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Licensed Unlicensed Requires Authentication Published by De Gruyter March 12, 2014

Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006

Vytas P. Karalius, Daniel Zinn, James Wu, Guichan Cao, Carla Minutti, Amy Luke, Holly Kramer and Ramon Durazo-Arvizu


Aim: To assess prevalence and population estimates of increased risk of 25-hydroxyvitamin D [25(OH)D] deficiency and inadequacy in US children based on the current Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium guidelines.

Methods: The analysis was limited to a nationally representative sample of non-institutionalized US children and adolescents aged 6–18 years who participated in the National Health and Nutrition Examination Survey completed in 2003–2006 and had complete data on 25(OH)D measurements (n=2877). The 25(OH)D levels were adjusted for assay drift and prevalence, and population estimates of increased risk of 25(OH)D deficiency (<12 ng/mL), risk of inadequacy (<16 ng/mL), and adequacy (>20 ng/mL) were calculated.

Results: Overall, 4.61% of children and adolescents are at increased risk of deficiency (population estimate 2.5 million) and 10.3% are at risk of inadequacy (population estimate 5.5 million) based on the Institute of Medicine guidelines.

Conclusion: Approximately 10.3% of US children aged 6–18 years (population estimate 5.5 million) have 25(OH)D levels <16 ng/mL.

Corresponding author: Holly Kramer, MD, MPH, Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, 2160 S First Avenue, Maywood, IL 60153, USA, Phone: +1-708-327-9039, Fax: +1-708-327-9007, E-mail:


This paper reflects the authors’ findings and conclusions and does not necessarily reflect the official opinions of Loyola University Chicago.

Conflict of interest statement

None of the authors has a financial or other relationship that might signify a conflict of interest.


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Received: 2013-6-14
Accepted: 2013-12-2
Published Online: 2014-3-12
Published in Print: 2014-5-1

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