Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004
Open accessAbstract
OBJECTIVES: To determine the prevalence of 25-hydroxyvitamin D (25[OH]D) deficiency and associations between 25(OH)D deficiency and cardiovascular risk factors in children and adolescents. METHODS: With a nationally representative sample of children aged 1 to 21 years in the National Health and Nutrition Examination Survey 2001–2004 (n = 6275), we measured serum 25(OH)D deficiency and insufficiency (25[OH]D <15 ng/mL and 15–29 ng/mL, respectively) and cardiovascular risk factors. RESULTS: Overall, 9% of the pediatric population, representing 7.6 million US children and adolescents, were 25(OH)D deficient and 61%, representing 50.8 million US children and adolescents, were 25(OH)D insufficient. Only 4% had taken 400 IU of vitamin D per day for the past 30 days. After multivariable adjustment, those who were older (odds ratio [OR]: 1.16 [95% confidence interval (CI): 1.12 to 1.20] per year of age), girls (OR: 1.9 [1.6 to 2.4]), non-Hispanic black (OR: 21.9 [13.4 to 35.7]) or Mexican-American (OR: 3.5 [1.9 to 6.4]) compared with non-Hispanic white, obese (OR: 1.9 [1.5 to 2.5]), and those who drank milk less than once a week (OR: 2.9 [2.1 to 3.9]) or used >4 hours of television, video, or computers per day (OR: 1.6 [1.1 to 2.3]) were more likely to be 25(OH)D deficient. Those who used vitamin D supplementation were less likely (OR: 0.4 [0.2 to 0.8]) to be 25(OH)D deficient. Also, after multivariable adjustment, 25(OH)D deficiency was associated with elevated parathyroid hormone levels (OR: 3.6; [1.8 to 7.1]), higher systolic blood pressure (OR: 2.24 mmHg [0.98 to 3.50 mmHg]), and lower serum calcium (OR: −0.10 mg/dL [−0.15 to −0.04 mg/dL]) and high-density lipoprotein cholesterol (OR: −3.03 mg/dL [−5.02 to −1.04]) levels compared with those with 25(OH)D levels ≥30 ng/mL. CONCLUSIONS: 25(OH)D deficiency is common in the general US pediatric population and is associated with adverse cardiovascular risks.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Vitamin D deficiency has been associated with type 1 diabetes, and use of cod liver oil during pregnancy and during the first year of life has been associated with lower risk of type 1 diabetes.
“Vitamin D deficiency has been associated with T1D64,65 and the use of cod liver oil (a rich source of vitamin D) during pregnancy66 and the first year of life67 has been associated with a lower risk of T1D.”
From Epidemiology of type 1 diabetes (2010) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Establishing a standard definition for child overweight and obesity worldwide: international survey
Cole, T. J. (2000) · BMJ · doi:10.1136/bmj.320.7244.1240 · Cited by 16,500 · see citing works
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) · PEDIATRICS · doi:10.1542/peds.114.2.s2.555 · Cited by 6,895 · see citing works
High density lipoprotein as a protective factor against coronary heart disease
Gordon, T., Castelli, W. P., Hjortland, M. C., Kannel, W. B., & Dawber, T. R. (1977) · The American Journal of Medicine · doi:10.1016/0002-9343(77)90874-9 · Cited by 5,059 · see citing works
Norman, A. W. (1979) · Cited by 3,770 · see citing works
Decreased bioavailability of vitamin D in obesity
Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z., & Holick, M. F. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.3.690 · Cited by 3,204 · see citing works
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) · PEDIATRICS · doi:10.1542/peds.114.s2.555 · Cited by 2,448 · see citing works
Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes
Bischoff-Ferrari, H. A., Giovannucci, E., Willett, W. C., Dietrich, T., & Dawson-Hughes, B. (2006) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.1.18 · Cited by 2,414 · see citing works
High Prevalence of Vitamin D Inadequacy and Implications for Health
Holick, M. F. (2006) · Mayo Clinic Proceedings · doi:10.4065/81.3.353 · Cited by 2,008 · see citing works
Calcium plus Vitamin D Supplementation and the Risk of Fractures
Jackson, R. D., LaCroix, A. Z., Gass, M. L. S., Wallace, R. B., Robbins, J. A., Lewis, C. E., Bassford, T. L., Beresford, S. A. A., Black, H. R., Blanchette, P. L., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa055218 · Cited by 1,861 · see citing works
Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents
Wagner, C. L., & Greer, F. R. (2008) · PEDIATRICS · doi:10.1542/peds.2008-1862 · Cited by 1,607 · see citing works
Hypovitaminosis D in Medical Inpatients
Thomas, M. K., Lloyd‐Jones, D. M., Thadhani, R., Shaw, A. C., Deraska, D. J., Kitch, B. T., Vamvakas, E. C., Dick, I. M., Prince, R. L., & Finkelstein, J. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803193381201 · Cited by 1,436 · see citing works
Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations
Misra, M., Pacaud, D., Petryk, A., Collett‐Solberg, P. F., & Kappy, M. S. (2008) · PEDIATRICS · doi:10.1542/peds.2007-1894 · Cited by 1,398 · see citing works
INCREASED SKIN PIGMENT REDUCES THE CAPACITY OF SKIN TO SYNTHESISE VITAMIN D3
Clemens, T. L., Henderson, S. L., Adams, J. S., & Holick, M. F. (1982) · The Lancet · doi:10.1016/s0140-6736(82)90214-8 · Cited by 1,166 · see citing works
Advances in Male Contraception
Page, S. T., Amory, J. K., & Bremner, W. J. (2008) · Endocrine Reviews · doi:10.1210/er.2007-0041 · Cited by 1,134 · see citing works
Nesby-O’Dell, S., Scanlon, K. S., Cogswell, M. E., Gillespie, C., Hollis, B. W., Looker, A. C., Allen, C., Doughertly, C., Gunter, E. W., & Bowman, B. A. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.1.187 · Cited by 1,001 · see citing works
Noncalcemic Actions of Vitamin D Receptor Ligands
Nagpal, S., Na, S., & Rathnachalam, R. (2005) · Endocrine Reviews · doi:10.1210/er.2004-0002 · Cited by 960 · see citing works
Trends in Blood Pressure Among Children and Adolescents
Muntner, P. (2004) · JAMA · doi:10.1001/jama.291.17.2107 · Cited by 887 · see citing works
Self-citationPrevalence of Vitamin D Deficiency Among Healthy Adolescents
Gordon, C. M., DePeter, K. C., Feldman, H. A., Grace, E., & Emans, S. J. (2004) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.158.6.531 · Cited by 877 · see citing works
Implications of Small Reductions in Diastolic Blood Pressure for Primary Prevention
Cook, N. R. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430070053006 · Cited by 828 · see citing works
Looker, A. C., Dawson‐Hughes, B., Calvo, M. S., Gunter, E. W., & Sahyoun, N. R. (2002) · Bone · doi:10.1016/s8756-3282(02)00692-0 · Cited by 801 · see citing works
Bao, W., Threefoot, S. A., Srinivasan, S., & Berenson, G. (1995) · American Journal of Hypertension · doi:10.1016/0895-7061(95)00116-7 · Cited by 798 · see citing works
Factors that influence the cutaneous synthesis and dietary sources of vitamin D
Chen, T. C., Chimeh, F., Lu, Z., Mathieu, J., Person, K. S., Zhang, A., Kohn, N., Martinello, S., Berkowitz, R., & Holick, M. F. (2007) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2006.12.017 · Cited by 547 · see citing works
Vitamin D Deficiency in Homebound Elderly Persons
Gloth, F. M. (1995) · JAMA · doi:10.1001/jama.1995.03530210037027 · Cited by 477 · see citing works
The coming of age of 1,25-dihydroxyvitamin D3 analogs as immunomodulatory agents
Mathieu, C., & Adorini, L. (2002) · Trends in Molecular Medicine · doi:10.1016/s1471-4914(02)02294-3 · Cited by 466 · see citing works
Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited
Glerup, H., Mikkelsen, K., Poulsen, L., Hass, E., Overbeck, S., Thomsen, J., Charles, P., & Eriksen, E. F. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00595.x · Cited by 436 · see citing works
Alemzadeh, R., Kichler, J., Babar, G., & Calhoun, M. (2008) · Metabolism · doi:10.1016/j.metabol.2007.08.023 · Cited by 419 · see citing works
Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers
Gordon, C. M., Feldman, H. A., Sinclair, L., Williams, A. L., Kleinman, P. K., Pérez-Rosselló, J. M., & Cox, J. E. (2008) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.162.6.505 · Cited by 399 · see citing works
Nutritional rickets in African American breast-fed infants
Kreiter, S. R., Schwartz, R. P., Kirkman, H. N., Charlton, P. A., Calikoglu, A. S., & Davenport, M. L. (2000) · The Journal of Pediatrics · doi:10.1067/mpd.2000.109009 · Cited by 395 · see citing works
Perwad, F., Zhang, M. Y. H., Tenenhouse, H. S., & Portale, A. A. (2007) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00463.2006 · Cited by 301 · see citing works
Weisberg, P., Scanlon, K. S., Li, R., et al. (2004) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/80.6.1697s · Cited by 280 · see citing works
Cheng, S., Tylavsky, F. A., Kröger, H., Kärkkäinen, M. U. M., Lyytikäinen, A., Koistinen, A., Mahonen, A., Alén, M., Halleen, J. M., Väänänen, K., et al. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.3.485 · Cited by 258 · see citing works
Weng, F. L., Justine Shults, A., Leonard, M. B., Stallings, V. A., & Zemel, B. S. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.1.150 · Cited by 249 · see citing works
Vitamin D intake in the United States
Moore, C. E., Murphy, M. M., Keast, D. R., & Holick, M. F. (2004) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2004.03.028 · Cited by 246 · see citing works
Adolescent Girls in Maine Are at Risk for Vitamin D Insufficiency
Sullivan, S. S., Rosen, C. J., Halteman, W. A., Chen, T. C., & Holick, M. F. (2005) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2005.03.002 · Cited by 227 · see citing works
Prevalence of Vitamin D Insufficiency in Obese Children and Adolescents
Smotkin-Tangorra, M., Purushothaman, R., Gupta, A., Nejati, G., Anhalt, H., & Ten, S. (2007) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2007.20.7.817 · Cited by 219 · see citing works
Vitamin D Status and Response to Vitamin D3 in Obese vs. Non‐obese African American Children
Rajakumar, K., Fernstrom, J. D., Holick, M. F., Janosky, J. E., & Greenspan, S. L. (2008) · Obesity · doi:10.1038/oby.2007.23 · Cited by 161 · see citing works
Relation between 25-hydroxyvitamin D3, apolipoprotein A-I, and high density lipoprotein cholesterol.
Auwerx, J. H., Bouillon, R., & Kesteloot, H. (1992) · Arteriosclerosis and Thrombosis A Journal of Vascular Biology · doi:10.1161/01.atv.12.6.671 · Cited by 123 · see citing works
25-Hydroxyvitamin D, cholesterol, and ultraviolet irradiation
Carbone, L. D., Rosenberg, E. W., Tolley, E. A., Holick, M. F., Hughes, T. A., Watsky, M. A., Barrow, K. D., Chen, T. C., Wilkin, N. K., Bhattacharya, S. K., et al. (2008) · Metabolism · doi:10.1016/j.metabol.2008.01.011 · Cited by 95 · see citing works
Vitamin D Deficiency and Nutritional Rickets in Children
Pettifor, J. M. (2011) · Elsevier eBooks · doi:10.1016/b978-0-12-381978-9.10060-5 · Cited by 85 · see citing works
Vitamin D deficiency in homebound elderly persons
Gloth, F. M. (1995) · JAMA · doi:10.1001/jama.274.21.1683 · Cited by 82 · see citing works
Nutritional Rickets Among Breast-fed Black and Alaska Native Children
Gessner, B. D. (1996) · PsycEXTRA Dataset · doi:10.1037/e415492005-001 · Cited by 43 · see citing works
Nutritional rickets still afflict children in north Texas.
Shah, M., Salhab, N., Patterson, D., et al. (2000) · PubMed · Cited by 41 · see citing works
Mylott, B. M., Kump, T., Bolton, M. L., et al. (2004) · PubMed · Cited by 32 · see citing works
Vitamin D Deficiency in the San Francisco Bay Area
McAllister, J. C., Lane, A. T., & Buckingham, B. A. (2006) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2006.19.3.205 · Cited by 28 · see citing works
Vitamin D Deficiency and Nutritional Rickets in Children
Pettifor, J. M. (2005) · Elsevier eBooks · doi:10.1016/b978-012252687-9/50068-1 · Cited by 25 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Vitamin D for health: a global perspective
Hossein-nezhad, A., & Holick, M. F. (2013) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2013.05.011 · Cited by 1,298 · see citing works
Epidemiology of type 1 diabetes
Maahs, D. M., West, N. A., Lawrence, J. M., & Mayer-Davis, E. J. (2010) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2010.05.011 · Cited by 1,092 · see citing works
Prevalence of vitamin D inadequacy in athletes: a systematic-review and meta-analysis
Farrokhyar, F., Tabasinejad, R., Dao, D., Peterson, D., Ayeni, O. R., Hadioonzadeh, R., & Bhandari, M. (2015) · Sports Medicine · doi:10.1007/s40279-014-0267-6 · Cited by 249 · see citing works
Ganji, V., Zhang, X., Shaikh, N., & Tangpricha, V. (2011) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.013516 · Cited by 189 · see citing works
Resilience: The Science of Mastering Life's Greatest Challenges
Southwick, S., & Charney, D. (2018) · doi:10.1017/9781108349246 · Cited by 153 · see citing works
Sports Health Benefits of Vitamin, D
Shuler, F. D., Wingate, M. K., Moore, G. H., & Giangarra, C. (2012) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738112461621 · Cited by 127 · see citing works
Wakayo, T., Belachew, T., Vatanparast, H., & Whiting, S. J. (2015) · PLOS ONE · doi:10.1371/journal.pone.0120963 · Cited by 81 · see citing works
Childhood Obesity: Immune Response and Nutritional Approaches
Magrone, T., & Jirillo, E. (2015) · Frontiers in Immunology · doi:10.3389/fimmu.2015.00076 · Cited by 67 · see citing works
- Authors
- Kumar, J., Muntner, P., Kaskel, F. J., Hailpern, S. M., & Melamed, M. L.
- Affiliations
- Children's Hospital at Montefiore (US)
- Icahn School of Medicine at Mount Sinai (US)
- Centers for Disease Control and Prevention (US)
- Albert Einstein College of Medicine (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2009-09-01
- Volume
- 124
- Issue
- 3
- Pages
- e362-e370
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3749840
- OpenAlex
- W2134433004
- Cited by
- 621
- References
- 45
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 24 · 2023: 19 · 2022: 31 · 2021: 38 · 2020: 27 · 2019: 25 · 2018: 39 · 2017: 35 · 2016: 40 · 2015: 51 · 2014: 51 · 2013: 60 · 2012: 53
- FWCI
- 38.15
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (K23 078774)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK084339, U01 DK63549, U01DK063549, K23DK078774, U01DK066174, T32DK007110)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Magnesium in Health and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- vitamin D deficiency, 25-hydroxyvitamin D, vitamin D insufficiency, children and adolescents, cardiovascular risk factors, parathyroid hormone, systolic blood pressure, obesity, vitamin D supplementation, milk consumption, screen time, racial and ethnic disparities, prevalence, vitamin D status assessment
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Male, Nutrition Surveys, Risk Factors, United States, Vitamin D, Vitamin D Deficiency, Prevalence, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
