Micronutrient deficiencies and health-related quality of life (HRQoL): the case of children with Vitamin D deficiency

Magda Aguiar, Lazaros Andronis*, Miranda Pallan, Wolfgang Högler, Emma Frew

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
239 Downloads (Pure)


Objective: To explore the extent to which micronutrient deficiencies (MND) affect children’s health-related quality of life (HRQoL), using vitamin D deficiency (VDD) as a case study.

Design: Proxy valuation study to estimate the impact of VDD on the HRQoL of younger (0–4 years) and older (>4 years) children. We used the Child Health Utility 9 Dimension (CHU9D) questionnaire to estimate HRQoL for children within six VDD-related health states: ‘hypocalcaemic cardiomyopathy’, ‘hypocalcaemic seizures’, ‘active rickets’, ‘bone deformities’, ‘pain and muscle weakness’ and ‘subclinical VDD’.

Setting: Sampling was not restricted to any particular setting and worldwide experts were recruited.

Participants: Respondents were paediatric bone experts recruited through network sampling.

Results: Thirty-eight experts completed the survey. The health state with the largest detrimental impact (mean score (se)) on children’s HRQoL was hypocalcaemic cardiomyopathy (0·47 (0·02)), followed by hypocalcaemic seizures (0·50 (0·02)) and active rickets (0·62 (0·02) in young children; 0·57 (0·02) in older children). Asymptomatic VDD had a modest but noticeable negative impact on HRQoL, attributed mostly to tiredness in both age groups and pain in the older paediatric population.

Conclusions: Elicitation of HRQoL from clinical experts suggests a negative impact of VDD on HRQoL, even if there is no recognizable clinical manifestation. HRQoL data from populations of patients with MND will inform public health policy decisions. In some settings, routine collection of HRQoL data alongside national nutrition surveys may help capture the full burden of MND and prioritize resources towards effective prevention.
Original languageEnglish
Number of pages8
JournalPublic Health Nutrition
Early online date12 Feb 2019
Publication statusE-pub ahead of print - 12 Feb 2019


  • Children
  • CHU9D
  • Health-related quality of life
  • Hypocalcaemia
  • Rickets
  • Utility
  • Vitamin D

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health


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