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Canadian Journal of Public Health

, Volume 104, Issue 4, pp e291–e297 | Cite as

Prevalence of Vitamin D Insufficiency and Associated Factors Among Canadian Cree: A Cross-sectional Study

  • Bruno RiverinEmail author
  • Eric Dewailly
  • Suzanne Côté
  • Louise Johnson-Down
  • Suzanne Morin
  • Sylvie Dodin
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: Aboriginal peoples affected by a nutrition transition and living at high latitudes are among the ethnic groups most at risk of vitamin D deficiency. The objectives of this study were to determine the prevalence of meeting predefined cut-off concentrations of vitamin D and to examine associated factors among James Bay Cree aged ≥15 years.

METHODS: A cross-sectional study was conducted between the months of May and September from 2005 to 2009. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by radioimmunoassay. Anthropometrics were measured and additional information on socio-demographic characteristics, lifestyle and dietary habits was obtained using questionnaires. A logistic regression model predicting vitamin D insufficiency (<50 nmol/L) included known covariates.

RESULTS: Data were obtained from 944 Cree (406 men (43%); mean age 37.4 years), with an effective participation rate of 49% among women and 41% among men. Mean serum 25(OH)D concentrations (nmol/L) by gender were 52.9 (95% CI 51.4-54.5) in men and 47.5 (95% CI 46.2-48.9) in women, and by age group were 46.0 (95% CI 44.9–48.9) in those 15-39 years and 59.6 (95% CI 57.9-61.4) in those ≥40 years of age. Overall, 5.8%, 42.6%, 40.0%, and 11.7% of the participants had 25(OH)D concentrations <30, 30-49.9, 50-74.9 and ≥75 nmol/L, respectively. Female gender, obesity, younger age, spring, low fish and milk intake, and low vigorous physical activity predicted vitamin D insufficiency (all p<0.05).

CONCLUSION: The vitamin D status in Eastern James Bay Cree is suboptimal with nearly half of the population having insufficient concentrations for optimum bone health.

Key Words

Vitamin D vitamin D deficiency prevalence Natives 

Résumé

OBJECTIFS: Les Autochtones en transition nutritionnelle qui vivent sous les latitudes élevées sont parmi les groupes ethniques les plus à risque de carences en vitamine D. Nous avons voulu déterminer la prévalence du respect des concentrations-limites prédéfinies en vitamine D et examiner les facteurs associés chez les Cris de la baie James âgés de ≥15 ans.

MÉTHODE: Nous avons mené une étude transversale entre les mois de mai et de septembre de 2005 à 2009. Les concentrations sériques de 25- hydroxyvitamine D (25-OH-D) ont été mesurées par radio-immuno-essai. Nous avons pris des mesures anthropométriques et obtenu de l’information supplémentaire sur les caractéristiques sociodémographiques, le mode de vie et les habitudes alimentaires à l’aide de questionnaires. Un modèle de régression logistique prédisant l’insuffisance en vitamine D (<50 nmol/L) englobait les covariables connues.

RÉSULTATS: Nous avons recueilli des données auprès de 944 Cris (406 hommes (43 %); âge moyen de 37,4 ans) avec un taux de participation réel de 49 % chez les femmes et de 41 % chez les hommes. Les concentrations sériques moyennes de 25-OH-D (nmol/L) selon le sexe étaient de 52,9 (IC de 95 % 51,4-54,5) chez les hommes et de 47,5 (IC de 95 % 46,2-48,9) chez les femmes; par groupe d’âge, elles étaient de 46,0 (IC de 95 % 44,9-48,9) chez les 15-39 ans et de 59,6 (IC de 95 % 57,9-61,4) chez les ≥40 ans. Globalement, 5,8 %, 42,6 %, 40,0 % et 11,7 % des participants avaient des concentrations de 25-OH-D <30, 30-49,9, 50-74,9 et ≥75 nmol/L, respectivement. Le sexe féminin, l’obésité, la jeunesse, le printemps, les faibles apports en poisson et en lait et les faibles taux d’activité physique vigoureuse étaient des prédicteurs de carence en vitamine D (p<0,05 dans tous les cas).

CONCLUSIONS: Le statut en vitamine D des Cris de l’Est de la baie James est sous-optimal; près de la moitié de la population en possède des concentrations insuffisantes à une santé osseuse optimale.

Mots Clés

vitamine D carence en vitamine D prévalence population d’origine amérindienne 

References

  1. 1.
    Ross, AC. The 2011 report on dietary reference intakes for calcium and vitamin D. Public Health Nutr 2011;14(5):938–39.CrossRefGoogle Scholar
  2. 2.
    Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International 2009;20(11):1807–20.CrossRefGoogle Scholar
  3. 3.
    Lips P. Worldwide status of vitamin D nutrition. J Steroid Biochemistry and Molecular Biology 2010;121(1-2):297–300.Google Scholar
  4. 4.
    Langlois K, Greene-Finestone L, Little J, Hidiroglou N, Whiting S. Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey. Health Rep 2010;21(1):47–55.PubMedGoogle Scholar
  5. 5.
    Weiler HA, Leslie WD, Krahn J, Steiman PW, Metge, CJ. Canadian Aboriginal women have a higher prevalence of vitamin D deficiency than non- Aboriginal women despite similar dietary vitamin D intakes. J Nutr 2007;137(2):461–65.CrossRefGoogle Scholar
  6. 6.
    Del Gobbo LC, Song Y, Dannenbaum DA, Dewailly E, Egeland, GM. Serum 25-hydroxyvitamin D is not associated with insulin resistance or beta cell function in Canadian Cree. J Nutr 2011;141(2):290–95.CrossRefGoogle Scholar
  7. 7.
    Holick, MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266–81.CrossRefGoogle Scholar
  8. 8.
    Chen TC, Chimeh F, Lu Z, Mathieu J, Person KS, Zhang A, et al. Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Arch Biochemistry and Biophysics 2007;460(2):213–17.CrossRefGoogle Scholar
  9. 9.
    Greene-Finestone LS, Berger C, de Groh M, Hanley DA, Hidiroglou N, Sarafin K, et, al. 25-Hydroxyvitamin D in Canadian adults: Biological, environmental, and behavioral correlates. Osteoporosis International 2011;22(5):1389–99.CrossRefGoogle Scholar
  10. 10.
    Pearce SH, Cheetham, TD. Diagnosis and management of vitamin D deficiency. BMJ 2010;340:b5664.CrossRefGoogle Scholar
  11. 11.
    Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 Dietary Reference Intakes for Calcium and Vitamin D: What dietetics practitioners need to know. J Am Diet Assoc 2011;111(4):524–27.CrossRefGoogle Scholar
  12. 12.
    Hanley DA, Cranney A, Jones G, Whiting SJ, Leslie WD, Cole DE, et al. Vitamin D in adult health and disease: A review and guideline statement from Osteoporosis Canada. CMAJ 2010;182(12):E610-18.Google Scholar
  13. 13.
    Engelsen O. The relationship between ultraviolet radiation exposure and vitamin D status. Nutrients 2010;2(5):482–95.CrossRefGoogle Scholar
  14. 14.
    Whiting SJ, Langlois KA, Vatanparast H, Greene-Finestone, LS. The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: An examination in children and adults with and without supplement use. Am J Clin Nutr 2011;94(1):128–35.CrossRefGoogle Scholar
  15. 15.
    Dewailly E, Blanchet C, Gingras S, Lemieux S, Holub, BJ. Cardiovascular disease risk factors and n-3 fatty acid status in the adult population of James Bay Cree. Am J Clin Nutr 2002;76(1):85–92.CrossRefGoogle Scholar
  16. 16.
    Berkes F, Farkas, CS. Eastern James Bay Cree Indians — Changing patterns of wild food use and nutrition. Ecol Food Nutr 1978;7(3):155–72.CrossRefGoogle Scholar
  17. 17.
    Bonnier-Viger Y, Dewailly E, Egeland G, Nieboer E, Pereg D. Environmental Health Study: Technical Report of Mistissini. Chisasibi, QC: Cree Board of Health and Social Services of James Bay, 2007.Google Scholar
  18. 18.
    Gagnon C, Baillargeon JP, Desmarais G, Fink, GD. Prevalence and predictors of vitamin D insufficiency in women of reproductive age living in northern latitude. Eur J Endocrinology 2010;163(5):819–24.CrossRefGoogle Scholar
  19. 19.
    Genuis SJ, Schwalfenberg GK, Hiltz MN, Vaselenak, SA. Vitamin D status of clinical practice populations at higher latitudes: Analysis and applications. Int J Environ Res Public Health 2009;6(1):151–73.CrossRefGoogle Scholar
  20. 20.
    Mai XM, Chen Y, Camargo CA, Jr., Langhammer A. Cross-sectional and prospective cohort study of serum 25-hydroxyvitamin D level and obesity in adults: The HUNT Study. Am J Epidemiol 2012;175(10):1029–36.CrossRefGoogle Scholar
  21. 21.
    Absoud M, Cummins C, Lim MJ, Wassmer E, Shaw N. Prevalence and predictors of vitamin D insufficiency in children: A Great Britain population based study. PLOS ONE 2011;6(7):e22179.Google Scholar
  22. 22.
    Gagnon C, Baillargeon JP, Desmarais G, Fink, GD. Prevalence and predictors of vitamin D insufficiency in women of reproductive age living in northern latitude. Eur J Endocrinology 2010;163(5):819–24.CrossRefGoogle Scholar
  23. 23.
    Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, et al. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: A longitudinal study. Lancet 2006;367(9504):36–43.Google Scholar
  24. 24.
    Stene LC, Ulriksen J, Magnus P, Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type I diabetes in the offspring. Diabetologia 2000;43(9):1093–98.CrossRefGoogle Scholar
  25. 25.
    Shenoy SD, Swift P, Cody D, Iqbal J. Maternal vitamin D deficiency, refractory neonatal hypocalcaemia, and nutritional rickets. Arch Dis Child 2005;90(4):437–38.CrossRefGoogle Scholar
  26. 26.
    MacLaughlin J, Holick, MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985;76(4):1536–38.CrossRefGoogle Scholar
  27. 27.
    Holick, MF. Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 1995;61(3 Suppl):638S-45S.Google Scholar
  28. 28.
    Willows, ND. Determinants of healthy eating in Aboriginal peoples in Canada: The current state of knowledge and research gaps. Can J Public Health 2005;96 Suppl 3:S32–36.Google Scholar
  29. 29.
    Engelsen O, Brustad M, Aksnes L, Lund E. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochemistry and Photobiology 2005;81(6):1287–90.CrossRefGoogle Scholar
  30. 30.
    Caron-Jobin M, Morisset AS, Tremblay A, Huot C, Legare D, Tchernof A. Elevated serum 25(OH)D concentrations, vitamin D, and calcium intakes are associated with reduced adipocyte size in women. Obesity (Silver Spring) 2011;19(7):1335–41.CrossRefGoogle Scholar
  31. 31.
    Mark S. Vitamin D status and recommendations to improve vitamin D status in Canadian youth. Appl Physiol Nutr Metab 2010;35(5):718.CrossRefGoogle Scholar
  32. 32.
    Bertrand KA, Giovannucci E, Liu Y, Malspeis S, Eliassen AH, Wu K, et al. Determinants of plasma 25-hydroxyvitamin D and development of prediction models in three US cohorts. Br J Nutr 2012;108(10):1889–96.CrossRefGoogle Scholar
  33. 33.
    Poel YH, Hummel P, Lips P, Stam F, van der Ploeg T, Simsek S. Vitamin D and gestational diabetes: A systematic review and meta-analysis. Eur J Int Med 2012;23(5):465–69.CrossRefGoogle Scholar
  34. 34.
    Haugen M, Brantsaeter AL, Trogstad L, Alexander J, Roth C, Magnus P, et al. Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology 2009;20(5):720–26.CrossRefGoogle Scholar
  35. 35.
    Borges MC, Martini LA, Rogero, MM. Current perspectives on vitamin D, immune system, and chronic diseases. Nutrition 2011;27(4):399–404.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2013

Authors and Affiliations

  • Bruno Riverin
    • 1
    Email author
  • Eric Dewailly
    • 1
    • 2
  • Suzanne Côté
    • 2
  • Louise Johnson-Down
    • 3
  • Suzanne Morin
    • 4
  • Sylvie Dodin
    • 1
    • 5
  1. 1.Faculty of Medicine, Dept. of Social and Preventive MedicineLaval UniversityQuébecCanada
  2. 2.Centre de Recherche du CHU de QuébecCHULQuébecCanada
  3. 3.Centre for Indigenous Peoples’ Nutrition and Environment, School of Dietetics and Human NutritionMcGill UniversitySte-Anne-de-BellevueCanada
  4. 4.Department of Medicine, Division of General Internal MedicineMcGill University Health CentreMontrealCanada
  5. 5.Department of Obstetrics and GynecologySt-François d’Assise Hospital Research CentreQuébecCanada

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