Preschool Children from Non-Western Immigrant Families have Lower Vitamin D Levels than Children from Western Families: A Target Kids! Study
Bibliographic record
Abstract
BACkgROuND: Toronto's multiculturalism plays an important role in shaping its population.National data suggests that infants of immigrant families are at increased risk of vitamin D deficiency rickets.Preschool children from immigrant families may also be at risk of low 25-hydroxyvitamin D levels.There is emerging data connecting low vitamin D levels and poor health outcomes, suggesting the importance of identifying subgroups at risk and targeting interventions.OBjECTIVES: To determine if preschool children from non-western immigrant families have lower serum 25-hydroxyvitamin D levels than children from western born families.Secondary objective was to examine which biological, ethnic, demographic and environmental factors influence this relationship.DESIgN/METhODS: Cross-sectional study using data from the TARGet Kids! cohort of healthy children ages one to five years recruited during routine primary care.For the primary analysis, 25-hydroxyvitamin D levels of children from non-western immigrant families (defined as children born outside of Europe, North America, Australia or New Zealand or had a parent who immigrated from a non-western country) was compared to children from western families.Linear regression was used to identify biological, ethnic, demographic and environmental factors which might influence this relationship.RESulTS: 1235 children enrolled in TARGet Kids! between July 2007 and August 2011 had measured 25-hydroxyvitamin D and were included in the analysis.Children from non-western immigrant families made up 29% of the population.The mean age was 35months (SD 18), 51% were male, 83% had 'light' skin pigmentation (Fitzpatrick scale I, II or III), 57% took vitamin D supplements and average milk intake was 436 ml/day (SD 304).Mean 25-hydroxyvitamin D level was 88.5 nmol/L (SD 32).Univariable analysis revealed that children from non-western immigrant families had 5nmol/L lower 25-hydroxyvitamin D than children from western families (p=0.0046).Linear regression modeling revealed that this association is primarily influenced by cow's milk intake (p<0.0001),vitamin D supplementation (p=0.0001) and season (p=0.0008).After adjusting for these variables the residual 25-hydroxyvitamin D difference was no longer significant.Subgroup analysis of children <36 months revealed that those with East Asian ethnicity appear to be at highest risk of low 25-hydroxyvitamin D. CONCluSIONS: Preschool children from non-western immigrant families have lower 25-hydroxyvitamin D levels than children from western families.This finding may be explained by lower cow's milk intake and less frequent vitamin D supplementation, which represent two modifiable targets for future intervention studies to increase 25-hydroxyvitamin D in this vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".