Vitamin DNEW2026-08

Hidden vitamin D insufficiency in a sun-rich equatorial country: age-, sex-, and season-specific evidence from 2961 Somali children.

Özcan Muhammet Engin, Abdi Abdulrahman Nor, Gahnug Mustafa — Journal of tropical pediatrics

Summary

Despite abundant sunshine, many children in Somalia, particularly adolescents and girls, showed low vitamin D levels. This study highlights that even in sunny regions, vitamin D deficiency can be a hidden problem, suggesting a need for targeted public health efforts.

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Key points

Even in sunny countries, vitamin D insufficiency can be common among children.
Older children and adolescents in the study had lower vitamin D levels than infants.
Girls consistently showed lower vitamin D levels compared to boys.
Vitamin D levels were lowest during certain seasons, even in an equatorial region.

What the study looked at

This study aimed to understand how common vitamin D deficiency and insufficiency were among children in Somalia, a country with ample sunlight, and if levels varied by age, sex, or season. This study looked back at health data from nearly 3,000 children and adolescents, aged 0 to 18, who visited a hospital in Somalia. They measured vitamin D levels in blood samples taken between 2020 and 2025 and grouped the results by age, sex, and the time of year. The study revealed that despite living in a very sunny region, many Somali children, especially adolescents and girls, had insufficient vitamin D. Vitamin D levels generally decreased with age, with infants having the highest levels and teenagers the lowest. Girls consistently had lower levels than boys, and levels were lowest during the July-September period. This suggests that even with abundant sun exposure, vitamin D status can be a concern for specific groups.

Dietary takeaway

This study suggests that relying solely on sun exposure might not be enough for optimal vitamin D, especially for older children and girls, even in sunny climates. While more research is needed, incorporating vitamin D-rich foods like fatty fish (salmon, mackerel), fortified milk, or certain mushrooms into the diet could be beneficial. Remember that this is just one study, and individual needs can vary, so consult a healthcare professional for personalized advice.

Abstract

This study aimed to determine the prevalence of vitamin D deficiency and insufficiency, and to evaluate age-, sex-, and season-specific variations in serum 25(OH)D levels among Somali children and adolescents. This retrospective cross-sectional study included pediatric outpatients aged 0-18 years who attended a tertiary care hospital in Mogadishu, Somalia, between January 2020 and August 2025. Serum 25(OH)D levels were analyzed in 2961 participants and categorized as deficient (<12 ng/ml), insufficient (12-20 ng/ml), or sufficient (>20 ng/ml) according to Global Consensus Recommendations. Participants were stratified by age group, sex, and season. Statistical analyses were performed using non-parametric tests, with P < .05 considered statistically significant. Mean serum 25(OH)D levels decreased progressively with age, with the highest concentrations observed in infants aged 0-1 year (53.8 ± 18.1 ng/ml) and the lowest in adolescents aged 12-18 years (27.4 ± 13.1 ng/ml). Vitamin D deficiency was absent in infants and rare in children aged 1-6 years, but increased substantially in older age groups, reaching 9.4% deficiency and 23.7% insufficiency among adolescents. Males consistently exhibited higher serum 25(OH)D levels than females across all age groups and seasons (P < .001). Seasonal variation was observed, with the lowest mean levels recorded during July-September. Despite abundant year-round sunlight, vitamin D insufficiency and deficiency are prevalent among Somali children, particularly in adolescents and females. These findings highlight the need for age- and sex-specific public health strategies, including targeted screening and supplementation beyond early childhood, to improve 25(OH)D status in pediatric populations living in sun-rich environments.

View on PubMed →DOI: 10.1093/tropej/fmag053