Vitamin D status of refugees arriving in Canada: findings from the Calgary Refugee Health Program.

objectiveTo determine the 25-hydroxyvitamin D (25[OH]D) serum levels in refugee women of childbearing age and in refugee children; to compare their 25(OH)D levels with the recommended levels in order to determine the prevalence of deficiency; to compare their 25(OH)D levels with those in the general Canadian population in the appropriate age and sex groups; and to investigate the association of vitamin D deficiency with potential risk factors.

designCross-sectional chart review.

settingThe Calgary Refugee Health Program, an urban family practice that serves newly arrived refugees in Calgary, Alta.

participantsA total of 1217 refugee women and children screened between June 2005 and January 2010.

main outcome measuresSerum 25(OH)D values that were measured during initial screening visits.

resultsOverall, 1217 of the 1768 eligible participants (69%) had 25(OH)D laboratory values recorded. The mean concentration of 25(OH)D was 52.0 nmol/L (95% CI 50.6 to 53.3 nmol/L). Using the Institute of Medicine guideline for adequate serum vitamin D levels (>50 nmol/L), 61% of women and 42% of children had lower-than-desirable 25(OH)D levels. Considering the Osteoporosis Canada guidelines, 88% of women and 81% of children had lower-than-desirable 25(OH)D levels (<75 nmol/L), and 21% of women and 10% of children were vitamin D deficient (<25 nmol/L). Mean levels of 25(OH)D were significantly lower across all age and sex groupings compared with the general Canadian population (P<.001). Women from the Middle East had lower mean 25(OH)D values (24.6 nmol/L, 95% CI 21.7 to 27.5 nmol/L) compared with women from Asia, Africa, or South America (P<.001). Mean values of 25(OH)D were lower during the winter in children (P=.01) but not in women. Female refugees between the ages of 12 and 19 years old had lower mean values of 25(OH)D than male refugees in the same age group did (P=.01).

conclusionMost refugees had lower-than-desirable vitamin D levels. All age groups studied had lower mean 25(OH)D levels compared with the general Canadian population. Health care providers should be aware of this concern and consider vitamin D supplementation among refugees.