Urban children not have enough vitamin D even with 13 months of sunshine – March 2016

Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in central Ethiopia.

PLoS One. 2015 Mar 30;10(3):e0120963. doi: 10.1371/journal.pone.0120963. eCollection 2015.
Wakayo T 1, Belachew T 1, Vatanparast H 2, Whiting SJ 2.
1Jimma University, Jimma, Ethiopia.
2University of Saskatchewan, Saskatoon, Canada.

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Studies examining vitamin D status among children living in sunny climates indicated that children did not receive adequate vitamin D, however, this has not been looked at among children living in Ethiopia. In this study, we determined vitamin D deficiency and its predictors among school children aged 11-18 years, examining circulating 25-hydroxy vitamin D [25(OH)D]. The school-based cross-sectional study was conducted in schools in Adama Town (n = 89) and in rural Adama (n = 85) for a total sample of 174. Students were randomly selected using multi-stage stratified sampling method from both settings. Socioeconomic status of parents and demographic, anthropometric, sun exposure status and blood 25(OH)D levels were obtained. Vitamin D deficiency, defined as circulating levels of 25(OH)D <50 nmol/L, was found in 42% of the entire study participants. Prevalence of deficiency was significantly higher among students in urban setting compared to rural (61.8% vs 21.2%, respectively, p<0.001). After controlling for potential confounders using multivariable logistic regression model, duration of exposure to sunlight, amount of body part exposed to sunlight, place of residence, maternal education, body fatness, having TV/computer at home and socioeconomic status were significant predictors of vitamin D deficiency. The findings suggest that Vitamin D deficiency was prevalent in healthy school children living both in urban and rural areas of a country with abundant year round sunshine providing UVB, with the prevalence of deficiency being significantly higher among urban school children who were less exposed to sunlight. Behaviour change communication to enhance exposure to ultraviolet light is critical to prevent vitamin D deficiency in tropical country like Ethiopia. Further study is required to assess the deleterious effect of its deficiency on bone mineral homeostasis of growing children in Ethiopia during their most critical period of bone development.

Table 2. Circulating 25(OH)D levels according to study variables among schoolchildren in Central Ethiopia.

Summary by VitaminDWiki

Variable (n = 174)	Frequency	Serum 25(OH)D (nmol/L)1	P value
All participants(n = 174)		54.5±15.9
Study setting  Urban lower
Urban	89	48.2±14.0	p<0.001
Rural	85	61.0±15.1
Gender  Females lower
Male	75	60.3±16.9	p<0.001
Female	99	50.0±13.5
Age groups  Older lower
11-14	97	57.3±14.1	p<0.001
15-18	77	52.2±16.8
Religion  More clothes lower
Muslim	35	44.3±14.3	p <0.001
Christian	139	57.0±15.2
BMI Classification  Higher BMI lower
>85th percentile	12	42.6±10.7	p = 0.007
<85th percentile	162	55.4±15.8
TSF Classification  More skinfold thickness lower
>90th percentile	18	44.0±10.2	p = 0.003
<90th percentile	156	55.7±15.9
Daily sun exposure on school days  Less sun lower
<30 min	33	40.7±10.5
30-60 min	48	51.0±13.7	p<0.001
>60 min	93	61.2±14.8
Body part exposed to the sun on school days  Less skin lower
Face, hands & feet	46	41.7±11.0	p<0.001
More than face, hands, & feet*	126	59.1±14.8
Daily sun exposure on weekend days  Less sun lower
<30 min	43	42.5±12.4	p<0.001
30-60 min	32	52.0±11.9
>60 min	99	60.5±15.2
Body part exposed to the sun on weekend days  Less sun lower
Face, hands & feet	31	41.0±11.8	p<0.001
More than face, hands, & feet*	143	57.4±15.1
Skin color  Very dark skin lower
Light brown	39	54.0±11.6
Dark brown	98	56.1±17.0	p = 0.211
Very dark	37	50.7±16.4
Socioeconomic index Higher economics: more media screens and air contitioning?
Low	49	65.2±12.3
Middle	52	64.1 ±11.4	p<0.001
High	73	40.0±8.0