Abstract
Background: Vitamin D deficiency is common in Saudi Arabia. No sufficient data are available on the vitamin D status of preschool children. Aims: To investigate the vitamin D status among toddlers and preschool children and to evaluate the factors associated with hypovitaminosis D in Western Saudi Arabia. Methods: A cross-sectional study was conducted on 503 preschool children in Makkah. The children were divided into two age categories: 1-3 years (toddlers) and 3-6 years (preschool). Sociodemographic factors, life-style factors, eating habits, body mass index (BMI), 25-(OH)-vitamin D-3, parathyroid hormone, calcium, phosphorous, and alkaline phosphatase concentrations were determined. Results: Sixty-three % of children had a vitamin D deficiency. Vitamin D in toddlers was significantly higher than in preschool children. Vitamin D levels were negatively correlated with BMI (r=-0.419, P <0.001), and duration of breast feeding (r=0.270, P=0.027), but a significant positive correlation with vitamin D intake (r=0.335, P=0.021), calcium intake (r=0.25, P=0.029), duration of formula feeding (r=0.354, P=0.019), and outdoor physical activity (r=0.381, P=0.011) was found. Multivariable predictors of hypovitaminosis D were preschool age (OR=11, [95 % CI: 2.78-43.57], P<0.001), outdoor physical inactivity (OR=2.44, [95 % CI: 0.93-14.12], P<0.001), obesity (OR=2.3, [95 % CI: 1.25-7.08], P=0.008), overweight (OR=2.16, [95% CI: 1.18-6.01], P=0.039), inadequate vitamin D intake (OR=1.65, [95% CI: 1.12-2.53], P=0.012), exclusive formula feeding (OR=0.53, [95% CI: 0.41-0.72], P< 0.001), and breast and formula feeding (OR=0.62 [95% CI: 0.39-0.88], P=0.002). Conclusion: Hypovitaminosis D is a public health concern, especially in preschool children. Possible determinants of low vitamin D status in preschool children in the Makkah region could be related to age, high BMI, inadequate vitamin D intake, exclusive breastfeeding, and outdoor physical inactivity.