Estimation of vitamin D and calcium intake in the United States and associations with cardiovascular risk factors and adiposity measures by age, sex, parental poverty income ratio, and race/ethnicity in children and adolescents 6–18 years

Estimates of vitamin D and calcium intake in the United States (US) were stratified by age, sex, parental poverty income ratio (PIR), and race/ethnicity in children (6 12 years) and adolescents (13 18 years) using the 2007-2008 National Health and Nutrition Examination Survey (NHANES) data set (STUDY I). Self-reported vitamin D and calcium intakes via dietary and supplemental sources were assessed by a 24-hour recalls. Information on 2347 participants, aged 6 18 years, including complete demographic and an in-person 24-hour recall, were obtained from the 2007-2008 NHANES data set. To evaluate differences in vitamin D and calcium intakes originating from diet and/or supplements, and by PIR, sex, and race/ethnicity categories, least-square means and standard errors were compared by univariate analysis of variance. Less than 10% of participants reported consuming a supplement that included either vitamin D or calcium. Non-Hispanic (NH) Blacks had significantly lower total vitamin D (4.22 + 0.19 ?g/d) and total calcium (754.5 + 21.2 mg/d) intakes than Mexican Americans, Other Hispanics, and Non-Hispanic Whites (NH). Female participants had significantly lower total vitamin D (4.84 + 0.2 ?g/d) and total calcium (801.7 + 16.1 mg/d) intake than males. Total vitamin D intake was lower in the 13 18 years age group (4.96 + 0.2 ?g/d) than in the 6 12 years age group (5.55 + 0.15 ?g/d). Total calcium intake was lower in the 6 12 years age group (840.9 + 15.4 mg/d) than in the 13- 18 years age group (914.8 + 23.9 mg/d). A subgroup analysis (n=1085; 12-18y) examined vitamin D and calcium intake associations with cardiovascular risk factors and adiposity by age, sex, parental PIR, and ethnicity (STUDY II). Male participants had significantly lower concentrations of total cholesterol (154.3 mg/dL), high-density lipoprotein cholesterol (HDL-C) (49.1 mg/dL), insulin (14.3uU/mL), C-reactive protein (CRP) (0.2 mg/dL), and diastolic blood pressure (59.0 mmHg). Systolic blood pressure was significantly lower in females (107.5 mmHg). Triglycerides (66.2 mg/dL) were significantly lower and HDL-C (55.1 mg/dL) was significantly higher in the NH Blacks. Diastolic blood pressure was significantly higher in NH Whites (61.4 mmHg) and NH Blacks (61.2 mmHg). Controlling for sex, race/ethnicity, and PIR (Model 3), linear regression analysis indicated a significant inverse association between vitamin D and calcium with triglycerides (p = 0.05) and hemoglobin A1c (HgbA1c) (p = 0.01). Controlling for sex and race/ethnicity (Model 2), linear regression analysis indicated a significant (p = 0.02) inverse association between vitamin D and calcium with waist circumference, triceps skinfold, and subscapular skinfold. Parents and nutrition professionals should encourage children and adolescents to consume an overall healthy diet including foods high in vitamin D and calcium, and to potentially help reduce adiposity, blood triglycerides, and hemoglobin A1c levels. Furthermore, food manufacturers should increase the number of fortified foods available to aid in reducing vitamin D and calcium deficiencies.