Low Levels of 25-hydroxyvitamin D in the Pediatric Populations: Prevalence and Clinical Outcomes

Michal L Melamed; Juhi Kumar


Pediatr Health. 2010;4(1):89-97. 

In This Article

Prevalence of Vitamin D Deficiency

Certain patient groups are more at risk for vitamin D deficiency, including obese and non-White children and adolescents. An analysis of 217 obese adolescents in Brooklyn, NY, USA, revealed that 55% of the patients were vitamin D deficient (defined as 25(OH)D levels <20 ng/ml) while 22% had levels below 10 ng/ml.[10] Another study showed that 52% of 307 Hispanic and African–American adolescents in Boston, MA, USA, had 25(OH)D levels below 15 ng/ml.[11] A study in 40 healthy, mostly Black, mother–infant pairs found that 50% of the mothers and 65% of the infants had 25(OH)D levels below 12 ng/ml.[12] A study of vitamin D levels in presumably healthy toddlers and infants attending a pediatrics clinic found that 12.1% (44 out of 365) of the children had levels below 20 ng/ml.[13]

Recently, a couple of studies have used nationally representative data to evaluate the 25(OH)D status of the US pediatric population.[14,15] Both these studies revealed a high prevalence of 25(OH)D deficiency, defined as below 15 ng/ml, and insufficiency, defined as less than 30 ng/ml. In our study using a sample of 9757 children and adolescents in the National Health and Nutrition Examination Survey (NHANES) 2001–2004, we found that 9% of the US pediatric population had levels below 15 ng/ml while an additional 61% had levels between 15 and 29 ng/ml.[15] As in previous studies, certain groups were at higher risk for deficiency. We found that the prevalence of deficiency was highest amongst non-Hispanic Black adolescent girls where the prevalence was almost 60%. The lowest prevalence was amongst non-Hispanic White boys aged 1–6 years in whom prevalence was approximately 1%. Looker et al. showed that the prevalence of vitamin D deficiency in the USA has increased between 1988 and 1994 (the years of the NHANES III survey), and 2001 and 2004 (NHANES 2001–2004).[14]

Data from other countries suggest that low vitamin D levels are a worldwide problem. A study from Andhra Pradesh in India revealed that 62–82% of children had 25(OH)D levels below 20 ng/ml.[16] A study of infants of Pakistani, Turkish and Somali immigrants to Norway revealed that 47% of infants had 25(OH)D levels below 10 ng/ml.[17] In 93 children from northern Jordan (mean age 5 years), 39% of the children had 25(OH)D levels below 20 ng/ml.[18] Reports from other countries confirm low levels of 25(OH)D amongst children.[19,20]


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