ & Pal, BR (2002) Vitamin D deficiency in UK Asian families: activating a new concern. Arch Dis Child 86, 147149.
7.Gartner, LM & Greer, F (2003) Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Section on Breastfeeding and Committee on Nutrition. Pediatrics 111, 908910.
8.Department of Health and Ageing, Australian Government, Australian National Health and Medical Research Council & New Zealand Ministry of Health (2006) Nutrient reference Values for Australia and New Zealand Including Recommended Dietary Intakes. Canberra: Commonwealth of Australia; available at
9.Ministry of Health (2006) Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women: A Background Paper. Wellington: Ministry of Health.
10.Cormack, B & Kushel, C (2005) Neonatal Nutrition Guideline. Auckland: Auckland District Health Board.
11.Charlton, K (2003) Auckland Regional Public Health Service Nutrition Fact Sheet – Vitamin D Deficiency. Auckland: Auckland Regional Public Health Service.
12.Blok, BH, Grant, CC, McNeil, AR & Reid, IR (2000) Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998. N Z Med J 113, 374376.
13.Walker, R (1993) The People in the North Health Region. Auckland: Northern Regional Health Authority.
14.Grant, CC, Wall, CR, Brunt, D, Crengle, S & Scragg, R (2007) Population prevalence and risk factors for iron deficiency in Auckland, New Zealand. J Paediatr Child Health 43, 532538.
15.Statistics New Zealand (2003) 2001 Census of Population and Dwellings. Wellington: Statistics New Zealand.
16.Dean, AG, Arner, TG, Sunki, GG et al. (2002) Epi Info™, A Database and Statistics Program for Public Health Professionals. Atlanta, GA: Centers for Disease Control and Prevention.
17.Crampton, P & Davis, P (1998) Measuring deprivation and socioeconomic status: why and how? N Z Public Health Rep 5, issue 11/12, 8184.
18.Salmond, C & Crampton, P (2002) NZDep2001 Index of Deprivation. Wellington: University of Otago.
19.Siegel, LJ & Peterson, L (1980) Stress reduction in young dental patients through coping skills and sensory information. J Consult Clin Psychol 48, 785787.
20.Lawson, M & Thomas, M (1999) Vitamin D concentrations in Asian children aged 2 years living in England: population survey. BMJ 318, 28.
21.Institute of Medicine, Food and Nutrition Board, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Vitamin D. In Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, pp. 250287. Washington, DC: National Academy Press.
22.Ceriotti, F & Ceriotti, G (1980) Improved direct specific determination of serum iron and total iron-binding capacity. Clin Chem 26, 327331.
23.Anon. (1985) Summary of a report on assessment of the iron nutritional status of the United States population. Expert Scientific Working Group. Am J Clin Nutr 42, 13181330.
24.Looker, AC, Dallman, PR, Carroll, MD, Gunter, EW & Johnson, CL (1997) Prevalence of iron deficiency in the United States. JAMA 277, 973976.
25.Scragg, R, Jackson, R, Holdaway, IM, Lim, T & Beaglehole, R (1990) Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol 19, 559563.
26.Zhang, J & Yu, KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 280, 16901691.
27.Food Standards Australia and New Zealand (2008) Australia New Zealand Food Standards Code. Canberra: Commonwealth of Australia.
28.Statistics New Zealand (2007) Crowding Measures by Ethnic Group. Housing Quality Statistics. Wellington: Statistics New Zealand.
29.Statistics New Zealand (2002) Employment and Income of Pacific Peoples in New Zealand. Wellington: Statistics New Zealand.
30.Arneil, GC & Crosbie, JC (1963) Infantile rickets returns to Glasgow. Lancet 2, 423425.
31.Benson, PF, Stroud, CE, Mitchell, NJ & Nicolaides, A (1963) Rickets in immigrant children in London. Br Med J 1, 10541056.
32.Bachrach, S, Fisher, J & Parks, JS (1979) An outbreak of vitamin D deficiency rickets in a susceptible population. Pediatrics 64, 871877.
33.Kreiter, SR, Schwartz, RP, Kirkman, HN Jr, Charlton, PA, Calikoglu, AS & Davenport, ML (2000) Nutritional rickets in African American breast-fed infants. J Pediatr 137, 153157.
34.Gessner, BD, Plotnik, J & Muth, PT (2003) 25-Hydroxyvitamin D levels among healthy children in Alaska. J Pediatr 143, 434437.
35.Edidin, DV, Levitsky, LL, Schey, W, Dumbovic, N & Campos, A (1980) Resurgence of nutritional rickets associated with breast-feeding and special dietary practices. Pediatrics 65, 232235.
36.Anon. (2007) New Zealand’s Climate. Information for New Zealand Cities 2007. (accessed July 2007).
37.Nicolaidou, P, Hatzistamatiou, Z, Papadopoulou, A, Kaleyias, J, Floropoulou, E, Lagona, E, Tsagris, V, Costalos, C & Antsaklis, A (2006) Low vitamin D status in mother–newborn pairs in Greece. Calcif Tissue Int 78, 337342.
38.Challa, A, Ntourntoufi, A, Cholevas, V, Bitsori, M, Galanakis, E & Andronikou, S (2005) Breastfeeding and vitamin D status in Greece during the first 6 months of life. Eur J Pediatr 164, 724729.
39.Baroncelli, GI, Bertelloni, S, Ceccarelli, C, Amato, V & Saggese, G (2000) Bone turnover in children with vitamin D deficiency rickets before and during treatment. Acta Paediatr 89, 513518.
40.Clemens, TL, Adams, JS, Henderson, SL & Holick, MF (1982) Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet 1, 7476.
41.Wills, MR, Phillips, JB, Day, RC & Bateman, EC (1972) Phytic acid and nutritional rickets in immigrants. Lancet 1, 771773.
42.Preece, MA, McIntosh, WB, Tomlinson, S, Ford, JA, Dunnigan, MG & O’Riordan, JL (1973) Vitamin-D deficiency among Asian immigrants to Britain. Lancet 1, 907910.
43.Ma, G, Li, Y, Jin, Y, Zhai, F, Kok, FJ & Yang, X (2007) Phytate intake and molar ratios of phytate to zinc, iron and calcium in the diets of people in China. Eur J Clin Nutr 61, 368374.
44.Jurutka, PW, Whitfield, GK, Hsieh, JC, Thompson, PD, Haussler, CA & Haussler, MR (2001) Molecular nature of the vitamin D receptor and its role in regulation of gene expression. Rev Endocr Metab Disord 2, 203216.
45.Salimpour, R (1975) Rickets in Tehran. Study of 200 cases. Arch Dis Child 50, 6366.
46.Parnell, WR, Reid, J, Wilson, NC, McKenzie, J & Russell, DG (2001) Food security: is New Zealand a land of plenty? N Z Med J 114, 141145.
47.Anon. (2007) The Social Report 2006. Wellington: Ministry of Social Development.
48.Cooper, C, Javaid, K, Westlake, S, Harvey, N & Dennison, E (2005) Developmental origins of osteoporotic fracture: the role of maternal vitamin D insufficiency. J Nutr 135, Suppl., 2728S2734S.
49.Dietrich, T, Joshipura, KJ, Dawson-Hughes, B & Bischoff-Ferrari, HA (2004) Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr 80, 108113.
50.Zipitis, CS & Akobeng, AK (2008) Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child 93, 512517.
51.Mathieu, C, Gysemans, C, Giulietti, A & Bouillon, R (2005) Vitamin D and diabetes. Diabetologia 48, 12471257.
52.Hypponen, E, Laara, E, Reunanen, A, Jarvelin, MR & Virtanen, SM (2001) Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358, 15001503.
53.Zasloff, M (2006) Fighting infections with vitamin D. Nat Med 12, 388390.
54.Meehan, MA, Kerman, RH & Lemire, JM (1992) 1,25-Dihydroxyvitamin D3 enhances the generation of nonspecific suppressor cells while inhibiting the induction of cytotoxic cells in a human MLR. Cell Immunol 140, 400409.
55.Camargo, CA Jr, Rifas-Shiman, SL, Litonjua, AA, Rich-Edwards, JW, Weiss, ST, Gold, DR, Kleinman, K & Gillman, MW (2007) Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr 85, 788795.
56.Grant, CC & Milne, R (2006) What does pneumonia cost New Zealand? In Burden of Preventable Breathing Diseases in Children and Young People, pp. 3539 [MI Asher and C Byrnes, editors]. Wellington: Asthma and Respiratory Foundation of New Zealand.
57.Rockell, JE, Skeaff, CM, Williams, SM & Green, TJ (2006) Serum 25-hydroxyvitamin D concentrations of New Zealanders aged 15 years and older. Osteoporos Int 17, 13821389.
58.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.
59.Rockell, JE, Green, TJ, Skeaff, CM et al. (2005) Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5–14 y. J Nutr 135, 26022608.
60.Gregory, JR, Lowe, S, Bates, CJ, Prentice, A, Jackson, LV, Smithers, G, Wenlock, R & Farron, M (2001) National Diet and Nutrition Survey: Young People Aged 4 to 18 Years. vol. 1: Report of the Diet and Nutrition Survey. London: TSO.
61.Leerbeck, E & Sondergaard, H (1980) The total content of vitamin D in human milk and cow’s milk. Br J Nutr 44, 712.
62.Leaf, AA (2007) Vitamins for babies and young children. Arch Dis Child 92, 160164.
63.Fraser, DR (1995) Vitamin D. Lancet 345, 104107.
64.Calvo, MS, Whiting, SJ & Barton, CN (2005) Vitamin D intake: a global perspective of current status. J Nutr 135, 310316.
65.Vieth, R, Bischoff-Ferrari, H, Boucher, BJ et al. (2007) The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr 85, 649650.
66.Williams, AF (2007) Vitamin D in pregnancy: an old problem still to be solved? Arch Dis Child 92, 740741.
67.Saadi, HF, Dawodu, A, Afandi, BO, Zayed, R, Benedict, S & Nagelkerke, N (2007) Efficacy of daily and monthly high-dose calciferol in vitamin D-deficient nulliparous and lactating women. Am J Clin Nutr 85, 15651571.



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