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Vitamin D status is associated with underweight and stunting in children aged 6–36 months residing in the Ecuadorian Andes

  • Rana R Mokhtar (a1) (a2), Michael F Holick (a1), Fernando Sempértegui (a3), Jeffrey K Griffiths (a4) (a5), Bertha Estrella (a3), Lynn L Moore (a6), Matthew P Fox (a7) (a8) and Davidson H Hamer (a2) (a5) (a8) (a9)...

There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting.


We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z-score≤−1) and stunting (defined as height-for-age Z-score≤−2) were assessed using multivariate logistic regression.


Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador.


Children (n 516) aged 6–36 months.


Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7).


Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.

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