Projeto: ISACamp-Nutri 2014.

RESUMO

INTRODUÇÃO: Vitamin D deficiency is recognized as a public health problem, especially among adolescents, since 50% of adult bone mass is obtained during this period1. Optimizing peak bone mass in this age group can minimize bone loss in old age 1,2 . Hypovitaminosis D is associated not only with bone health disorders, but also with the risk of other diseases such as cancer, autoimmune diseases, high blood pressure, infectious diseases and some neurophysiological diseases1-3. Even in sunny countries like Brazil, the prevalence of hypovitaminosis D in adolescents is high2-7. There are several factors that influence the nutritional status of vitamin D, and exogenous vitamin D intake represents an important contribution to the status of the circulating vitamin1,3,4

OBJETIVOS: Considering the importance of vitamin D in the essential role of growth and maintenance of bone remodeling, especially in adolescents and the lack of data on their intake, the aim of this study is to assess vitamin D intake by adolescents living in the city of Campinas-SP and its relationship with sociodemographic variables, BMI and breakfast frequency, and to identify the main food groups that contributed to the consumption of the nutrient.

MÉTODOS: This is a cross-sectional population-based study using data from the Campinas Health Survey (ISACamp 2014-15) and the Food Consumption and Nutritional Status Survey (ISACamp-Nutri 2015-16). The surveys collected information from adolescents aged 10 to 19 living in the urban area of Campinas, SP. The sample of ISACamp 2014-15 was obtained through probabilistic sampling, by conglomerates and in two stages: census sector and household. In the first stage, a systematic drawing of 70 census sectors with probability proportional to size (number of domiciles) was made. The sectors were ordered by the average income of the heads of households and, later, 14 sectors were selected in each of the five health districts of the municipality. The assessment of dietary Vitamin D intake and food sources was made by asking to ISACamp participants to complete a food consumption assessment questionnaire, which contained a 24- hour dietary recall and the data were imputed in the Nutrition Data System for Research (NDS-R) software.

RESULTADOS: 891 adolescents aged 10 to 19 years with an average age of 14.6 years (14.4- 14.8) were analyzed.The total consumption of vitamin D by the adolescents in the city of Campinas was low. The average consumption of vitamin D was 4.02 ± 0.52 μg, with no differences in consumption between boys and girls, skin color, adolescent occupation, father's education, type of school, income and BMI. Adolescents aged 15 to 19 years had a lower consumption of vitamin D than those aged 10 to 14 years, and adolescents who consume breakfast only three days a week have lower averages of vitamin D consumption, 3.37 ± 0.84 μg. Furthermore, there was a difference between breakfast consumption between the sexes, with the prevalence of daily breakfast consumption being 58.7 and 67.3% (p= 0.003) for girls and boys, respectively. When compared to the intake recommendations (EAR), there is a high prevalence of inadequate vitamin D intake among the adolescent population (96.9%). Girls had higher prevalence values of inadequate vitamin D intake than boys: 97.9 and 95.9%, respectively (p=0.03). No teenager had a higher intake than recommended, in addition, it appears that even in the percentile of higher consumption (P95), vitamin D intake is below the recommendation. Ten food groups represent 98.11% of the total vitamin D present in the adolescents' diet. Cow's milk provided the highest content of vitamin D ingested (56.09%), followed by the meat group (12.73%) and egg (8.95%). The group of milk and its derivatives account for 64.09% of the total vitamin D. Also noteworthy is the contribution from processed meats, such as sausages and smoked meats, which for the general population ranked fourth, but in girls it is not an important source of the nutrient, occupying the fourteenth place. It is noted the importance that fish represents in the total vitamin D consumed by adolescents, since, despite its low consumption, it appears in fifth place for the general population (3.85%), in fourth for girls (5.10%) and sixth for boys (2.88%).

CONCLUSÃO: The present study shows high prevalence of inadequacy intake of vitamin D among adolescents. Unhealthy lifestyle habits, common to this stage of life, such as not consuming breakfast, high intake of sugary drinks, soda, fast food and processed foods, to the detriment of the consumption of vitamin D source foods, such as fish, may explain the reduction in the intake of this nutrient, with milk being the food with the greatest contribution to the total vitamin D in the adolescents' diet. These findings may encourage public health agencies to support and promote interventions in this at-risk population, such as nutritional education, as well as enabling the development of regulatory measures to improve vitamin D consumption, including food fortification.

BIBLIOGRAFIA: 1. Holick M F. Vitamin D Deficiency. N Engl J Med. 2007;357:3-19. 2. Peters B S E, Santos L C, Fisberg M, Wood R J, Martini L A. Prevalence of Vitamin D Insufficiency in Brazilian Adolescents. Ann Nutr Metab. 2009;54:15–21. 3. Bischofova S, Dofkova M, Blahova J, Kavrik R, Nevrla J, Rehurkova I, Ruprich J. Dietary Intake of Vitamin D in the Czech Population: A Comparison with Dietary Reference Values, Main Food Sources Identified by a Total Diet Study. Nutrients. 2018;10(10):1452. 4. Salamoun MM, Kizirian AS, Tannous RI, Nabulsi MM, Choucair MK, Deeb ME, et al. Low calcium and vitamin D intake in healthy children and adolescents and their correlates. European Journal of Clinical Nutrition.2005;59:177-84. 7. Unger MD, Cuppari L, Titan SM, Magalhães MCT, Sassaki AL, Reis LM, et al. 5. Vitamin D status in a sunny country: Where has the sun gone? Clinical Nutrition. 2010;29:784-88. 6. Araújo EPS, Queiroz DJM, Neves JPR, Lacerda LM, Gonçalves MCR, Carvalho AT. Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital of northeastern Brazil. Nutr Hosp. 2017;34(6):1416-23. 7. Cabral M, Araújo J, Lopes C, Barros H, Guimarães JT, Severo M, et al. Relationship between dietary vitamin D and serum 25-hydroxyvitamin D levels in Portuguese adolescents. Public Health Nutrition. 2017;21(2):325- 32.

PALAVRA-CHAVE: Adolescent; Vitamin D; Food intake