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High prevalence of vitamin D insufficiency and its association with BMI-forage among primary school children in Kuala Lumpur , Malaysia
| Content Provider | Semantic Scholar |
|---|---|
| Author | Khor, Geok Lin Chee, Winnie Ss Shariff, Zalilah Mohd Poh, Bee Koon Arumugam, Mohan Rahman, Jamalludin Ab Theobald, Hannah E. |
| Copyright Year | 2011 |
| Abstract | Background: Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur. Methods: A cross sectional study of primary aged school children was undertaken in 2008. A total of 402 boys and girls aged 7-12 years, attending primary schools in Kuala Lumpur participated in the study. Fasting blood samples were taken to assess vitamin D [as 25(OH)D], vitamin B12, folate, zinc, iron, and ferritin and haemoglobin concentrations. Height-for-age and body mass index for age (BMI-for-age) of the children were computed. Results: Most of the children had normal height-for-age (96.5%) while slightly over half (58.0%) had normal BMIfor-age. A total of 17.9% were overweight and 16.4% obese. Prevalence of obesity was significantly higher among the boys (25%) than in the girls (9.5%) (c = 22.949; P < .001). Most children had adequate concentrations of haemoglobin, serum ferritin, zinc, folate and vitamin B12. In contrast, 35.3% of the children had serum 25(OH)D concentrations indicative of vitamin D deficiency(≤37.5 nmol/L) and a further 37.1% had insufficiency concentrations (> 37.5-≤50 nmol/L). Among the boys, a significant inverse association was found between serum vitamin D status and BMI-for-age (c = 5.958; P = .016). Conclusions: This study highlights the presence of a high prevalence of sub-optimal vitamin D status among urban primary school children in a tropical country. In light of the growing problem of obesity in Malaysian children, these findings emphasize the important need for appropriate interventions to address both problems of obesity and poor vitamin D status in children. Background Micronutrient deficiencies are common world-wide and adversely affect growth, health, behavioural and cognitive development in children [1]. Serious micronutrient deficiencies may lead to death. It is estimated that deficiencies of vitamin A and zinc were responsible for 0.6 million and 0.4 million child deaths, respectively in 2008 [2]. Thus, the importance of micronutrient interventions to reduce morbidity and mortality in children is well recognized. In Malaysia, data on the micronutrient status of children is derived mostly from dietary studies. Such studies face methodological challenges including poor availability of data on the content of key micronutrients in local foods. There is a scarcity of studies on micronutrients in young children determined through urine or blood analysis [3]. There are a few such studies at the national level undertaken mainly by the Ministry of Health (MOH). These include a study on iodine deficiency disorders (IDD) among children aged 8-10 years in 2008, * Correspondence: geoklin_khor@imu.edu.my Department of Nutrition and Dietetics, School of Pharmacy & Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia Full list of author information is available at the end of the article Khor et al. BMC Public Health 2011, 11:95 http://www.biomedcentral.com/1471-2458/11/95 © 2011 Khor et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. which showed that the majority of the children had normal urinary iodine excretion concentrations (> 100 μg/ L), but 31.6% had mild IDD levels and another 14.2% with moderate severity status [4]. As for vitamin A deficiency, Malaysia is considered to have a mild public health problem by the World Health Organization [5], based on the MOH/UNICEF study in 1999-2000, which reported a national prevalence of vitamin A deficiency of 3.5% (serum retinol <0.70 μmol/L) among preschoolaged children. Anaemia is a common problem in young children from poor communities and in the last decade or so, levels of 20-23% and 16-17% respectively in children aged 7-12.9 years and 13-18 years from rural areas were reported [6]. In contrast, there is copious anthropometric data on children across Malaysia. The largest national assessment of the nutritional status of children is the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, involving more than 21,000 children below 18 years of age [7]. The NHMS III reported underweight in 13.2%, stunting in 15.8% and overweight in 5.4%. These data indicate markedly lower levels of under-nutrition in Malaysian children compared to previous studies and unpublished MOH national surveillance data. However, overweight prevalence is increasing in recent years. In 2001-2002, a study on about 12,000 schoolchildren aged 6-12 years in Peninsular Malaysia reported that 10.5% were overweight and 5.9% obese [8]. For the same age group, the NHMS III in 2006 reported overweight and obesity as 15.9% and 12% respectively [7]. Against the backdrop of limited data on micronutrient status, and evidence of increasing overweight in children, this study was undertaken to determine the status of key micronutrients based on biochemical analysis in children and to relate the findings to their nutritional status. |
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| Alternate Webpage(s) | http://download-redirector.springer.com/redirect?contentType=pdf&ddsId=art:10.1186/1471-2458-11-95&originUrl=http://bmcpublichealth.biomedcentral.com/article/10.1186/1471-2458-11-95 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
