Use of vitamin D and other dietary supplements by Finnish children at the age of 2 and 3 years

The aims of this study were to investigate the frequency of the use of vitamin D and other dietary supplements by Finnish children at the age of 2 and 3 years, to evaluate daily nutrient intake from supplements, and to investigate the relation between supplement use and various sociodemographic factors. The families of 534 newborn infants were invited to a birth cohort study in 1996-1997. Families of 292 children at the child's age of 2 years and families of 263 children at the age of 3 years completed a three-day food record from which the daily use of dietary supplements was calculated. The frequency of dietary supplement use was 50% among the two-year-olds, and 37% among the three-year-old children. The most commonly used supplements among the two-year-olds were vitamin D or vitamin A + D combination (38%) and fluoride (16%) and among the three-year-olds fluoride (19%) and multivitamins (16%), respectively. Intake of nutrients other than vitamin D or fluoride from supplements was rare among two-year-olds, whereas 16% of the three-year-olds received also vitamin A, C, E, and several group B vitamins. Mean daily intake of vitamin D from supplements was 6.7 micrograms at the age of 2 years and 5.3 micrograms at the age of 3 years, respectively. The level of parental education was positively associated with the child's vitamin D supplementation at the age of 2 years. As the compliance with national recommendations of vitamin D supplementation was low, intensified counseling of the parents is needed at the well-baby clinics in Finland.     

3～12岁儿童营养素补充剂摄入量研究

目的通过横断面调查,描述营养素补充剂的使用率和日均使用量。方法采用多阶段随机整群抽样抽取中国7城市2农村岁3~12岁儿童1 823名,通过6个月内营养素补充剂调查问卷获得其营养素补充剂摄入情况。结果3~6岁儿童各营养素补充率均高于7~12岁儿童(P均0.05)。3~12岁儿童最常使用的营养素依次为钙(27.46%),维生素D(16.61%),锌(13.73%),维生素B2(12.35%),维生素B12(12.30%),维生素B1(12.24%),维生素C(12.18%),维生素A(11.35%),维生素B6(10.47%),叶酸(8.68%),烟酸(7.03%),泛酸(6.70%),维生素E(6.17%),铁(4.87%)。来自于补充剂的日均营养素摄入量分布范围跨度较大,且有部分极值超过可耐受最高量。大多数补充剂摄入量低于推荐量,3~6岁儿童维生素A补充剂摄入量均值和中位数高于推荐量。结论维生素A补充剂摄入量存在一定程度的超量风险。要更准确地评估儿童的营养状态和潜在的健康风险,应建立营养素补充剂摄入量的推荐标准和安全范围。     

Vitamin D intake and its food sources in Taiwanese

In the early 20th Century, vitamin D was discovered and its Recommended Daily Allowance developed. However, average daily dietary intakes have not been reported until recently in the US. There are no food composi-tion and no intake data for vitamin D available in Taiwan. We have taken advantage of several population representative Nutrition and Health Surveys in Taiwan (NAHSIT) conducted from 1993 onwards of various age groups to examine this possibility systematically. Firstly, we collected and compiled the vitamin D content of foods from various sources to supplement the Taiwanese Food Composition Tables. Though these vitamin D data may not be fully representative of local food items, they serve as a reference point. Secondly, we have used the three NAHSITs databases, which all used the 24-hr recall method to collect dietary intake date and five food frequency questionnaire type questions to collect supplement data, to estimate most gender- and age-specific (in-clude: school children, adults and elderly) vitamin D intake from food source and supplements. Thirdly, we have defined the sources of vitamin D intake in Taiwanese (gender- and age-specific). Vitamin D intakes of Taiwanese were adequate except girls of high school and indigenous people. Fish and its products, milk, mushroom were the major vitamin D food sources. Supplement source vitamin D also varied greatly between age and gen-der groups. Elderly women consumed almost 20% of vitamin D from supplements; 16-18 years old boys consumed 2.47% vitamin D from supplements only.     

Vitamin D intake is low and hypovitaminosis D common in healthy 9- to 15-year-old Finnish girls.

OBJECTIVES: To study the prevalence of hypovitaminosis D, the effect of vitamin D supplementation on serum 25-hydroxyvitamin D [S-25(OH)D], and the intakes of vitamin D and calcium in Finnish 9- to 15-year-old athletic and nonathletic girls. DESIGN: 1-year follow-up study (February 1997-March 1998) with three months of vitamin D supplementation (10 microg/d) from October to January. SETTING: Turku University Central Hospital, Finland. SUBJECTS: 191 female volunteers aged 9-15 y (131 athletes and 60 controls). METHODS: Vitamin D and calcium intakes were estimated by a four-day food recording and a semi-quantitative food frequency questionnaire (FFQ). S-25(OH)D was followed by radioimmunoassay (RIA). RESULTS: At baseline the mean S-25(OH)D concentration was 33.9 nmol/l among all girls. In winter severe hypovitaminosis D (S-25(OH)D < 20 nmol/l) occurred in 13.4% of the participants and in 67.7% S-25(OH)D was below 37.5 nmol/l. By the next summer the mean S-25(OH)D concentration was 62.9 nmol/l and in 1.6% of the subjects it was below 37.5 nmol/l. The prevalence of severe hypovitaminosis D was not significantly reduced by three months of vitamin D (10 microg/d) supplementation. At baseline, the mean intake of vitamin D was 2.9 microg/d by food recording and 4.3 microg/d by FFQ. The mean calcium intake was 1256 mg/d and 1580 mg/d, respectively. The intakes of vitamin D and calcium remained unchanged during the follow-up period. The athletes consumed more calcium than nonathletic controls, whereas the intake of vitamin D was quite similar among both groups. The vitamin D intake by FFQ correlated with the S-25(OH)D concentration in wintertime (r = 0.28, P < 0.01). CONCLUSION: Hypovitaminosis D is fairly common in growing Finnish girls in the wintertime, and three months of vitamin D supplementation with 10 microg/d was insufficient in preventing hypovitaminosis D. The daily dietary vitamin D intake was insufficient (< 5 microg/d) in the majority of participants, while the calcium intake was usually sufficient.     

Nutritional supplements and elevated serum vitamin A levels in children on chronic dialysis

Vitamin A is known to accumulate in patients with chronic renal failure (CRF), but it is present in many micronutrient and all complete nutritional supplements. Measurements were made of serum vitamin A concentrations in eight children (mean age 6 years, range 2–15 years) on chronic dialysis six continuous cyclic peritoneal dialysis patients (CCPD) and two haemodialysis (HD) patients, before and 6 months and 12 months after commencing a daily supplement containing vitamins A and D (Ketovite Liquid; Paines & Byrne Ltd, West Byfleet, Surrey, UK). Seven children were receiving complete nutritional supplements (two oral, five via gastrostomy buttons). Dietary energy and vitamin A intakes were determined by 3-day dietary records. Prior to Ketovite Liquid supplementation, a mean of 68% (range 28–103%) of the reference nutrient intake (RNI) for vitamin A was provided by the diet, with a significant contribution from complete nutritional supplements. When receiving Ketovite Liquid supplementation, mean vitamin A intakes exceeded twice the RNI. Mean serum vitamin A concentrations (2.7±0.8 μ mol/l) at baseline were above the revised normal reference range. Levels rose significantly post Ketovite Liquid supplementation at 6 months (mean 4.2±0.6 μ mol/l, P <0.05) and 12 months (mean 4.8±0.8 μ mol/l, P <0.05). This study confirms that vitamin A supplementation should be avoided in children on chronic dialysis. Any dietary supplement, either micronutrient or complete, must be carefully analysed for its potential contribution to total vitamin A intake.     

Vitamin D intakes by children and adults in the United States differ among ethnic groups

Concerns about vitamin D status in the United States have resurfaced due to increasing reports of insufficiency and deficiency. Few foods contain vitamin D naturally, and currently few foods are fortified in the United States. Intakes of vitamin D in the United States from food and food plus supplements by age, sex, and race/ethnicity group were estimated. Individuals > or = 1 y old who participated in the 1999-2000 National Health and Nutrition Examination Survey (NHANES 1999-2000) were included in the analysis. Vitamin D intake by non-Hispanic (NH) white, NH black, Mexican American, and all individuals in the United States was estimated and compared with recommended levels. Vitamin D intakes were highest among children and teenagers, and lowest in the oldest age categories. Among children age 1-8 y, adequate intake (AI) levels for vitamin D from food were met or exceeded by 69% of Mexican American, 59% of NH white, and 48% of NH black subpopulations. Among adults > or = 51 y old, only 4% met or exceeded the AI from food alone. Few women 19-50 y old or men and women > or = 51 y old were estimated to consume recommended vitamin D levels from food. Mean dietary intakes of vitamin D from food plus supplements were consistently highest among NH white populations, although only small proportions of all those > or = 51 y old had intakes above the recommended levels. The large discrepancy between vitamin D intake by older individuals from food plus supplements and recommended levels, especially for NH black and Mexican American adults, warrants intervention.     

Impact of national fortification of fluid milks and margarines with vitamin D on dietary intake and serum 25-hydroxyvitamin D concentration in 4-year-old children

OBJECTIVE: To assess the impact of national fortification of fluid milks and margarines with vitamin D on dietary intake and on serum 25-hydroxyvitamin D concentration in Finnish 4-year-old children. DESIGN, SUBJECTS AND METHODS: Two cohorts of children were studied during wintertime, one before (n=82) in 2001-2002 and the other after (n=36) the initiation of fortification in 2003-2004. Dietary intake was estimated by 4-day food records and serum 25-hydroxyvitamin D concentration was analyzed by radioimmunoassay. RESULTS: The mean intake of vitamin D was higher the after initiation of fortification (mean (95% confidence interval (CI)); 4.5 (3.8-5.1) microg) than before it (2.1 (95% CI 1.8-2.3) microg; P<0.001), although there were no differences in consumption of the main food sources of vitamin D between the two cohorts. The difference between the cohorts was also evident when the intake of vitamin D was adjusted for energy intake (0.78 (95% CI 0.70-0.90) and 0.37 (95% CI 0.32-0.42) microg/MJ after and before fortification, respectively, P<0.001). After fortification, the mean intake approached that recommended, but was achieved by only 30.6% of the children. Equally, the serum 25-hydroxyvitamin D concentration was higher after fortification (64.9 (95% CI 59.7-70.1) nmol/l) compared to prior it (54.7 (95% CI 51.0-58.4) nmol/l; P=0.002). CONCLUSIONS: The results indicate that the national fortification of fluid milks and margarines with vitamin D safely improved the vitamin D status of children. This approach, in view of the novel health effects beyond bone metabolism, encourages fortification of new food sources with vitamin D or use of vitamin D supplements particularly during wintertime.     

Vitamin intakes from supplements and fortified food in German children and adolescents: results from the DONALD study

Frequent consumption of supplements is a common behavior in adults, as well as children and adolescents. We report on vitamin intake from consuming supplements, taking into account the vitamin intake from fortified and usual foods. A total of 5990 3-d weighed dietary records from 931 German subjects (452 males, 479 females, 2-18 y of age) between 1986 and 2003 from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study were evaluated. We identified 133 different vitamin-containing supplements in 451 records (7.5%). Slightly more males (8.0%) than females (7.1%) consumed supplements, with highest frequencies found between ages 15 and 18 y. For the majority (10 of 13) of vitamins (vitamin A, vitamin E, vitamin K, thiamin, riboflavin, vitamin B-6, vitamin B-12, niacin, biotin, and vitamin C), intake from usual and fortified food already reached or exceeded 80% of the recommended dietary allowances in all age groups. In the case of folate and pantothenic acid, intake from supplements was necessary to achieve at least 80% of recommended dietary allowances for half of the age groups, especially in females. Supplements with vitamin D considerably helped increase vitamin intake but failed to achieve 80% of references in almost all age groups. Intakes of vitamin A and folic acid exceeded the tolerable upper level most frequently in many age groups and were most pronounced in up to 32% and 13% of children aged 2-3 y. Intake of vitamin D, vitamin E, and vitamin C exceeded the tolerable upper level in single age groups only (<7% of subjects). For the other vitamins, no exceeded limits were identified. The ubiquitous availability of supplements might indicate that even healthy children and adolescents profit by taking them. However, it is difficult to evaluate whether consumers receive more benefits or risks from the unrestricted consumption of supplements as they are marketed today.     

成都市婴幼儿营养补充剂应用及影响因素探讨

目的了解成都市婴幼儿营养补充剂使用现状及影响因素。方法随机选取成都市两个社区257名0～3岁婴幼儿及其家长作为研究对象,通过问卷调查收集婴幼儿营养补充剂使用相关信息和家庭基本情况,分析影响营养补充剂使用的相关因素。结果婴幼儿营养补充剂总使用率为87.5%,各类营养补充剂使用率依次为维生素D 76.3%、维生素A 75.5%、钙33.5%、锌16.3%、铁3.9%;除铁制剂外,不同月龄组间婴幼儿营养补充剂使用率差异有显著性(P<0.05),随月龄增加钙、锌使用率呈上升趋势,维生素D和维生素A在6～11月龄段使用率最高;营养补充剂使用分别与家长对婴幼儿期营养重视程度(OR=0.186,P<0.05)和婴幼儿生长发育状况(OR=2.317,P<0.05)有关。结论成都市婴幼儿营养补充剂使用已较普遍,需加强专业指导以保证营养补充剂的合理应用。     

Geographical differences in vitamin D status, with particular reference to European countries

Vitamin D is produced endogenously when the skin is exposed to sunlight and can be obtained exogenously from a few natural food sources, from food fortification and from supplements. Generally, vitamin D intake is low < or = 2-3 microg/d in Europe. Casual exposure to sunlight is thought to provide most of the vitamin D requirement of the human population. However, skin synthesis of vitamin D may not compensate for the low nutritional intake in Europe, even in countries with high supplies from food fortification and supplements. For assessment of vitamin D nutritional status the concentration of 25-hydroxyvitamin D (25(OH)D) in serum is considered to be an accurate integrative measure reflecting an individual's dietary intake and cutaneous production. A substantial percentage of the elderly and adolescents in Europe have a low concentration of 25(OH)D; in the elderly this percentage ranges from approximately 10 in the Nordic countries to approximately 40 in France. Low vitamin D status seems to be aggravated by disease and immobility, and by a low frequency of supplement use.     

Associations of diet, supplement use, and ultraviolet B radiation exposure with vitamin D status in Swedish women during winter

BACKGROUND: Vitamin D is produced endogenously after sun exposure but can also be obtained from natural food sources, food fortification, and dietary supplements. OBJECTIVE: We aimed to determine the vitamin D status of women (61-86 y old) living in central Sweden (latitude 60 degrees ) during winter and its relation with vitamin D intake and exposure to ultraviolet B radiation. DESIGN: In a cross-sectional study, we assessed the vitamin D status (serum 25-hydroxyvitamin D [25(OH)D]) of 116 women by using an enzyme immunoassay. The women completed questionnaires covering food habits, use of dietary supplements, and sun-related behavior. RESULTS: In a multiple linear regression model, the main determinants of serum 25(OH)D concentrations (x +/- SD: 69 +/- 23 mmol/L) were dietary vitamin D (6.0 +/- 1.8 mug/d), travel to a sunny location during winter within the previous 6 mo (26%), and the use of dietary supplements (16%). There was no association between serum 25(OH)D status during the winter and age, time spent outdoors, the use of sunscreen, or skin type. Serum 25(OH)D concentrations increased by 25.5 nmol/L with 2-3 servings (130 g/wk) fatty fish/wk, by 6.2 nmol/L with the daily intake of 300 g vitamin D-fortified reduced-fat dairy products, by 11.0 nmol/L with regular use of vitamin D supplements, and by 14.5 nmol/L with a sun vacation during winter. Among nonsupplement users without a wintertime sun vacation, 2-3 servings fatty fish/wk increased serum vitamin D concentrations by 45%. CONCLUSION: Fatty fish, vitamin D-fortified reduced-fat dairy products, regular supplement use, and taking a sun vacation are important predictors for serum concentrations of 25(OH)D during winter at a latitude of 60 degrees .     

600名婴幼儿维生素D制剂应用现状及影响因素

目的 了解0~3岁婴幼儿维生素D的应用现状,分析其影响因素,为指导维生素D的合理应用提供依据。方法 随机抽取2016年1-12月在郑州大学第三附属医院儿童保健门诊进行健康体检和计划免疫的600名0~3岁婴幼儿作为调查对象,采用自制问卷对婴幼儿的主要带养人进行调查。结果 郑州市婴幼儿维生素D制剂的使用率为63.5%,平均添加时间为3月龄,平均停服时间为15月龄。多因素Logistic回归分析显示,婴幼儿年龄(OR＝0.816,95%CI:0.586~0.912)、母亲文化水平(OR＝0.573,95%CI:0.319~0.881)和喂养方式(OR＝0.346,95%CI:0.272~0.874)是影响维生素D制剂应用的因素。结论 维生素D制剂在婴幼儿中应用不规范,建议开展有效的健康教育活动,指导儿童家长合理补充维生素D制剂。     

Vitamin D intakes in 18-64-y-old Irish adults

OBJECTIVE: To estimate vitamin D intakes in a representative sample of Irish adults and to assess the contribution of foods to these intake estimates. DESIGN: Vitamin D intakes in 1379, 18-64-y-old adults from the North/South Ireland Food Consumption Survey were estimated using a combination of new analytical data for vitamin D in foods, determined by HPLC, and used to revise recipe calculations, together with existing data from McCance and Widdowson's The Composition of Foods, 5th Edition plus supplements. RESULTS: The total mean daily intake (MDI) of vitamin D (1 microg=40 IU) from all sources was 4.2 microg. The MDI was significantly higher (P<0.001) when the contribution from nutritional supplements was included (4.2 microg) compared with food sources only (3.2 microg). Men had significantly higher intakes (4.4 microg) than women (4.0 microg; P<0.001), which increased significantly (P<0.001) with age in both sexes. Meat/meat products (30.1%), fish/fish products (14.3%) and eggs/egg dishes (9.1%) were the main contributors to vitamin D intake. Supplements contributed 6.8 and 12% to MDI in men and women, respectively. In all, 74% of adults had an MDI of vitamin D that was less than the median (5 microg) of the recommended daily range of 0-10 microg. CONCLUSION: The findings of this study suggest that a large number of Irish adults have low vitamin D intakes. This, along with emerging evidence of low vitamin D status in at least some population subgroups, suggests that strategies to increase vitamin D intakes, including fortification of food, should be investigated.     

Prospective study on food fortification with vitamin D among adolescent females in Finland: minor effects

Vitamin D insufficiency is common particularly during winter time. After the recommendation by the Ministry of Social Affairs and Health, Finnish fluid milks and margarines have been fortified with vitamin D since February 2003. The aims of the present study were to examine the impact of vitamin D fortification of food supplies on serum 25-hydroxyvitamin D (S-25(OH)D) concentrations and on daily dietary vitamin D intake among adolescent females. One hundred and forty-two girls of Caucasian ethnicity aged 12-18 years completed semi-quantitative FFQ from which the dietary vitamin D and Ca intakes were calculated. S-25(OH)D was measured by radioimmunoassay. The study was performed from February-March 2000 to February-March 2004, one year after the initiation of fortification. The mean dietary intake of vitamin D was < 7.5 microg in 91.5 % of the adolescent girls in 2000 and 83.8 % in 2004. The midwinter mean S-25(OH)D concentration did not change significantly during the follow-up period (48.3 v. 48.1 nmol/l, NS). The proportion of participants who had S-25(OH)D concentration < 50 nmol/l was 60.6 % in 2000 and 65.5 % in 2004. Only 7.0 % of the participants had an adequate S-25(OH)D ( >or= 75 nmol/l) level in 2000 or 4 years later. The vitamin D fortification of fluid milks and margarines was inadequate to prevent vitamin D insufficiency. There are numerous adolescent girls and women who are not reached by the current fortification policy. Therefore new innovative and feasible ways of improving vitamin D nutrition are urged.     

Food Sources of Fiber and Micronutrients of Concern in Infants and Children in the United Arab Emirates: Findings from the Feeding Infants and Toddlers Study (FITS) and the Kids Nutrition and Health Survey (KNHS) 2020

We estimated the usual intakes of fiber, iron, zinc, calcium, folate, vitamin D, and vitamin A and the top foods that contribute to them among children in the UAE. Dietary intake was assessed using 24 h recalls among 5 age groups of infants and children. Foods were clustered into 54 food groups and ranked by their percentage contribution to the nutrients of interest in this study. The percentage achieving the adequate intake (AI) of fiber was negligible among all children. The top source of fiber was vegetables among children under 4 years, and white breads among those over 4 years. Only 45% of infants achieved iron adequacy, but iron standards were met by most children beyond the age of 1. The main contributors to iron intake were infant/young child formula and baby cereal in children under 4 years, while children over 4 years obtained it primarily from grains (fortified) and meat/fish. Vitamin D was inadequate across all age groups, with the percentage achieving adequacy ranging from 0 to 19% among pre-adolescents and toddlers, respectively. The top sources of vitamin D were fortified milks. Overall, nutrient inadequacies in fiber, calcium, and vitamin D highlight the need for greater intakes of whole grains and fortified dairy products in the UAE.     

Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age

BACKGROUND: Vitamin D deficiency and asthma are common at higher latitudes. Although vitamin D has important immunologic effects, its relation with asthma is unknown. OBJECTIVE: We hypothesized that a higher maternal intake of vitamin D during pregnancy is associated with a lower risk of recurrent wheeze in children at 3 y of age. DESIGN: The participants were 1194 mother-child pairs in Project Viva-a prospective prebirth cohort study in Massachusetts. We assessed the maternal intake of vitamin D during pregnancy from a validated food-frequency questionnaire. The primary outcome was recurrent wheeze, ie, a positive asthma predictive index (>or=2 wheezing attacks among children with a personal diagnosis of eczema or a parental history of asthma). RESULTS: The mean (+/-SD) total vitamin D intake during pregnancy was 548 +/- 167 IU/d. By age 3 y, 186 children (16%) had recurrent wheeze. Compared with mothers in the lowest quartile of daily intake (median: 356 IU), those in the highest quartile (724 IU) had a lower risk of having a child with recurrent wheeze [odds ratio (OR): 0.39; 95% CI: 0.25, 0.62; P for trend < 0.001]. A 100-IU increase in vitamin D intake was associated with lower risk (OR: 0.81; 95% CI: 0.74, 0.89), regardless of whether vitamin D was from the diet (OR: 0.81; 95% CI: 0.69, 0.96) or supplements (OR: 0.82; 95% CI: 0.73, 0.92). Adjustment for 12 potential confounders, including maternal intake of other dietary factors, did not change the results. CONCLUSION: In the northeastern United States, a higher maternal intake of vitamin D during pregnancy may decrease the risk of recurrent wheeze in early childhood.     

Dietary intake and use of dietary supplements in relation to demographic variables among pregnant Finnish women

Proper nutrition during pregnancy may be important for maternal health and fetal growth and development. In Finland, targeted recommendations are given to guide pregnant women in their food choice and dietary supplement use so that they may obtain adequate nutritional status and meet the increased need for nutrients. The aims of the present study were to examine food choices, nutrient intake and dietary supplement use of pregnant Finnish women in association with demographic variables. One thousand and seventy-five families were invited to a birth cohort study during 1998-9. Mothers of 797 newborns completed a validated 181-item food-frequency questionnaire from which the food and nutrient intakes were calculated. The information about supplement use was collected concerning the whole pregnancy. The results of the present study suggest that healthy food choices are rather common among pregnant Finnish women and the choices are positively correlated with age and education. Nutrient supplements were used by 85 % of the women. Supplements were favoured by the older and well-educated women and by those who had normal weight before pregnancy. Of the women in the present study, 31 % received vitamin A-containing supplements, although it is not recommended during pregnancy. Taking food and supplementation into account, the intake of vitamin D did not meet the dietary recommendation and folic acid intake was below recommendation in 44 % of the women. Therefore there seemed to be unnecessary nutrient supplementation and at the same time lack of relevant supplementation among these pregnant women.     

Validation of a dietary vitamin D questionnaire using multiple diet records and the block 98 health habits and history questionnaire in healthy postmenopausal women in northern California

Vitamin D deficiency is common in older women and can negatively impact bone status. A simple method by which clinicians and researchers can evaluate a patient's vitamin D dietary intake could help identify individuals at risk for vitamin D deficiency. This study was done to validate a short dietary vitamin D questionnaire. Postmenopausal women (n=122), with a mean age of 63.9 ± 7.8 years, completed a Brief Vitamin D Questionnaire (BVDQ), the Block Health History and Habits Questionnaire 1998 (BHHHQ98), a 3-day food record, and an evaluation of serum 25 hydroxyvitamin D (25[OH]D) levels. Data were analyzed using Pearson correlation coefficients, Wilcoxon signed ranks tests, and Bland-Altman analyses to compare the performance of the BVDQ to the BHHHQ98 and to the diet record. As assessed by the BVDQ, vitamin D intake averaged 178.7 ± 112.3 IU per day, correlating well with the Block HHHQ98 (r=0.51, P<0.001) and the 3-day food record (r=0.43, P<0.001). Compared with the food record, both the BVDQ and the BHHHQ98 overestimated dietary vitamin D intake by less than 100 IU/day. The two questionnaires performed nearly identically at all levels of vitamin D intake. Serum 25(OH)D was not related to vitamin D intake as measured by either the BVDQ or the BHHHQ98, but did correlate weakly with vitamin D intake from the 3-day diet record (r=0.20, P=0.04). The Brief Vitamin D Questionnaire correlated well with the longer and more intense dietary assessment methods, making it a simple and accurate instrument for assessing vitamin D intake.     

Vitamin D intakes of children differ by race/ethnicity,sex, age,and income in the United States, 2007 to 2010

The 2007-2010 National Health and Nutrition Examination Survey was used to estimate vitamin D intakes of children 1 to 18 years old in the United States by race/ethnicity, sex, age, and family using 24-hour dietary intake recalls and dietary supplement use questionnaires. We hypothesized that total, dietary, and supplemental vitamin D intakes of children would differ by race/ethnicity, sex, age, and income. Statistical analyses of weighted data were performed using Statistical Analysis Software (V 9.2) to estimate means ± SE. Race and ethnic intake differences controlling for poverty income ratio (PIR), sex, and age were assessed by analysis of covariance. Total (dietary and supplement) vitamin D intake was greater in the high (7.9 ± 0.3 μg/d) vs the medium (6.5 ± 0.3 μg/d) income group, but not the low (7.2 ± 0.2 μg/d) PIR group. Total vitamin D intake of non-Hispanic (NH) white children (8.1 ± 0.2 μg/d) was greater than Hispanic (7.0 ± 0.2 μg/d) and NH black (5.9 ± 0.2 μg/d) children. Total vitamin D intake declined with age, and intake by boys was higher than girls. Only 17.4% of the children consumed supplements containing vitamin D. Overall, mean intake of vitamin D by all children in each age and ethnic group was lower than the estimated average requirement for vitamin D. Public health efforts should encourage consumption of foods high in vitamin D, expand the number of foods fortified, and target health messages to parents to increase use of vitamin D supplements by children.     

Early Life Nutrition and the Role of Complementary Feeding on Later Adherence to the Mediterranean Diet in Children up to 3 Years of Age

The first years of life represent a window of opportunity to establish proper dietary patterns and to maintain them over time. Our aim was to describe the diet of a cohort of Spanish children, from 2 to 36 months, and to identify the components that could influence the quality of the diet at 24 and 36 months of age. This was a longitudinal prospective study analyzing information from administered questionnaires about general characteristics and food frequency consumption in 97 full-term babies. At 2–3 months of age, only 53.6% of infants were observed to be breastfed. The intake of animal foodstuffs from 12 to 36 months was higher than national recommendations, and the contrary was true for fruits and vegetables. The intake of vitamin D was below European Food Safety Authority recommendations. Moreover, energy intake at 6 months was inversely associated with Mediterranean Diet Score (MDS) at 24 months, whereas vegetables intake was positively associated with MDS at 36 months. These results could be useful in the creation of future guidelines focused on the promotion of breastfeeding and healthy early-life food habits.