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尽管爱尔兰幼儿所处的纬度偏北且普遍存在摄入不足的情况,但仍普遍存在维生素 D 缺乏症。

Low vitamin D deficiency in Irish toddlers despite northerly latitude and a high prevalence of inadequate intakes.

机构信息

Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.

The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.

出版信息

Eur J Nutr. 2018 Mar;57(2):783-794. doi: 10.1007/s00394-016-1368-9. Epub 2016 Dec 26.

Abstract

PURPOSE

While reports of inadequate vitamin D intakes among young children are widespread, data on the prevalence of vitamin D deficiency are inconsistent. We aimed to quantify vitamin D intake and serum 25-hydroxyvitamin D [25(OH)D] concentrations in children aged 2 years in the prospective Cork BASELINE Birth Cohort Study.

METHODS

Serum 25(OH)D was analysed using UPLC-MS/MS in 741 children living in Cork, Ireland (51°N). Two-day weighed food diaries were collected in 467 children, and 294 provided both a blood sample and a food diary.

RESULTS

Mean (SD) 25(OH)D concentrations were 63.4 (20.4) nmol/L [winter: 54.5 (19.9), summer: 71.2 (17.5)]. The prevalence of vitamin D deficiency (<30 nmol/L) was 4.6, and 26.7% were <50 nmol/L [45.2% during winter (November-April) and 10.4% in summer (May-October)]. With a mean (SD) vitamin D intake of 3.5 (3.1) µg/day, 96% had intakes below 10 µg/day, the current IOM estimated average requirement and the SACN safe intake value for this age group. After adjustment for season, vitamin D intake (µg/day) was associated with higher 25(OH)D concentrations [adjusted estimate (95% CI) 2.5 (1.9, 3.1) nmol/L]. Children who did not consume vitamin D-fortified foods or supplements had very low vitamin D intakes (1.2 (0.9) µg/day), and during winter, 12 and 77% were <30 and <50 nmol/L, respectively, compared with 6 and 44% of fortified food consumers.

CONCLUSION

There was a high prevalence of low vitamin D status during winter, especially among children who did not consume fortified foods or nutritional supplements. Our data indicate the need for dietary strategies to increase vitamin D intakes in this age group. This report provides further evidence that DRVs for vitamin D should be based on experimental data in specific population groups and indicates the need for dose-response RCTs in young children.

摘要

目的

尽管有大量报道称幼儿维生素 D 摄入量不足,但维生素 D 缺乏的流行情况数据却不一致。本研究旨在定量评估爱尔兰科克市 BASeline 出生队列研究中 2 岁儿童的维生素 D 摄入量和血清 25-羟维生素 D [25(OH)D]浓度。

方法

在居住于爱尔兰科克市(北纬 51°)的 741 名儿童中,采用超高效液相色谱-串联质谱法(UPLC-MS/MS)分析血清 25(OH)D。在 467 名儿童中收集了为期两天的食物称重日记,其中 294 名儿童提供了血液样本和食物日记。

结果

儿童血清 25(OH)D 浓度的平均值(标准差)为 63.4(20.4)nmol/L[冬季:54.5(19.9),夏季:71.2(17.5)]。维生素 D 缺乏症(<30 nmol/L)的患病率为 4.6%,<50 nmol/L 的比例为 26.7%[冬季(11 月至 4 月)为 45.2%,夏季(5 月至 10 月)为 10.4%]。维生素 D 摄入量的平均值(标准差)为 3.5(3.1)µg/天,96%的儿童摄入量低于 10 µg/天,这一数值低于当前 IOM 估计的平均需求量和 SACN 为该年龄组设定的安全摄入量值。经季节调整后,维生素 D 摄入量(µg/天)与较高的 25(OH)D 浓度相关[校正估计值(95%CI)为 2.5(1.9,3.1)nmol/L]。未食用维生素 D 强化食品或补充剂的儿童维生素 D 摄入量非常低(1.2(0.9)µg/天),且在冬季,分别有 12%和 77%的儿童<30 和<50 nmol/L,而食用强化食品的儿童中这两个比例分别为 6%和 44%。

结论

冬季儿童维生素 D 状态低下的比例很高,尤其是未食用强化食品或营养补充剂的儿童。本研究数据表明,需要采取饮食策略来增加该年龄段儿童的维生素 D 摄入量。本报告进一步证明,维生素 D 的 DRV 应基于特定人群的实验数据,并表明需要对幼儿进行剂量-反应随机对照试验。

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