Vitamin D: The Evidence in Children
Vitamin D – the efficacy of colecalciferol in children
- The prevalence of vitamin D insufficiency in children may vary enormously according to a number of factors: latitude, ethnicity, social status, critical diseases and supplementation1,2
- A re-assessment of Recommended Dietary Allowance (RDA) for vitamin D (set as the intake associated with 25(OH)D levels >50nmol/L) was carried out in Canada and demonstrated inadequate RDAs in 14.1% of 6-11 year olds and 26.3% of 12-19 year olds3
- Vitamin D deficiency is a common condition in adolescents. In the UK, Absoud (2011) found vitamin D levels were insufficient in 35% of 1102 subjects aged 4-18 years and decreased with age in both sexes, (mean=62.1nmol/L, 95% CI 60.4-63.7)4
- Vitamin D is significantly associated with muscle power and force in adolescent girls5
- In 2008, Cashman demonstrated that 12 and 15 year old girls in Northern Ireland with high vitamin D status (>74.1nmol/L) had significantly greater forearm (but not heel) BMD and lower serum PTH concentrations and bone turnover markers than did those with low vitamin D status. This was not observed in boys6
- Similar results were obtained in a recent large prospective cohort study conducted in the UK (Sayers 2012). It showed that 25(OH)D3 (and not 25(OH)D2) was positively related to subsequent cortical bone mass and predicted strength. In vitamin D deficient children in whom supplementation is being considered, these results suggest that colecalciferol should preferably be used7
1. McNally JD, Kusum M, Chakraborty P, et al. The association of vitamin D status with pediatric critical illness. Pediatrics. 2012;130(3):429–436.
2. Madden K, Feldman HA, Smith EM, et al. Vitamin D deficiency in critically ill children. Pediatrics Vol 130, No 3, Sept 2012, 421-8.
3. Whiting SJ, Langlois KA, Vatanparast H, Greene-Finestone LS. The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use. Am J Clin Nutr 2011; 94(1):128-35.
4. Absoud M, Cummins C, Lim MJ, Wassmer E, Shaw N. Prevalence and predictors of vitamin D insufficiency in children: a Great Britain population based study. PLoS One 2011; 6(7):e22179.
5. Ward KA, Das G, Berry JL et al. Vitamin D status and muscle function in post-menarchal adolescent girls. J Clin Endocrinol Metab 2009; 94(2):559-6.
6. Cashman KD, Hill TR, Cotter AA et al. Low vitamin D status adversely affects bone health parameters in adolescents. Am J Clin Nutr 2008; 87(4):1039-44.
7. Sayers A, Fraser WD, Lawlor DA, Tobias JH. 25-Hydroxyvitamin-D3 levels are positively related to subsequent cortical bone development in childhood: findings from a large prospective cohort study. Osteporos Int 2012; 23(8):2117-28.