Recent Surge in Severe 25-hydroxyvitamin D Deficiency Among African American Children and Pregnant Women: Implications for Rickets.

BACKGROUND

Nutritional rickets is disproportionately prevalent among African American children and is closely linked to vitamin D (VD) deficiency. This study aims to analyze the prevalence and trends of vitamin D deficiency in American children, as well as pregnant and lactating women, from 2001 to 2023, with a focus on African American children.

METHODS

We analyzed serum 25(OH)D levels from 2001 to 2023, as well as dietary and supplemental vitamin D intake from 2007 to 2020, among children aged 1-17 years and pregnant and lactating women. Data were from the US National Health and Nutrition Examination Survey.

RESULTS

In the 2021-2023 sample, African American children had the highest rate of severe 25(OH)D deficiency (< 25 nmol/L) at 13.8% among all racial groups. This represents a significant increase from 5% in 2001-2002. Additionally, 2% of African American toddlers aged 12-23 months had severely deficient 25(OH)D levels between 2003 and 2023. An increase in severe 25(OH)D deficiency was also observed in pregnant and lactating African American women during the 2021-2023 period. Furthermore, 83.3% of African American children and 61.4% of pregnant and lactating African American women had daily vitamin D intakes below 10 mcg (400 IU), the highest inadequacy rates among all racial groups from 2007 to 2020.

CONCLUSION

The recent rise in severe vitamin D deficiency among African American children, pregnant, and lactating women increases the risk of nutritional rickets and calls for prompt public health attention.