Dietary vitamin D intake and sun exposure are not associated with type 1 diabetic schoolchildren and adolescents: A first report in Algeria1

Abstract

BACKGROUND: A large number of children and adolescents worldwide suffer from physiological vitamin D (VD) deficiency, which has been associated with sun exposure and, consequently, the risk of developing various autoimmune diseases, including type 1 diabetes (T1D). However, the association of the disease with VD intake and sun exposure has yet to be explored. MATERIALS AND METHODS: We conducted a food frequency questionnaire and a 24-hour food recall survey, using “Ciqual table 2016” in 335 type 1 diabetic and age- and gender-matched healthy Algerian school children and adolescents from sunny Saharan and relatively less sunny Northern regions, aged between 5 and 19 years. RESULTS: Both dietary VD intake and VD levels were similar in T1D patients when comparing northern and southern regions (for both comparisons, p > 0.05). Neither sun exposure nor VD intake was associated with the disease (respectively, relative risk [RR] = 1.050, p = 0.680; RR = 1.082, p = 1.000. For Cochran and Mantel-Haenszel analysis; RR = 0.841, p = 0.862). VD intake showed a significant difference between diabetics and non-diabetics in the sunny region (p = 0.022). Additionally, significant differences were found between normal and T1D schoolboys (p = 0.038), and when comparing the two groups according to the dry areas (p = 0.016). Moreover, in contrast to circulating VD levels, which were lower in T1D patients than in healthy controls, those of VD intake were significantly higher (p < 0.05), especially in male patients and in those with balanced diet, low protein or carbohydrate consumption, specific food intolerances, and regular meals (p < 0.05), as well as in patients with a moderate or low consumption of cooked meals or steamed foods (p < 0.01). Conversely, VD intake was markedly lower in type 1 diabetics than in controls for dry and sunny areas, including the region of Adrar, as well as for consumption of low-fat foods and eggs (p < 0.05 for all comparisons). Nevertheless, the relative risk of sun exposure and dietary vitamin D intake according to the World Health Organization (WHO) standard did not show a significant association with T1D (common Mantel-Haenszel estimation, RR = 0.841, 95% CI 0.118–5.973, p > 0.05). CONCLUSIONS: T1D does not appear to be associated with VD intake and sun exposure in the Algerian Sahara region. Therefore, the consumption of VD in T1D patients in the Algerian Sahara would suspect that its association with the disease would be related to its synthesis alteration.