Vitamin d for kids
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The Role of Vitamin D in Children's Health
Importance of Vitamin D for Kids
Vitamin D is crucial for children's health, primarily due to its role in calcium and phosphate metabolism, which are essential for bone health. It is synthesized in the skin upon exposure to sunlight and can also be obtained from dietary sources and supplements 68. Despite its importance, a significant number of children worldwide are deficient in vitamin D, which can lead to various health issues 68.
Effects on Bone Health and Growth
Bone Mineral Density
Vitamin D supplementation has been studied extensively for its effects on bone mineral density (BMD) in children. Research indicates that while vitamin D is essential for bone health, supplementation in children with normal vitamin D levels does not significantly improve BMD. However, in children with low vitamin D levels, supplementation may have a beneficial effect on bone mineral content and lumbar spine BMD 5.
Linear Growth and Stunting
The impact of vitamin D on linear growth and stunting in children under five years of age has been mixed. Some studies suggest that vitamin D supplementation may slightly improve height-for-age z-scores but has little to no effect on actual linear growth or stunting rates 1. The evidence is not strong enough to confirm a significant impact, and more extensive, well-designed studies are needed 1.
Safety of High-Dose Vitamin D Supplementation
High-dose vitamin D supplementation has been a concern due to the potential risk of toxicity. However, a systematic review and meta-analysis of 32 randomized clinical trials found that high-dose vitamin D supplementation (up to 10,000 IU daily or 600,000 IU bolus) is generally safe for children aged 0 to 6 years, with no significant increase in the risk of serious adverse events 2. Clinical adverse events were rare, suggesting that high-dose vitamin D is well-tolerated in young children 2.
Vitamin D Deficiency and Supplementation Recommendations
Prevalence of Deficiency
Vitamin D deficiency is common among children, especially in certain high-risk groups such as those with darker skin, limited sun exposure, or specific health conditions 89. In Europe, for instance, a considerable number of healthy children are vitamin D deficient, necessitating targeted supplementation strategies 89.
Supplementation Guidelines
To prevent vitamin D deficiency, various health organizations recommend supplementation. For infants up to one year, a daily dose of 400 IU is generally advised. Beyond this age, recommendations vary based on individual risk factors and local sunlight exposure 8910. For children at higher risk of deficiency, higher doses or year-round supplementation may be necessary 10.
Conclusion
Vitamin D plays a vital role in children's health, particularly in bone development and growth. While supplementation can be beneficial, especially for those with low vitamin D levels, the evidence does not strongly support its use for improving bone density or linear growth in children with normal levels. High-dose vitamin D supplementation appears to be safe, but careful monitoring is recommended to avoid toxicity. Ensuring adequate vitamin D intake through diet, sensible sun exposure, and supplementation when necessary is crucial for maintaining optimal health in children.
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Most relevant research papers on this topic
Effects of oral vitamin D supplementation on linear growth and other health outcomes among children under five years of age.
Oral vitamin D supplementation may make little to no difference in linear growth and probably makes little to no difference in stunting among children under five years of age.
Meta-Analysis
Very Rigorous JournalSafety of High-Dose Vitamin D Supplementation Among Children Aged 0 to 6 Years
High-dose vitamin D supplements in daily doses up to 10 000 IU/d or bolus doses up to 600 000 IU are well-tolerated and rarely associated with serious adverse events in children aged 0 to 6 years.
Meta-Analysis
Rigorous JournalDietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.
Increasing vitamin D intakes in young children through fortification of alternative dairy products leads to significantly higher serum concentrations and a greater proportion with serum 25(OH)D 50 nmol/L during minimal ultraviolet B radiation exposure.
RCTVery Rigorous JournalVitamin D supplementation and risk of toxicity in pediatrics: a review of current literature.
Vitamin D toxicity in children is rare but life-threatening, and monitoring levels is recommended for infants receiving long-term supplementation at or above the recommended upper intake.
Systematic ReviewRigorous Journal
Highly CitedVitamin D supplementation for improving bone mineral density in children
Vitamin D supplementation does not significantly improve bone density in healthy children with normal vitamin D levels, but may be useful for deficient children.
Meta-AnalysisVery Rigorous JournalHighly CitedVitamin D in pediatric health and disease
Vitamin D supplementation is crucial for optimal bone health in children, but pediatricians should consider lifestyle risk factors and only suggest it when rational reasons exist for its use.
Rigorous JournalSupplementation with 1000 IU vitamin D/d leads to parathyroid hormone suppression, but not increased fractional calcium absorption, in 4-8-y-old children: a double-blind randomized controlled trial.
Vitamin D3 supplementation at 1000 IU/d increases 25(OH)D and decreases parathyroid hormone in children with average vitamin D intake below dietary recommendations, but does not significantly affect calcium absorption.
RCTVery Rigorous JournalVitamin D in the Healthy European Paediatric Population
Vitamin D deficiency is common in healthy European infants, children, and adolescents, with risk groups including breast-fed infants, those with dark skin, and those without adequate sun exposure.
Literature ReviewVery Rigorous JournalHighly CitedVitamin D in European children—statement from the European Academy of Paediatrics (EAP)
European children may be vitamin D deficient, especially in high-risk groups, but routine screening for deficiency in healthy children is not justified.
Very Rigorous JournalHighly CitedVitamin D: still a topical matter in children and adolescents. A position paper by the Committee on Nutrition of the French Society of Paediatrics.
Vitamin D supplementation is recommended for pregnant women, breastfed infants, and children aged 18 months to 5 years, with doses varying based on age and risk factors.
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