Skip to main content
Top
Published in: BMC Pediatrics 1/2015

Open Access 01-12-2015 | Research article

Vitamin D status in Saudi school children based on knowledge

Authors: Yousef Al-Saleh, Nasser M Al-Daghri, Nasiruddin Khan, Hanan Alfawaz, Abdulaziz M Al-Othman, Majed S Alokail, George P Chrousos

Published in: BMC Pediatrics | Issue 1/2015

Login to get access

Abstract

Background

The prevalence of vitamin D deficiency in the kingdom of Saudi Arabia is rising unexpectedly in every age group. Apart from several risk factors, the lack of awareness is posing a serious threat for low vitamin D levels in children as well. The aim of our study was to compare the knowledge and status of vitamin D in Saudi school children.

Methods

Saudi students, 1188 boys (15.1 ± 2.2 years) and 1038 girls (15.1 ± 2.0 years), were recruited and a pre-designed questionnaire with regards to knowledge about vitamin D was administered. Blood samples were collected and serum 25hydroxyvitamin D (25(OH)D was measured.

Results

A significantly higher percentage of boys answered correctly than girls regarding knowledge questions as sun exposure (p = 0.002, and 0.011), breastfeeding (p < 0.001) and diseases (p < 0.001). The percentage of girls was significantly higher who thought that fruits and vegetables are not rich sources of vitamin D (24.7% girls vs. 15.4% boys; p < 0.001and 29.6% girls vs. 20.9% boys p < 0.001), respectively. Boys had a higher prevalence and frequency of sun exposure than girls (p < 0.001 for both). Girls showed a significantly higher percentage of sunscreen use and full covering during sun exposure (p = 0.001 for both).Vitamin D deficiency was significantly higher in girls than boys (47.0% versus 19.4.0%; p < 0.001). Vitamin D status in boys was significantly higher than girls (p < 0.001). In girls, those who answered correctly about vitamin D related disease (p = 0.03) and sources (p = 0.015), demonstrated significantly higher vitamin D levels.

Conclusions

The awareness of vitamin D and sunlight in children needs to be improved by provision of trained physicians and school teachers. Creating more areas where girls can uncover freely during routine works and outdoor activities will help increase their vitamin D levels.
Literature
1.
go back to reference Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMed Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMed
2.
go back to reference Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr. 2003;142:169–73.CrossRefPubMed Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr. 2003;142:169–73.CrossRefPubMed
3.
go back to reference Kamycheva E, Joakimsen RM, Jorde R. Intakes of calcium and vitamin d predict body mass index in the population of Northern Norway. J Nutr. 2003;133:102–6.PubMed Kamycheva E, Joakimsen RM, Jorde R. Intakes of calcium and vitamin d predict body mass index in the population of Northern Norway. J Nutr. 2003;133:102–6.PubMed
4.
go back to reference Ye WZ, Reis AF, Dubois-Laforgue D, Bellanne-Chantelot C, Timsit J, Velho G. Vitamin D receptor gene polymorphisms are associated with obesity in type 2 diabetic subjects with early age of onset. Eur J Endocrinol. 2001;145:181–6.CrossRefPubMed Ye WZ, Reis AF, Dubois-Laforgue D, Bellanne-Chantelot C, Timsit J, Velho G. Vitamin D receptor gene polymorphisms are associated with obesity in type 2 diabetic subjects with early age of onset. Eur J Endocrinol. 2001;145:181–6.CrossRefPubMed
5.
go back to reference Hirani V, Mosdol A, Mishra G. Predictors of 25-hydroxyvitamin D status among adults in two British national surveys. Br J Nutr. 2009;101:760–4.CrossRefPubMed Hirani V, Mosdol A, Mishra G. Predictors of 25-hydroxyvitamin D status among adults in two British national surveys. Br J Nutr. 2009;101:760–4.CrossRefPubMed
6.
go back to reference Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006;98:451–9.CrossRefPubMed Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006;98:451–9.CrossRefPubMed
7.
go back to reference Kumar S, Mahajan G, Kumar N. Prevalence of vitamin D deficiency in apparently healthy children in north India. J Pediatr Endocrinol Metabol. 2014;27:1151–6.CrossRef Kumar S, Mahajan G, Kumar N. Prevalence of vitamin D deficiency in apparently healthy children in north India. J Pediatr Endocrinol Metabol. 2014;27:1151–6.CrossRef
8.
go back to reference Al-Daghri NM, Al-Attas OS, Al-Okail MS, Alkharfy KM, Al-Yousef MA, Nadhrah HM, et al. Severe hypovitaminosis D is widespread and more common in non-diabetics than diabetics in Saudi adults. Saudi Med J. 2010;31:775–80.PubMed Al-Daghri NM, Al-Attas OS, Al-Okail MS, Alkharfy KM, Al-Yousef MA, Nadhrah HM, et al. Severe hypovitaminosis D is widespread and more common in non-diabetics than diabetics in Saudi adults. Saudi Med J. 2010;31:775–80.PubMed
9.
go back to reference Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Nadhrah HM, et al. Hypovitaminosis D and cardiometabolic risk factors among non-obese youth. Cent Eur J Med. 2010;5:752–7. Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Nadhrah HM, et al. Hypovitaminosis D and cardiometabolic risk factors among non-obese youth. Cent Eur J Med. 2010;5:752–7.
10.
go back to reference Elsammak MY, Al-Wosaibi AA, Al-Howeish A, Alsaeed J. Vitamin d deficiency in Saudi Arabs. Horm Metab Res. 2010;42:364–8.CrossRefPubMed Elsammak MY, Al-Wosaibi AA, Al-Howeish A, Alsaeed J. Vitamin d deficiency in Saudi Arabs. Horm Metab Res. 2010;42:364–8.CrossRefPubMed
11.
go back to reference Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M, et al. Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocrinol (Oxf). 2012;76:346–50.CrossRef Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M, et al. Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocrinol (Oxf). 2012;76:346–50.CrossRef
12.
go back to reference Al-Othman A, Al-Musharaf S, Al-Daghri NM, Krishnaswamy S, Yusuf DS, Alkharfy KM, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC Pediatr. 2012;12:92.CrossRefPubMedPubMedCentral Al-Othman A, Al-Musharaf S, Al-Daghri NM, Krishnaswamy S, Yusuf DS, Alkharfy KM, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC Pediatr. 2012;12:92.CrossRefPubMedPubMedCentral
13.
go back to reference Janda M, Youl P, Bolz K, Niland C, Kimlin M. Knowledge about health benefits of vitamin D in Queensland Australia. Prev Med. 2010;50:215–6.CrossRefPubMed Janda M, Youl P, Bolz K, Niland C, Kimlin M. Knowledge about health benefits of vitamin D in Queensland Australia. Prev Med. 2010;50:215–6.CrossRefPubMed
14.
go back to reference Christie FT, Mason L. Knowledge, attitude and practice regarding vitamin D deficiency among female students in Saudi Arabia: a qualitative exploration. Int J Rheum Dis. 2011;14:e22–9.CrossRefPubMed Christie FT, Mason L. Knowledge, attitude and practice regarding vitamin D deficiency among female students in Saudi Arabia: a qualitative exploration. Int J Rheum Dis. 2011;14:e22–9.CrossRefPubMed
15.
go back to reference Siddiqui AM, Kamfar HZ. Prevalence of vitamin D deficiency rickets in adolescent school girls in Western region, Saudi Arabia. Saudi Med J. 2007;28:441–4.PubMed Siddiqui AM, Kamfar HZ. Prevalence of vitamin D deficiency rickets in adolescent school girls in Western region, Saudi Arabia. Saudi Med J. 2007;28:441–4.PubMed
16.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.CrossRefPubMedPubMedCentral
17.
go back to reference Heywood P, Wootten SA. Nutritional knowledge and attitudes towards nutrition education in medical students at Southampton University Medical School. Proc Nutr Soc. 1992;51:67A. Heywood P, Wootten SA. Nutritional knowledge and attitudes towards nutrition education in medical students at Southampton University Medical School. Proc Nutr Soc. 1992;51:67A.
18.
19.
go back to reference Beshyah SA, Mehri WA, Khalil AB. Osteoporosis and its management: knowledge, attitudes and practices of Physicians in United Arab Emirates. Ibnosina J Med Biomed Sci. 2013;5:270–9. Beshyah SA, Mehri WA, Khalil AB. Osteoporosis and its management: knowledge, attitudes and practices of Physicians in United Arab Emirates. Ibnosina J Med Biomed Sci. 2013;5:270–9.
20.
go back to reference Daradkeh GAF, Bader KA, Singh R. The nutrition knowledge of primary care physicians in the state of Qatar. Pak J Nutr. 2012;11:781–5.CrossRef Daradkeh GAF, Bader KA, Singh R. The nutrition knowledge of primary care physicians in the state of Qatar. Pak J Nutr. 2012;11:781–5.CrossRef
21.
go back to reference Kung AWC, Lee K. Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong. BioMed Central Public Health. 2006;6:226.CrossRefPubMedPubMedCentral Kung AWC, Lee K. Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong. BioMed Central Public Health. 2006;6:226.CrossRefPubMedPubMedCentral
22.
go back to reference Vu LH, van der Pols JC, Whiteman DC, Kimlin MG, Neale RE. Knowledge and attitudes about vitamin D and impact on sun protection practices among urban office workers in Brisbane, Australia. Cancer Epidemiol Biomarkers Prev. 2010;19:1784–9.CrossRefPubMed Vu LH, van der Pols JC, Whiteman DC, Kimlin MG, Neale RE. Knowledge and attitudes about vitamin D and impact on sun protection practices among urban office workers in Brisbane, Australia. Cancer Epidemiol Biomarkers Prev. 2010;19:1784–9.CrossRefPubMed
23.
go back to reference Khalsa K. The vitamin D revolution, How the power of this amazing vitamin Can change your life. New York: Hay House Inc.; 2009. Khalsa K. The vitamin D revolution, How the power of this amazing vitamin Can change your life. New York: Hay House Inc.; 2009.
24.
go back to reference Al-Numair KS. Nutrition knowledge of primary care physicians in Saudi Arabia. Pak J Nutr. 2004;3:344–7.CrossRef Al-Numair KS. Nutrition knowledge of primary care physicians in Saudi Arabia. Pak J Nutr. 2004;3:344–7.CrossRef
25.
go back to reference Al-Zahrani AM, Al-Raddadi RM. Nutritional knowledge of primary health care physicians in Jeddah, Saudi Arabia. Saudi Med J. 2009;30:284–7.PubMed Al-Zahrani AM, Al-Raddadi RM. Nutritional knowledge of primary health care physicians in Jeddah, Saudi Arabia. Saudi Med J. 2009;30:284–7.PubMed
26.
27.
go back to reference Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med. 2000;247:260–8.CrossRefPubMed Glerup H, Mikkelsen K, Poulsen L, Hass E, Overbeck S, Thomsen J, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med. 2000;247:260–8.CrossRefPubMed
28.
go back to reference Fuleihan G. Vitamin D deficiency in the Middle East and its health consequences for children and adults. Clinic Rev Bone Miner Metab. 2009;7:77–93.CrossRef Fuleihan G. Vitamin D deficiency in the Middle East and its health consequences for children and adults. Clinic Rev Bone Miner Metab. 2009;7:77–93.CrossRef
30.
go back to reference Holick M. The vitamin D epidemic and its health consequences. J Nutr. 2005;35:2739S–48. Holick M. The vitamin D epidemic and its health consequences. J Nutr. 2005;35:2739S–48.
31.
go back to reference Kensarah OA, Azzeh FS. Vitamin D status of healthy school children from western Saudi Arabia. Pak J Nutr. 2012;3:288. Kensarah OA, Azzeh FS. Vitamin D status of healthy school children from western Saudi Arabia. Pak J Nutr. 2012;3:288.
32.
go back to reference Holick M. Sunlight “D” ilemma: risk of cancer or bone disease and muscle weakness. Lancet. 2001;357:4–6.CrossRefPubMed Holick M. Sunlight “D” ilemma: risk of cancer or bone disease and muscle weakness. Lancet. 2001;357:4–6.CrossRefPubMed
33.
go back to reference Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back Pain in Saudi Arabia. Spine. 2003;28:177–9.CrossRefPubMed Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back Pain in Saudi Arabia. Spine. 2003;28:177–9.CrossRefPubMed
34.
go back to reference Hobbs RD, Habib Z, Alromaihi D, Idi L, Parikh N, Blocki F, et al. Severe vitamin D deficiency in Arab-American women living in Dearborn. Mich Endocr Pract. 2009;15:35–40.CrossRef Hobbs RD, Habib Z, Alromaihi D, Idi L, Parikh N, Blocki F, et al. Severe vitamin D deficiency in Arab-American women living in Dearborn. Mich Endocr Pract. 2009;15:35–40.CrossRef
35.
go back to reference Sedrani SH, Elidrissy AW, El Arabi KM. Sunlight and vitamin D status in normal Saudi subjects. Am J Clin Nutr. 1983;38:129–32.PubMed Sedrani SH, Elidrissy AW, El Arabi KM. Sunlight and vitamin D status in normal Saudi subjects. Am J Clin Nutr. 1983;38:129–32.PubMed
36.
go back to reference Islam MZ, Akhtaruzzaman M. Hypovitaminosis D is common in both veild and nonveild Bangladeshi women. Asia Pac Clin Nut. 2006;15:81–7. Islam MZ, Akhtaruzzaman M. Hypovitaminosis D is common in both veild and nonveild Bangladeshi women. Asia Pac Clin Nut. 2006;15:81–7.
Metadata
Title
Vitamin D status in Saudi school children based on knowledge
Authors
Yousef Al-Saleh
Nasser M Al-Daghri
Nasiruddin Khan
Hanan Alfawaz
Abdulaziz M Al-Othman
Majed S Alokail
George P Chrousos
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2015
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-015-0369-9

Other articles of this Issue 1/2015

BMC Pediatrics 1/2015 Go to the issue