(P10-010-24) Social Determinants of Insufficient Serum Vitamin D Status in Adolescents 9-18y: NHANES 2001-2018

Objectives: The purpose of this secondary analysis of the National Health and Nutrition Examination Survey (NHANES) was to describe vitamin D insufficiency among adolescents 9-18y across poverty-to-income ratio (PIR) groups, food security status, Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children's (WIC) benefits.  

Methods: Adolescents (9-18y) from the 2001-2018 cycles who provided a serum vitamin D sample and were not pregnant or lactating at the time of examination were included. Variables included: PIR <1.85 (low-income) or ≥1.85 (higher-income); SNAP benefits (yes/no); WIC benefits (yes/no); and food security status (full/marginal vs. low/very-low). Serum vitamin D (25OHD) was assessed using 2001-2006 radioimmunoassay values converted to equivalent 2007-2018 ultra-high performance liquid chromatography-tandem mass spectrometry . Serum 25OHD 30-49 nmol/L was considered insufficient. Analyses accounted for the NHANES survey design and used appropriate sample weights.

Results: This analysis included 14,706 adolescents 9-18y. Mean[SE] serum 25OHD insufficiency of 9-13y and 14-18y in households with a PIR < 1.85 was 22.4[1.3]% and 29.4[1.4]%, respectively, compared to 10.1[0.8]% of 9-13y and 14.1[1.0]% of 14-18y in households with a PIR ≥1.85. In households reporting low or very-low food security, 21.7[1.7]% of 9-13y and 31.4[1.8]% of 14-18y had insufficient serum 25OHD vs. 14.1[0.8]% of 9-13y and 18.1[1.0]% of 14-18y in households reporting full or marginal food security. In households receiving SNAP benefits, 25.5[1.6]% of 9-13y and 32.8[1.8]% of 14-18y were insufficient vs. 12.4[0.9]% of 9-13y and 17.8[1.0]% of 14-18y in households that did not receive SNAP. In households receiving WIC benefits, 19.9[1.9]% of 9-13y and 29.3[2.8]% of 14-18y were insufficient vs. 15.3[0.9]% of 9-13y and 19.9[1.0]% of 14-18y in households that did not receive WIC.

Conclusions: Adolescents 9-18y in households that were of lower-income status, less food secure, and receiving SNAP or WIC benefits are at increased risk for insufficient vitamin D.

Funding Sources: This project was funded by Reckitt|Mead Johnson Nutrition .