Vitamin D Status for Chinese Children and Adolescents in CNNHS 2016–2017

Vitamin D is very important in maintaining children’s bone health because of its regulatory role in calcium and phosphate metabolism. To better understand vitamin D status and related risk factors of children and adolescents in China, this study analyzed the 25-hydroxyvitamin-D (25(OH)D) concentration of children and adolescents aged 6–17 years in China and assessed the risk factors of vitamin D deficiency and insufficiency. We analyzed the data of 25(OH)D concentration collected from the China National Nutrition and Health Survey of Children and Lactating Mothers in 2016–2017 (CNNHS 2016–2017). The age, sex, region type, ethnicities, season, weight and height were recorded, measured by unified questionnaire, equipment and standards. The concentration of 25(OH)D was detected by LC-MS/MS. A total of 64,391 participants from the cross-sectional study of CNNHS in 2016–2017 were included in this study. The median serum 25(OH)D concentration was 17.70 (13.20–22.68) ng/mL, 18.70 (14.10–23.80) ng/mL in boys and 16.60 (12.40–21.40) ng/mL in girls. The total prevalence rate of vitamin D deficiency and insufficiency was 65.98% when the cut-off was 20 ng/mL, 60.42% for boys and 71.99% for girls. According to the results of logistic regression analysis, girls aged above 12 y, living in midlands and northern regions, in spring and winter seasons and with abdominal obesity will have a significantly increased risk of vitamin D deficiency and insufficiency among Chinese children and adolescents. The results showed that vitamin D deficiency and insufficiency are very common among children and adolescents aged 6–17 y in China. They should be encouraged to have more effective sunlight exposure, increased intake of vitamin D from food or supplements in their diet, especially for those aged above 12 y, living in the northern or midlands areas, in spring and winter, and abdominally obese.     

Correlation between Serum 25-Hydroxyvitamin D Level and Peripheral Arterial Stiffness in Chronic Kidney Disease Stage 3–5 Patients

Vitamin D deficiency and high brachial-ankle pulse wave velocity (baPWV) are each independently associated with higher incidence of mortality and cardiovascular (CV) disease or CV events, respectively. This study aimed to evaluate the relationship between serum 25-hydroxyvitamin D levels and baPWV in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). We enrolled 180 CKD patients. A commercial enzyme-linked immunosorbent assay was used to measure 25-hydroxyvitamin D levels. BaPWV values were measured using an automatic pulse wave analyzer. Either left or right baPWV > 18.0 m/s was considered indicative of peripheral arterial stiffness (PAS). In this study, 73 (40.6%) patients were found to have PAS. Compared to those without PAS (control group), patients with PAS were older and had higher incidence of diabetes mellitus, higher systolic and diastolic blood pressure, higher levels of intact parathyroid hormone, and C-reactive protein, and lower levels of 25-hydroxyvitamin D. Multivariate logistic regression analysis found 25-hydroxyvitamin D levels (odds ratio [OR]: 0.895, 95% confidence interval [CI] 0.828–0.968, p = 0.005) and old age (OR: 1.140, 95% CI 1.088–1.194, p < 0.001) to be independently associated with PAS in patients with stage 3–5 CKD. Lower serum 25-hydroxyvitamin D levels and older age were associated with PAS in these patients.     

江苏省0~5岁儿童维生素D营养状况研究

目的 了解江苏省0~5岁儿童维生素D营养状况,分析年龄、性别、出生情况、地区、季节和户籍的儿童维生素D营养状况。方法 本研究首次进行了多中心大样本的抽样调查,于2014年4月-2015年3月采用分层整群随机抽样方法从江苏省的10个城市招募0~5岁的儿童。采用自行设计的问卷调查儿童一般健康状况,采用酶联免疫法检测血清25-羟维生素D[(25-(OH)D)]含量。结果 本次研究共调查5 289名儿童。0~5岁儿童维生素D缺乏率为30.1%,不足率为35.5%。0~、12~、24~、36~、48~、60~<72月龄儿童维生素D缺乏率分别为23.0%,21.3%、27.8%、32.4%、37.9%、39.7%;维生素D不足率分别为26.9%、34.4%、36.5%、38.6%、39.6%、38.4%。0~5岁儿童25-(OH)D平均水平M(P₂₅~ P₇₅)为64.0 (46.3~83.0) nmol/ml。女童维生素D缺乏率(32.1% )显著高于男童(28.3%)(Z＝8.709,P=0.003),女童25-(OH)D平均水平(62.7 nmol/ml)显著低于男童(65.1 nmol/ml)(Z＝9.453,P＝0.002)。2~5岁儿童、女童,第一胎,第一产,在春冬季调查,在苏南地区、苏中地区和苏北地区的儿童患维生素D缺乏的风险增加(P<0.05)。结论 江苏省0~5岁儿童普遍处于维生素D缺乏状态,尤其学龄前儿童是防治维生素D缺乏关键人群。维生素D状况与年龄、性别、胎次、产次、出生体重、季节、城乡户籍和地区相关,与胎龄、分娩方式无关。     

江苏省0~5岁儿童维生素D营养状况研究

目的 了解江苏省0~5岁儿童维生素D营养状况,分析年龄、性别、出生情况、地区、季节和户籍的儿童维生素D营养状况。方法 本研究首次进行了多中心大样本的抽样调查,于2014年4月-2015年3月采用分层整群随机抽样方法从江苏省的10个城市招募0~5岁的儿童。采用自行设计的问卷调查儿童一般健康状况,采用酶联免疫法检测血清25-羟维生素D[(25-(OH)D)]含量。结果 本次研究共调查5 289名儿童。0~5岁儿童维生素D缺乏率为30.1%,不足率为35.5%。0~、12~、24~、36~、48~、60~<72月龄儿童维生素D缺乏率分别为23.0%,21.3%、27.8%、32.4%、37.9%、39.7%;维生素D不足率分别为26.9%、34.4%、36.5%、38.6%、39.6%、38.4%。0~5岁儿童25-(OH)D平均水平M(P₂₅~ P₇₅)为64.0 (46.3~83.0) nmol/ml。女童维生素D缺乏率(32.1% )显著高于男童(28.3%)(Z＝8.709,P=0.003),女童25-(OH)D平均水平(62.7 nmol/ml)显著低于男童(65.1 nmol/ml)(Z＝9.453,P＝0.002)。2~5岁儿童、女童,第一胎,第一产,在春冬季调查,在苏南地区、苏中地区和苏北地区的儿童患维生素D缺乏的风险增加(P<0.05)。结论 江苏省0~5岁儿童普遍处于维生素D缺乏状态,尤其学龄前儿童是防治维生素D缺乏关键人群。维生素D状况与年龄、性别、胎次、产次、出生体重、季节、城乡户籍和地区相关,与胎龄、分娩方式无关。     

Association between Vitamin D Receptor Polymorphism and Serum Vitamin D Levels in Children with Low-Energy Fractures

Objective: Fractures of bones, especially forearm fractures, are very common in children and their number is increasing. This study was designed to determine the impact of vitamin D serum levels and vitamin D receptor (VDR) polymorphisms on the occurrence of low-energy fractures in children.

Methods: The study group consisted of 100 children with clinically relevant bone fractures and a control group consisted of 127 children without fractures. Total vitamin D [25(OH)D3 plus 25(OH)D2] serum concentrations were evaluated in every patient. Genotypes for 4 restriction fragment length polymorphisms of the vitamin D receptor gene (FokI, ApaI, TaqI, and BsmI) were determined by standard polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) techniques.

Results: Differences in concentrations of vitamin D were observed between the group with bone fractures (median = 12 ng/ml) and the control group (median = 16 ng/ml; p = 0.000044).

Higher levels of vitamin D reduced the risk of fracture by 1.06 times (p = 0.0005). No impact of particular VDR polymorphism on the occurrence of low-energy fractures in children was detected. However, there were significant differences in the prevalence of FokI polymorphism genotypes between the fracture and control groups (p = 0.05). Furthermore, the recessive “aa” genotype of ApaI polymorphism and the dominant “TT” genotype of TaqI polymorphism were associated with higher levels of vitamin D (p = 0.005 and p = 0.036, respectively).

Conclusions: Vitamin D deficiency is an independent risk factor for fractures in children. ApaI polymorphism recessive “aa” and TaqI polymorphism dominant “TT” genotypes are associated with higher levels of vitamin D in serum.     

Relationship between Serum 25-Hydroxyvitamin D Level and Risk of Recurrent Stroke

Evidence for the association between vitamin D and risk of recurrent stroke remains sparse and limited. We aimed to assess the relationship between serum circulating 25-hydroxyvitamin D (25(OH)D) level and risk of recurrent stroke in patients with a stroke history, and to identify the optimal 25(OH)D level in relation to lowest recurrent stroke risk. Data from the nationwide prospective United Kingdom Biobank were used for analyses. Primary outcome was time to first stroke recurrence requiring a hospital visit during follow-up. We used Cox proportional hazards regression model with restricted cubic splines to explore 25(OH)D level in relation to recurrent stroke. The dose-response relationship between 25(OH)D and recurrent stroke risk was also estimated, taking the level of 10 nmol/L as reference. A total of 6824 participants (mean age: 60.6 years, 40.8% females) with a baseline stroke were included for analyses. There were 388 (5.7%) recurrent stroke events documented during a mean follow-up of 7.6 years. Using Cox proportional hazards regression model with restricted cubic splines, a quasi J-shaped relationship between 25(OH)D and risk of recurrent stroke was found, where the lowest recurrent stroke risk lay at the 25(OH)D level of approximate 60 nmol/L. When compared with 10 nmol/L, a 25(OH)D level of 60 nmol/L was related with a 48% reduction in the recurrent stroke risk (hazard ratio = 0.52, 95% confidence interval: 0.33–0.83). Based on data from a large-scale prospective cohort, we found a quasi J-shaped relationship between 25(OH)D and risk of recurrent stroke in patients with a stroke history. Given a lack of exploring the cause–effect relationship in this observational study, more high-quality evidence is needed to further clarify the vitamin D status in relation to recurrent stroke risk.     

Comparison of Vitamin D and 25-Hydroxyvitamin D Concentrations in Human Breast Milk between 1989 and 2016–2017

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D₃ concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

Relationship between Dietary Creatine and Growth Indicators in Children and Adolescents Aged 2–19 Years: A Cross-Sectional Study

A possible role of dietary creatine for ensuring proper growth and development remains unknown. The main aim of this cross-sectional study was to quantify the amount of creatine consumed through regular diet among U.S. children and adolescents aged 2 to 19 years and investigate the relationship between creatine intake and growth indicators, using data from the 2001–2002 National Health and Nutrition Examination Survey (NHANES). We included data for NHANES 2001–2002 respondents (4291 participants, 2133 boys and 2158 girls) aged 2 to 19 years at the time of screening, who provided valid dietary information and examination measures (standing height and weight). Individual values for total grams of creatine consumed per day for each participant were computed using the average amount of creatine (3.88 g/kg) across all sources of meat-based foods. All participants were categorized for height-for-age and BMI-for-age categories. The average daily intake of creatine across the whole sample was 1.07 ± 1.07 g (95% CI, from 1.04 to 1.10). Height, weight, and BMI were significantly different across creatine quartiles (p < 0.001), with all measures significantly higher in the 4th quartile of creatine intake (≥1.5 g/day) than those in other quartiles (p < 0.05). The participants from the 3rd quartile of creatine intake (0.84–1.49 g/day) were significantly different from others with respect to having lower rates of normal stature and higher rates of tall stature (p < 0.05). Each additional 0.1 g of creatine consumed per day increases height by 0.60 cm (simple model) or 0.30 cm (adjusted model). The daily intake of creatine from a regular diet in taller children and adolescents was higher than in shorter peers aged 2–19 years. Future research has to monitor temporal changes in growth and dietary creatine and validate our findings in interventional studies across pediatric populations.     

Self-Reported Sedentary Behavior and Metabolic Syndrome among Children Aged 6–14 Years in Beijing,China

(1) Objective: This study aimed to examine the prevalence of metabolic syndrome (MetS) in children aged 6–14 years in Beijing, and to determine whether sedentary behavior is a risk factor. (2) Methods: Using a multistage stratified cluster random sampling method, 3460 students were selected for the Nutrition and Health Surveillance in Schoolchildren of Beijing (NHSSB). Data on children’s sedentary behavior time and MetS indicators were collected using the questionnaires, physical measurements, and laboratory tests. MetS was defined according to the CHN2012 criteria, and logistic regression analysis was used to compare the effects of different sedentary time on MetS and its components. (3) Results: The overall prevalence of MetS among children aged 6–14 in Beijing was 2.4%, and boys, suburban children, and older age were associated with a higher prevalence (χ² values were 3.947, 9.982, and 27.463, respectively; p < 0.05). In boys, the prevalence rates of abdominal obesity, hyperglycemia, high triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C) were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05); and in girls, the prevalence rates of high TG, low HDL-C, and MetS were higher in the high-level sedentary behavior group than those in the low-level sedentary behavior group (p < 0.05). After adjusting for confounding factors, the multivariate logistic regression results showed that compared with children with low-level sedentary behavior, the risks of abdominal obesity and low HDL-C were higher in boys with high-level sedentary behavior (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.10–2.07, p = 0.011; OR 2.25, 95% CI 1.06–4.76, p = 0.034, respectively); while the risk of abdominal obesity was higher in girls with medium and high-level sedentary behavior (OR 1.52, 95% CI 1.01–2.27, p = 0.043; OR 1.59, 95% CI 1.04–2.43, p = 0.032, respectively). (4) Conclusions: Higher sedentary behavior time was related to the higher risk of MetS components among children aged 6–14 in Beijing. Reducing sedentary behavior may be an important method for preventing metabolic diseases.     

Vitamin D Nutritional Status of Chinese Pregnant Women,Comparing the Chinese National Nutrition Surveillance (CNHS) 2015–2017 with CNHS 2010–2012

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015–2017, analyze the risk factors of vitamin D deficiency (VDD), and compare them with those in CNHS 2010–2012. Serum 25 hydroxyvitamin D (25(OH)D) was measured by ELISA method. City type, district, latitude, location, age, vitamin D supplements intake, education, marital status, annual family income, etc., were recorded. The median 25(OH)D concentration was 13.02 (10.17–17.01) ng/mL in 2015–2017, and 15.48 (11.89–20.09) ng/mL in 2010–2012. The vitamin D sufficient rate was only 12.57% in 2015–2017, comparing to 25.17% in 2010–2012. The risk factors of vitamin D inadequacy (25(OH)D < 20 ng/mL) in 2015–2017 were not exactly consistent with that in 2010–2012. The risk factors included season of spring (p < 0.0001) and winter (p < 0.001), subtropical (p < 0.001), median (p < 0.0001) and warm temperate zones (p < 0.0001), the western (p = 0.027) and the central areas (p = 0.041), while vitD supplements intake (p = 0.021) was a protective factor in pregnant women. In conclusion, vitD inadequacy is very common among Chinese pregnant women. We encourage pregnant women to take more effective sunlight and proper vitD supplements, especially for those from the subtropical, warm and medium temperate zones, the western and the central, and in the seasons of spring and winter.     

Sugar-Sweetened Beverage Consumption Status and Its Association with Childhood Obesity among Chinese Children Aged 6–17 Years

Objective: There is a remarkable growth in sugar-sweetened (SSB) production and obesity prevalence among school-aged children in China. This paper describes SSB consumption and its association with obesity among Chinese children aged 6–17 years in 2012. Methods: in total, 25,553 children aged 6~17 years enrolled in the China Nutrition and Health Surveillance 2010–2013 were included in this study. Data of SSB consumption frequency and quantity were obtained from a food frequency questionnaire, and the children’s nutritional status was assessed. Multivariate logistic regression was used to evaluate the association between SSB consumption and obesity status. Results: SSB intake was estimated as 181.0 g/day, occurring 2.2 times/week. Older children, males, children from urban areas, and children with higher socioeconomic status were more likely to consume SSBs. Children who consumed SSBs 1~<5 times/week (11.7%) and >5 times/week (12.9%) were more likely to be overweight/obesity than those who consumed SSBs less than once/week. Conclusion: SSB consumption was common among Chinese school-aged children, especially among males, older children, and children from urban areas. High consumption of SSBs was associated with a higher prevalence of overweight/obesity. Actions and plans are required to reduce SSB consumption and control childhood obesity in China.     

泰州市儿童血清25羟维生素D水平分析

目的 通过对泰州地区部分儿童血清25羟维生素D检测,了解健康儿童25羟维生素D水平,为佝偻病防治提供依据。方法 选取2013年10月-2014年9月儿保门诊儿童共476 例。取清晨空腹血,采用串联质谱法检测其血清25羟维生素D水平。结果 泰州市儿童各年龄组血清25羟维生素D水平均呈偏态分布,以中位数表示,分别为婴儿组、幼儿组、学龄前期组、学龄组。经秩和检验,不同年龄组维生素D水平差异有统计学意义(P<0.05)。各年龄组维生素D水平男女性别差异无统计学意义(P>0.05)。476例儿童中, 维生素D严重缺乏(≤5 ng/ml)占3.15%(15/476); 缺乏(≤15 ng/ml) 占38.45%(183/476);不足或以下(15～20 ng/ml)占17.86% (85/476);充足(>20 ng/ml)占40.55%(193/467) ;过量(>100 ng/ml)为0。维生素D不足(≤20 ng/ml) 的儿童占59.45% (283/476),其中婴儿组为9.3% (8/476);幼儿组为36.21%(42/467);学龄前组为70.13%(54/567 );学龄期组为90.86%(179/476),以学龄期儿童为主,各组间差异有统计学意义(P<0.05)。不同季节血清维生素D值差异有统计学意义(P<0.05)。结论 泰州市儿童维生素D水平随年龄增长而下降,学龄儿童维生素D缺乏尤为严重,3岁以上儿童需注意补充维生素D,尤其是冬季。     

Serum Levels of Vitamin D and Dental Caries in 7-Year-Old Children in Porto Metropolitan Area

Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (<30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children’s demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d_1–6mft/D_1–6MFT > 0), and advanced caries (d_3–6mft/D_3–6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children’s vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ≤7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.     

Association of Milk Consumption and Vitamin D Status in the US Population by Ethnicity: NHANES 2001–2010 Analysis

Vitamin D has been identified as a nutrient of public health concern, and higher intake of natural or fortified food sources of vitamin D, such as milk, are encouraged by the 2015–2020 Dietary Guidelines for Americans. We, therefore, examined the association of milk consumption and vitamin D status in the United States (US) population. Twenty-four-hour dietary recall data and serum 25(OH)D concentrations were obtained from the National Health and Nutrition Examination Survey 2001–2010 and were analyzed by linear and logistic regression after adjusting for anthropometric and demographic variables. Significance was set at p < 0.05. Approximately 57–80% children and 42–60% adults were milk consumers. Milk intake (especially reduced-fat, low fat and no-fat milk) was positively associated (p _{linear trend} < 0.05) with serum vitamin D status and with a 31–42% higher probability of meeting recommended serum vitamin D (>50 nmol/L) levels among all age groups. Serum vitamin D status was also associated with both type and amount of milk intake depending upon the age and ethnicity. In conclusion, the results indicate that milk consumers consistently have higher serum vitamin D levels and higher probability of meeting recommended levels. Therefore, increasing milk intake may be an effective strategy to improve the vitamin D status of the US population.     

Temporal Association of Reduced Serum Vitamin D with COVID-19 Infection: Two Single-Institution Case–Control Studies

(1) Background: Vitamin D supplementation has been proposed for the prevention and treatment of COVID-19, but it is not clear if reduced serum vitamin D predisposes individuals to COVID-19 and/or is a secondary consequence of infection. This study assessed the temporal association between serum vitamin D and COVID-19 with two single-institution case–control studies through the University of California San Diego (UCSD) Health System. (2) Methods: This study included patients who tested positive for COVID-19 from 1 January to 30 September 2020 with serum 25-hydroxy-vitamin D (25(OH)D) measured within 180 days of diagnosis. Patients were separated based on whether 25(OH)D was measured before (n = 107 cases, 214 controls) or after (n = 203 cases, 406 controls) COVID-19 diagnosis. COVID-19 infection status was the outcome variable in the pre-diagnosis study, whereas serum 25(OH)D level was the outcome variable in the post-diagnosis study. (3) Results: Serum 25(OH)D levels were not associated with the odds of subsequent COVID-19 infection (OR 1.0, 95% CI: 1.0 to 1.0, p = 0.98). However, COVID-19-positive individuals had serum 25(OH)D measurements that were 2.7 ng/mL lower than the controls (95% CI: −5.2 to −0.2, p = 0.03). (4) Conclusions: In our study population, serum 25(OH)D levels were not associated with the risk of acquiring COVID-19 infection but were reduced in subjects after COVID-19 infection. These results support the possibility that reduced serum 25(OH)D is a consequence and not a cause of COVID-19 infection.     

Breakfast Frequency and Composition in a Group of Polish Children Aged 7–10 Years

Breakfast is considered one of the crucial elements of a healthy diet. Most studies evaluate breakfast consumption with the risk of obesity and other health effects. Less attention is paid to the evaluation of breakfast composition and patterns. Thus, this study aimed to describe the most frequently observed breakfast patterns and to assess breakfast composition and quality in a group of Polish early school-age children. The cross-sectional survey study was conducted in school years 2017/2018 and 2018/2019. Information regarding breakfast was obtained with the use of an original paper-based weekly observation diary, and breakfast quality was assessed with a special scoring designed to be used together with the diary. In total, 223 schoolchildren of the second and third grades participated in the study, and 200 diaries were analyzed. More than ¾ of the participants consumed breakfast every day. Nearly 68% of meals were classified as well balanced, but only 16.5% of children eat a well-balanced breakfast every day. The number of children who usually (≥5 times per week) eat a sandwich for breakfast was 94 (47%), and that of those who habitually eat cereal and milk or porridge was 29 (14.5%). Only 7% of children consumed fruit or vegetables for breakfast daily, and 26.5% never eat fruit or vegetables for breakfast. Concluding, most children eat breakfast regularly, but the meal composition and quality might be improved.     

武汉地区城乡3岁以下儿童血清维生素A水平调查

<正> 儿童维生素A缺乏症是世界上四大营养缺乏病之一。一些资料表明儿童每日膳食中维生素A的摄入量未达到供给量标准。维生素A的长期摄入不足,势必造成体内的缺乏。国内关于维生素A营养状况的评价多采用膳食调查结果,为确切了解儿童维生素A的营养状况,我们于1987年3月对武汉市区及郊县农村3岁以下儿童血清维生素A水平进行了调查。 对象与方法 1.实验对象 从武汉市武昌区三个工厂托儿所抽取6月～3岁儿童260人,其家庭每人月平均收入在武汉市属中等经济水平。另从经济水平相似的汉川县近郊2个自然村抽取235名同龄儿童。