Abstract
BackgroundDeficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.MethodsA cross sectional study of primary aged school children was undertaken in 2008. A total of 402 boys and girls aged 7-12 years, attending primary schools in Kuala Lumpur participated in the study. Fasting blood samples were taken to assess vitamin D [as 25(OH)D], vitamin B12, folate, zinc, iron, and ferritin and haemoglobin concentrations. Height-for-age and body mass index for age (BMI-for-age) of the children were computed.ResultsMost of the children had normal height-for-age (96.5%) while slightly over half (58.0%) had normal BMI-for-age. A total of 17.9% were overweight and 16.4% obese. Prevalence of obesity was significantly higher among the boys (25%) than in the girls (9.5%) (χ2 = 22.949; P < .001). Most children had adequate concentrations of haemoglobin, serum ferritin, zinc, folate and vitamin B12. In contrast, 35.3% of the children had serum 25(OH)D concentrations indicative of vitamin D deficiency(≤37.5 nmol/L) and a further 37.1% had insufficiency concentrations (> 37.5-≤50 nmol/L). Among the boys, a significant inverse association was found between serum vitamin D status and BMI-for-age (χ2 = 5.958; P = .016).ConclusionsThis study highlights the presence of a high prevalence of sub-optimal vitamin D status among urban primary school children in a tropical country. In light of the growing problem of obesity in Malaysian children, these findings emphasize the important need for appropriate interventions to address both problems of obesity and poor vitamin D status in children.
Highlights
Deficiencies of micronutrients can affect the growth and development of children
There are a few such studies at the national level undertaken mainly by the Ministry of Health (MOH). These include a study on iodine deficiency disorders (IDD) among children aged 8-10 years in 2008, which showed that the majority of the children had normal urinary iodine excretion concentrations (> 100 μg/ L), but 31.6% had mild IDD levels and another 14.2% with moderate severity status [4]
These results may be due to the socio-demographic background of the families - most parents having formal education, earning middle level income on average, and with access to affordable health care and exposure to nutrition information in the capital city of Kuala Lumpur
Summary
Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Micronutrient deficiencies are common world-wide and adversely affect growth, health, behavioural and cognitive development in children [1]. In Malaysia, data on the micronutrient status of children is derived mostly from dietary studies. There are a few such studies at the national level undertaken mainly by the Ministry of Health (MOH) These include a study on iodine deficiency disorders (IDD) among children aged 8-10 years in 2008, which showed that the majority of the children had normal urinary iodine excretion concentrations (> 100 μg/ L), but 31.6% had mild IDD levels and another 14.2% with moderate severity status [4]. As for vitamin A deficiency, Malaysia is considered to have a mild public health problem by the World Health Organization [5], based on the MOH/UNICEF study in 1999-2000, which reported a national prevalence of vitamin A deficiency of 3.5% (serum retinol
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