{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:10:32Z","timestamp":1790971832764,"version":"4.1.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,4,1]]},"abstract":"\n Background.<\/jats:title>\n Vitamin D is essential for skeletal growth, but there are currently no guidelines for vitamin D supplementation after infancy. This study investigates vitamin D insufficiency in healthy children.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n Children ages 10 to 16 years from 3 private schools in Beirut, Lebanon, with differing socioeconomic status (SES) were studied: 169 in the spring of 1999 and 177 in the following fall; 83 students participated in both study phases. They had a physical examination, answered a dietary questionnaire, and blood was drawn for calciotropic hormones and indices of bone turnover.<\/jats:p>\n <\/jats:sec>\n \n Results.<\/jats:title>\n Overall, 52% of the students were vitamin D-insufficient; the proportion of insufficiency was 65% in the winter and 40% at the end of the summer. During both seasons, girls had lower vitamin D levels than did boys; those who followed the dress code of covered head, arms, and legs had the lowest levels. Students in the mid-SES school had lower 25-hydroxyvitamin D (25-OHD) levels than did the ones from the high-SES school. After adjusting for confounders, gender, SES, and body mass index remained the significant predictors of vitamin D levels in both seasons (R2 = 0.53, for spring and 0.28 for fall). There was a significant inverse correlation between 25-OHD levels and parathyroid hormone levels that was best fitted by a curvilinear model (R2 = 0.19).<\/jats:p>\n <\/jats:sec>\n \n Conclusion.<\/jats:title>\n Even in a sunny country, hypovitaminosis D is common in schoolchildren, more so in the winter. Girls, especially those with a lower SES, are at particular risk. The inverse changes in parathyroid hormone suggest that insufficient vitamin D levels may deleteriously affect skeletal metabolism in healthy adolescents. Vitamin D insufficiency may be prevalent in many other countries where supplementation of milk with vitamin D is not mandatory. Our results call to a reconsideration of vitamin D supplementation in high-risk adolescents to further optimize skeletal health. vitamin D insufficiency, bone metabolism, nutrition, gender, socioeconomic status.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.107.4.e53","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"e53-e53","source":"Crossref","is-referenced-by-count":252,"title":["Hypovitaminosis D in Healthy Schoolchildren"],"prefix":"10.1542","volume":"107","author":[{"given":"Ghada El-Hajj","family":"Fuleihan","sequence":"first","affiliation":[{"name":"From the Department of Internal Medicine, Endocrine Division, Calcium Metabolism and Osteoporosis Program; and the Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Nabulsi","sequence":"additional","affiliation":[{"name":"Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Choucair","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Endocrine Division, Calcium Metabolism and Osteoporosis Program; and the Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Salamoun","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Endocrine Division, Calcium Metabolism and Osteoporosis Program; and the Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Hajj","family":"Shahine","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Endocrine Division, Calcium Metabolism and Osteoporosis Program; and the Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Kizirian","sequence":"additional","affiliation":[{"name":"Food Technology and Nutrition, American University of Beirut, Beirut, Lebanon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Tannous","sequence":"additional","affiliation":[{"name":"Food Technology and Nutrition, American University of Beirut, Beirut, Lebanon."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2001,4,1]]},"reference":[{"key":"2021121003482051300_B1"},{"key":"2021121003482051300_B2"},{"key":"2021121003482051300_B3","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1093\/ajcn\/67.2.342","article-title":"Dietary calcium and vitamin D intake in elderly woman: effect on serum parathyroid hormone and vitamin D metabolites.","volume":"67","author":"Kinyamu","year":"1998","journal-title":"Am J Clin Nutr"},{"key":"2021121003482051300_B4","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1001\/jama.1995.03530210037027","article-title":"Vitamin D deficiency in homebound elderly 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