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Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia.

ABSTRACT: Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC-MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.

SUBMITTER: Chee WSS

PROVIDER: S-EPMC8308301 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundLow income communities are vulnerable to non-communicable diseases (NCDs), which affect their economy and disability status. An effective approach to address the NCD burden is through the multidimensional concept of health-promoting lifestyle. Another preferred approach by the population worldwide for NCD treatment is natural health product (NHP). Studies on NHP and health-promoting lifestyle among this vulnerable population, specifically the low-income urban community, are limited. Therefore, this study, aimed at investigating the NHP knowledge and health-promoting lifestyle, and to determine the factors associated with health-promoting lifestyle in a low income urban community in Cheras, Kuala Lumpur. This study has focused on sociodemographic characteristics, annual health monitoring activities, and health status, which are modifiable and non-modifiable factors.MethodsPhase 1 of the study involves developing the Malay-version NHP knowledge questionnaire, whereas Phase 2 involves a cross-sectional study of 446 randomly selected low-income respondents to determine their level of health-promoting lifestyle and the associated factors. The respondents' sociodemographic, socioeconomic, health monitoring activity, health status, and NHP knowledge data were obtained using the newly developed Malay-version NHP questionnaire and the Health-Promoting Lifestyle Profile II (HPLP II) questionnaire. The independent variables include sociodemographic status, annual health monitoring activities, health status and NHP knowledge were analysed using simple and multiple linear regression.ResultsIn this study, the 10-item NHP knowledge questionnaire developed in the Malay version contains two domains [safe use (eight items) and point of reference (two items)] (total variance explained: 77.4%). The mean of NHP knowledge score was 32.34 (standard deviation [SD] 7.37). Meanwhile, the mean score of health-promoting lifestyle was 109.67 (SD 25.01). The highest and lowest scores of health-promoting lifestyles are attributed to spiritual growth and physical activity, respectively. Ethnicity is associated with a higher health-promoting lifestyle level, same goes to the occupational status - NHP knowledge interaction. "Unclassified" education status and annual blood glucose level monitoring are associated with a lower level of health-promoting lifestyle.ConclusionA new questionnaire in Malay version was developed to measure NHP knowledge. Compared to other subpopulations, the respondents' health-promoting lifestyle levels in this study were low, associated with ethnicity, education status, and health monitoring activities. The findings provided insight into the interaction between NHP knowledge and occupational status, which is associated with a higher health-promoting lifestyle level. Accordingly, the future health-promoting lifestyle intervention programmes in healthcare delivery should target these factors.

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Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia.

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