Abstract
BACKGROUND: Vitamin D is required for growth and development. However, little is known about dietary intake and status during early childhood. OBJECTIVES: To determine vitamin D intake and status in a group of Canadian toddlers. METHODS: This is a secondary analysis of data from toddlers enrolled in a double-blind randomized controlled trial of fatty acid supplementation, between ages 1 y and 2 y in Vancouver (latitude 49°N), Canada. Dietary information was collected using a 3-d food record, and supplement use by questionnaire. Plasma 25-hydroxyvitamin D(3) (25OHD) concentrations were quantified by liquid chromatography-tandem mass spectrometry. Blood sampling was dichotomized by season as winter (September to February) and summer (March to August). RESULTS: At age 1 y (n = 110) and 2 y (n = 86), the top food sources of vitamin D were dairy (73‒81%), fish (6.8‒14%), and eggs (4.1‒5.5%). Vitamin D-containing supplements were consumed by 43% of the toddlers at age 1 y and 48% at 2 y. Daily median (interquartile range) total vitamin D intakes were 7.9 (4.9‒13) μg at age 1 y and 7.2 (4.8‒14) μg at age 2 y. There was a higher prevalence of inadequate intake (<10 μg/d) in toddlers not using vitamin D supplements at age 1 y (92% compared with 19%) and 2 y (96% compared with 34%). Overall, mean (standard deviation) 25OHD concentrations were 59.9 (17.6) nmol/L at age 1 y (n = 124) and 60.9 (13.6) nmol/L at 2 y (n = 104). The prevalence of low vitamin D status (<50 nmol/L) was 27% at age 1 y and 22% at 2 y. At age 1 y, the prevalence of low vitamin D status was higher in winter (adjusted prevalence 43% compared with 13%; P < 0.001). Total vitamin D intake correlated with 25OHD at both ages (r ∼0.2, P < 0.05). CONCLUSIONS: These findings suggest a high prevalence of inadequate vitamin D intakes in toddlers who do not consume a vitamin D supplement. A national-level surveillance is needed for this important life stage.