Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter May 22, 2014

Prevalence of vitamin D deficiency among Iranian adolescents

Mehdi Ebrahimi, Patricia Khashayar, Abbasali Keshtkar, Koroush Etemad, Mahboubeh Dini, Zahra Mohammadi, Hossein Ebrahimi, Reza Chaman and Bagher Larijani


Objective: Despite the high prevalence of vitamin D deficiency in adults worldwide, not many studies have evaluated the condition in adolescents. The present study was therefore conducted to assess the prevalence of vitamin D deficiency in a group of students from Shahroud, Iran.

Methods: The cross-sectional descriptive analytical study was conducted on junior high and high school students of both genders from urban and rural areas of Shahroud, the largest city of Semnan Province in Iran, in winter 2011. The combination of stratified and cluster random sampling methods was applied in the study. A questionnaire on the demographic data, socioeconomic status, lifestyle habits (sun exposure, physical activity, dairy consumption), and drug and personal history was completed for each student. Blood samples were taken to assess vitamin D levels.

Results: One thousand forty-seven students from four junior high and six high schools were recruited. From among them, 42.2% were boys and 57.8% were girls. Mean and standard deviation of vitamin D levels in the studied population were 14.7±9.4 ng/mL. Only 7.2% of the boys and 3.8% of the girls had sensible sun exposure. The median of milk consumption was 3 glasses per week, ranging from 0 to 7.

Conclusion: It could be concluded that vitamin D deficiency is quite prevalent among the Iranian adolescents, and this is mainly because this group follows an unhealthy lifestyle due to osteoporosis.

Corresponding author: Abbasali A. Keshtkar, Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Kargar St, Tehran, Iran, Phone/Fax: +98 21 88220072, E-mail:


1. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988;67:373–8.10.1210/jcem-67-2-373Search in Google Scholar PubMed

2. Das G, Crocombe S, McGrath M, Berry JL, Mughal MZ. Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child 2006;91:569–72.10.1136/adc.2005.077974Search in Google Scholar PubMed PubMed Central

3. Guillemant J, Le HT, Maria A, Allemandou A, Peres G, et al. Wintertime vitamin D deficiency in male adolescents: effect on parathyroid function and response to vitamin D3 supplements. Osteoporos Int 2001;12:875–9.10.1007/s001980170040Search in Google Scholar PubMed

4. Muhairi SJ, Mehairi AE, Khouri AA, Naqbi MM, Maskari FA, et al. Vitamin D deficiency among healthy adolescents in Al Ain, United Arab Emirates. BMC Public Health 2013;13:33.10.1186/1471-2458-13-33Search in Google Scholar PubMed PubMed Central

5. Matkovic V, Fontana D, Tominac C, Goel P, Chesnut CH 3rd. Factors that influence peak bone mass formation: A study of calcium balance and the inheritance of bone mass in adolescent females. Am J Clin Nutr 1990;52:878–88.10.1093/ajcn/52.5.878Search in Google Scholar PubMed

6. Gartner LM, Greer FR; Section on Breastfeeding and Committee on Nutrition. American Academy of Pediatrics. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 2003;111:908–10.10.1542/peds.111.4.908Search in Google Scholar PubMed

7. Fehily AM, Coles RJ, Evans WD, Elwood PC. Factors affecting bone density in young adults. Am J Clin Nutr 1992;56:579–86.10.1093/ajcn/56.3.579Search in Google Scholar PubMed

8. Garg MK, Marwaha RK, Khadgawat R, Ramot R, Obroi AK, et al. Efficacy of vitamin D loading doses on serum 25-hydroxy vitamin D levels in school going adolescents: an open label non-randomized prospective trial. J Pediatr Endocrinol Metab 2013;26:515–23.10.1515/jpem-2012-0390Search in Google Scholar PubMed

9. Winzenberg T, Powell S, Shaw KA, Jones G. Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis. Br Med J 2011;25:c7254.10.1136/bmj.c7254Search in Google Scholar PubMed PubMed Central

10. Khashayar P, Aghaei Meybodi HR, Rezai Homami M, Amini MR, Mohajeri Tehrani MR, et al. The discriminative value of various biochemical parameters in detecting varying degrees of vitamin D deficiency in the Iranian population. Clin Lab 2011;57:163–70.Search in Google Scholar

11. Neyestani TR, Hajifaraji M, Omidvar N, Eshraghian MR, Shariatzadeh N, et al. High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert. Public Health Nutr 2008;15:324–30.10.1017/S1368980011000188Search in Google Scholar PubMed

12. Aghaei Meybodi HR, Khalili N, Khashayar P, Heshmat R, Hossein-nezhad A, et al. Association between reproductive factors and postmenopausal osteoporosis. Osteologie 2011;20:248–51.10.1055/s-0037-1620001Search in Google Scholar

13. Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press, 2010.Search in Google Scholar

14. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398–417.10.1542/peds.2007-1894Search in Google Scholar

15. Docio S, Riancho JA, Perez A, Olmos JM, Amado JA, et al. Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies? J Bone Miner Res 1998;13:544–8.10.1359/jbmr.1998.13.4.544Search in Google Scholar

16. Smith DM, Nancy WE, Kang KW, Christian JC, Johnston CC Jr. Genetic factors in determining bone mass. J Clin Invest 1973;52:2800–8.10.1172/JCI107476Search in Google Scholar

17. Välimäki M, Kärkkäinen M, Lamberg-Allardt C, Laitinen K, Alhava E, et al. Exercise, smoking, and calcium intake during adolescence and early adulthood as determinants of peak bone mass. Br Med J 1994;309:230–5.10.1136/bmj.309.6949.230Search in Google Scholar

18. Lamberg-Allardt C, Kirjaranta M, Dessypris AG. Serum 25-hydroxy-vitamin D, parathyroid hormone and calcium levels in adult inhabitants above the arctic circle in northern Finland. Ann Clin Res 1983;15:142–5.Search in Google Scholar

19. Lamberg-Allardt C. Vitamin D intake, sunlight exposure and 25-hydroxyvitamin D levels in the elderly during one year. Ann Nutr Metab 1984;28:144–50.10.1159/000176796Search in Google Scholar

20. Tjellesen L, Christiansen C: Vitamin D metabolites in normal subjects during one year. A longitudinal study. Scand J Clin Lab Invest 1983;43:85–9.10.3109/00365518309168226Search in Google Scholar

21. Ala-Houhala M, Parviainen MT, Pyykko K, Visakorpi JK. Serum 25-hydroxyvitamin D levels in Finnish children aged 2 to 17 years. Acta Paediatr Scand 1984;73:232–6.10.1111/j.1651-2227.1984.tb09934.xSearch in Google Scholar

22. Rosen CJ, Morrison A, Zhou H, Storm D, Hunter SJ, et al. Elderly women in northern New England exhibit seasonal changes in bone mineral density and calciotropic hormones. Bone Miner 1994;25:83–92.10.1016/S0169-6009(08)80250-4Search in Google Scholar

23. Riancho JA, Del Arco C, Florez J, Gonzalez-Macias J. Annual course of serum 25-OH-D and 1,25-(OH)2-D in children and adults from northern Spain. J Steroid Biochem 1986;Suppl 25:71S.10.1016/0022-4731(86)90653-9Search in Google Scholar

24. Ardestani PM, Salek M, Keshteli AH, Nejadnik H, Amini M, et al. Vitamin D status of 6-to 7-year-old children living in Isfahan, Iran. Endokrynol Pol 2010;61:377–82.Search in Google Scholar

25. Moussavi M, Heidarpour R, Aminorroaya A, Pournaghshband Z, Amini M. Prevalence of vitamin D deficiency in Isfahani high school students in 2004. Horm Res Paediatr 2005;64:144–8.10.1159/000088588Search in Google Scholar PubMed

26. Bassir M, Laborie S, Lapillonne A, Claris O, Chappuis MC, et al. Vitamin D deficiency in Iranian mothers and their neonates: a pilot study. Acta Paediatr 2001;90:577–9.10.1111/j.1651-2227.2001.tb00802.xSearch in Google Scholar

27. Shakiba M, Nafei Z, Lotfi MH, Shajari A. Prevalence of vitamin D deficiency among female students in secondary guidance school in Yazd City. Acta Med Iran 2009;47:209–14.Search in Google Scholar

28. Talaei A, Yadegari N, Rafee M, Rezvanfar MR, Moini A. Prevalence and cut-off point of vitamin D deficiency among secondary students of Arak, Iran in 2010. Indian J Endocrinol Metab 2010;16:786.10.4103/2230-8210.100676Search in Google Scholar PubMed PubMed Central

29. Rabbani A, Alavian SM, Motlagh ME, Ashtiani MT, Ardalan G, et al. Vitamin D insufficiency among children and adolescents living in Tehran, Iran. J Trop Pediatr 2009;55:189–91.10.1093/tropej/fmn078Search in Google Scholar PubMed

30. Kazemi A, Sharifi F, Jafari N, Mousavinasab N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. J Womens Health (Larchmt) 2009;18:835–9.10.1089/jwh.2008.0954Search in Google Scholar PubMed

31. Hintzpeter B, Scheidt-Nave C, Müller MJ, Schenk L, Mensink GB. Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr 2008; 138:1482–90.10.1093/jn/138.8.1482Search in Google Scholar PubMed

32. Al-Othman A, Al-Musharaf S, Al-Daghri NM, Krishnaswamy S, Yusuf DS, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC Pediatr 2012;12:92.10.1186/1471-2431-12-92Search in Google Scholar PubMed PubMed Central

Received: 2013-11-5
Accepted: 2014-4-1
Published Online: 2014-5-22
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

Scroll Up Arrow