Vitamin D Status of People 3 to 79 Years of Age from the Canadian Health Measures Survey 2012–2019
Hope A. Weiler, Kurtis Sarafin, Chantal Martineau, Janice Daoust, Krista A. Esslinger, Linda S. Greene-Finestone, Lidia Loukine, Veronique Dorais
Abstract
Vitamin D is recognized in bone health and the prevention of rickets and osteomalacia. This study aimed to assess vitamin D status of people in Canada and to identify factors associated with vitamin D inadequacy and deficiency. Serum 25-hydroxyvitamin D (25(OH)D) from the Canadian Health Measures Survey (cycles 3–6, n = 21,770, 3–79 y) were evaluated for geometric means and proportions <40 (inadequate) and <30 (risk of deficiency) nmol/L. Factors associated with inadequacy or deficiency were tested using logistic regression. Mean serum 25(OH)D was 57.9 (95% CI: 55.4, 60.5) nmol/L; the prevalence of inadequacy was 19.0% (95% CI: 15.7, 22.3) and risk of deficiency was 8.4% (95% CI: 6.5, 10.3). Prominent dietary factors associated with inadequacy in adults included: not consuming fish compared with ≥1/wk (adjusted OR adj : 1.60; 95% CI: 1.21, 2.11), none compared with ≥1/d for cow’s milk (OR adj : 1.41; 95% CI: 1.02, 1.94) or margarine (OR adj : 1.42; 95% CI: 1.08, 1.88); or nonuser compared with user of vitamin D supplements (OR adj : 5.21; 95% CI: 3.88, 7.01). Notable demographic factors included: younger adults compared with 71 to 79 y (19–30 y OR adj : 2.33; 95% CI: 1.66, 3.29); BMI ≥30 compared with <25 kg/m 2 (OR adj : 2.30; 95% CI: 1.79, 2.95); lower household income quartile 1 compared with 4 (OR adj : 1.46; 95% CI: 1.00, 2.15); and self-reported Black (OR adj : 8.06; 95% CI: 4.71, 13.81), East/Southeast Asian (OR adj : 3.83; 95% CI: 2.14, 6.85), Middle Eastern (OR adj : 4.57; 95% CI: 3.02, 6.92), and South Asian (OR adj : 4.63; 95% CI: 2.62, 8.19) race compared with White. Similar factors were observed in children and for deficiency. Most people in Canada have adequate vitamin D status; nonetheless, racialized groups have an elevated prevalence of inadequacy. Further research is required to evaluate if current strategies to improve vitamin D status, including increasing vitamin D in fortified foods and supplements, and dietary guidance to include a source of vitamin D every day help to reduce health inequality in Canada.