World Arthritis Day: Children with arthritis lack vitamin D

Oct. 12, 2021, 8:10 a.m. IST

Editor's Note: This article, originally published in October 2019, is republished on World Arthritis Day today.

In an analysis of global research, we recently discovered that children with type of arthritis the most common, juvenile idiopathic arthritis (JIA) have abnormally low blood levels of vitamin D . We also found that people living in northern countries, such as Canada and parts of northern Europe, are more likely to have low levels of vitamin D and associated active disease.

In Canada, arthritis is one of the most common chronic childhood illnesses. About three in 1,000 Canadian children (over 20,000 in total) have arthritis. The prevalence of childhood arthritis varies across the world .

Geographic differences in the frequency of childhood arthritis could be related to genetic, ethnic, environmental, and lifestyle influences. The cause of arthritis in children is unknown, but the interaction of genetic and environmental factors is considered important.

Vitamin D is vital for bone health and is essential for regulating the body's immune and inflammatory functions. The level of vitamin D in the body is also influenced by genetic factors, skin tone and clothing that affect skin exposure to the sun, and dietary intake of vitamin D.

Environmental variations in exposure to ultraviolet B (UVB) rays from sunlight, which are necessary for the activation of vitamin D in the body, are affected by latitude and season.

Children in northern countries do the worst

Our team reviewed 38 studies from around the world. We found that in 84% of them, the vitamin D levels in children with JIA were lower than recommended .

Vitamin D status also followed a north-south geographic gradient, with people residing in northern latitudes having abnormally low vitamin D levels.

The analysis also showed a correlation between vitamin D status and arthritic activity, as children with lower vitamin D levels had more active arthritis.

Information from the existing literature indicates that it is important to determine vitamin D status in children with arthritis. Children with arthritis who live in northern regions, in Canada and around the world, may be vulnerable to vitamin D deficiency, especially during the winter months.

We can ensure that children have appropriate levels of vitamin D by carefully exposing themselves to the sun, eating foods rich in vitamin D (such as oily fish like salmon and tuna, eggs, beef, liver and fortified dairy products and cereals) and taking supplements if necessary.

Indigenous children at risk

The main source of vitamin D is that produced by the skin after exposure to the sun. Above 33 degrees north (the latitude of San Diego in the United States), UVB radiation is not intense enough for skin synthesis of vitamin D throughout the year.

At latitudes between 42 degrees (the latitude of the Oregon / California border) and 53 degrees north (the latitude of Fort McMurray in Canada), between October and April, UVB radiation is not intense enough for vitamin synthesis. D.

Students board a school bus at Nakasuk Elementary School in Iqaluit, Nunavut, in 2009. Image Credit: THE CANADIAN PRESS / Nathan Denette

The indigenous people of northern Canada are particularly at risk of vitamin D deficiency due to limited sun exposure because of geography and limited access to foods rich in vitamin D .

Low levels of vitamin D may partly explain the prevalence and severity of childhood arthritis in some northern Canadian communities.

This research suggests that a comprehensive management plan for children with JIA should include ensuring optimal levels of vitamin D, through a combination of reasonable sun exposure, diet, and supplements as needed.

Alain Rosenberg , Professor, The University of Saskatchewan ; Hassan Vatanparast , Professor of Public Health, University of Saskatchewan , and Sarah Finch , PhD Student in Nutrition and Registered Dietitian, University of Saskatchewan

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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