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. 2025 Feb 11;184(2):190.
doi: 10.1007/s00431-025-06024-9.

Vitamin D status and muscle strength in a pan-European cohort of children and adolescents with normal weight and overweight/obesity

Hajo Zeeb  1   2 , Tilman Brand  3 , Lauren Lissner  4 , Fabio Lauria  5 , Dénes Molnár  6 , Toomas Veidebaum  7 , Matthias Nauck  8   9 , Michael Tornaritis  10 , Stefaan De Henauw  11 , Luis A Moreno  12   13 , Wolfgang Ahrens  3 , Hermann Pohlabeln  3 , Maike Wolters; IDEFICS and I.Family consortia
Affiliations

Vitamin D status and muscle strength in a pan-European cohort of children and adolescents with normal weight and overweight/obesity

Hajo Zeeb et al. Eur J Pediatr. .

Abstract

This aimed to investigate associations between the vitamin D status and handgrip strength in children and adolescents considering weight status. Participants aged 7 to < 16 years from the European IDEFICS/I.Family cohort were included. Serum 25-hydroxyvitamin D [25(OH)D] and handgrip strength were measured in 2013/2014. In multivariable logistic regression models, we investigated the association of vitamin D status with handgrip strength adjusted for demographic variables, BMI z-score, sports club membership, screen time and UV intensity. Vitamin D-sufficient children had higher odds for a high handgrip strength (OR = 1.92, 95%-CI: 1.12, 3.30), but this association was limited to children with thinness/normal weight (OR = 2.60, 95%-CI: 1.41-4.81). Children with overweight (OR = 2.64, 95%-CI: 2.00, 3.49) and obesity (OR = 4.53, 95%-CI: 2.93, 7.02) were more likely to have a high handgrip strength than thin/normal weight children.

Conclusions: The positive association of vitamin D with muscle strength in our study is limited to children with low and normal BMI. In children with overweight or obesity, the higher muscle strength seems to superimpose the association with vitamin D. Overall, our results indicate the importance of sufficient levels of vitamin D and offers physical activity perspectives for children with overweight and obesity.

Study registration: ISRCTN: https://doi.org/10.1186/ISRCTN62310987 .

What is known: • Studies have shown a positive association between vitamin D status and handgrip strength in older adults while studies in children and adolescents are scarce. • Conflicting results were found on whether overweight and obesity are associated with reduced or increased handgrip strength compared to normal weight.

What is new: • The results of this large pan-European study in children and adolescents indicate that a sufficient vitamin D status is associated with better handgrip strength, particularly in participants with thinness/normal weight. • Children with overweight and obesity have a higher handgrip strength as compared to children with thinness/normal weight which seems to superimpose the positive association between vitamin D status and handgrip strength in this group.

Keywords: Children cohort; Handgrip strength; Obesity; Overweight; Vitamin D.

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Conflict of interest statement

Declarations. Informed consent and ethics approval: Parents and children aged 12 years and older provided written informed consent before the start of the study while younger children gave oral consent. Ethics approval for the IDEFICS/I.Family studies was obtained from the following institutional review boards of all study centres: Ethics Committee of the Gent University Hospital, Belgium, 15/10/2007, ref: No. EC UZG 2007/243 and 19/02/2013, No. B670201316342; Cyprus National Bioethics Committee, Cyprus, 12/07/2007, ref: No. EEBK/EM/2007/16 and 21/Feb/2013, No. EEBK/ETI/2012/33; Tallinn Medical Research Ethics Committee, Estonia, 14/06/2007, ref: No. 1093 and 17/January 2013, No. 128; Ethic Commission of the University of Bremen, Germany, 16/01/2007 and 11/12/2012; Medical Research Council, Hungary, 21/Jun/2007, ref: 22–156/2007-1018EKU and 18/12/2012, 4536/2013/EKU; Ethics Committee of the Local Health Authority, Avellino, Italy, 19/06/2007, ref: No. 2/CE and 18/Sep/2012, No. 12/12; Ethics Committee for Clinical Research of Aragon, Spain, 20/06/2007, ref:No. PI07/13 and 13/Feb/2013, No. PI13/0012; Regional Ethics Research Board in Gothenburg, Sweden, 30/07/2007, ref: No. 264–07 and 10/Jan/2013, No. 927–12. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Conflict of interest: The authors declare no competing interests.

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