Journal of Pediatric Health And Nutrition
- Foster care center
- Vitamin D deficiency
Vitamin D deficiency is considered a pandemic problem. The global estimations of vitamin D deficiency is more than 1 billion people. In Iran’s population, the prevalence rate varied from 2.5% to 98% based on geographical regions (1,2). various factors such as the amount of skin pigments, low dietary vitamin D intakes (insufficient intake of fish oil, certain fish, egg yolks), malnutrition, genetic factors, exclusively breastfed, maternal vitamin D deficiency during pregnancy, prematurity, chronic use of medications (such as anticonvulsants, aluminum-containing antacids, rifampicin, isoniazid, antifungals, antiretroviral, and glucocorticoids), malabsorptive conditions, winter season, obesity may result vitamin d deficiency (1,3).
Vitamin D is an essential nutrient with hormone-like activity, which regulates calcium and bone metabolism. And associate with immune status, autoimmune disorders, infectious diseases, and psychiatric diseases.)3)
Children enter foster care at a disadvantage due to early adverse childhood experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to those not in care. Foster children are at risk for growth and nutritional deficiencies due to their nutritional environment prior to placement in foster care, which may be inadequate due to food insecurity or a poor diet. Insufficient caloric content resulting in growth deficiencies. Evidence found that risk of stunting and underweight is high in this population(4).
The risk of developing hypovitaminosis D was significantly higher in foster care children. some reason is they experience high rates of child abuse, emotional deprivation, and physical neglect than children living with their families. Moreover, these children likely do not spend much time outdoors and that they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D. (3)
Serum 25-hydroxy-vitamin D (25(OH)D) concentration is currently the marker of choice for diagnosis vitamin D deficiency, because has low biological activity, is relatively inactive and very stable and it is the most abundant circulating form of vitamin D with its half-life at 2 to 3 weeks and is little regulated by serum calcium (Ca), phosphorus (P), and parathyroid hormone (PTH), so its value reflects both the amount produced in the skin after sun exposure and that assumed with food. (5)
Thus, given the limited number of researches carried out on this area in Iran , and on the other hand, if diagnosis and treatment of vitamin D deficiency is done promptly in these children it can reduce many of their problems in the future , the current research is conducted.
The aim of this study is to evaluate the prevalence of vitamin deficiency in children care in Ali Asghar foster center and relationship with factors that may cause vitamin D deficient.
Iranian government make efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency and the country’s healthcare system should be managed through accurate planning.