Vitamin D in the Healthy Paediatric Population: A Position Paper by the ESPGHAN Committee on Nutrition

*Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, Zurich, Switzerland †Department of Pediatrics, University of Granada, Spain ‡Hospital Necker, Paris, France §Department of Paediatrics, University of Pecs, Hungary ||Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden ¶MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK #Children's Hospital Zagreb, Zagreb, Croatia **Department of Paediatrics, Deaconry Hospital, Schwaebisch Hall, Germany ††Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark ‡‡Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Israel §§Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, France ||||Pediatrics, VU University Medical Center Amsterdam Netherlands and Pediatrics, Emma Children's Hospital-AMC, Amsterdam, the Netherlands. 1Committee Secretary. 2Committee Chair.
Journal of pediatric gastroenterology and nutrition (Impact Factor: 2.63). 03/2013; 56. DOI: 10.1097/MPG.0b013e31828f3c05
Source: PubMed


In recent years, reports suggesting a resurgence of vitamin D deficiency in the Western world, combined with various proposed health benefits for vitamin D supplementation have resulted in increased interest from healthcare professionals, the media and the public. The aim of this position paper is to summarize the published data on vitamin D intake and prevalence of vitamin D deficiency in the healthy European paediatric population, to discuss health benefits of vitamin D and to provide recommendations for the prevention of vitamin D deficiency in this population. Vitamin D plays a key role in calcium and phosphate metabolism and is essential for bone health. There is insufficient evidence from interventional studies to support vitamin D supplementation for other health benefits in infants, children and adolescents. The pragmatic use of a serum concentration above 50 nmol/l to indicate sufficiency and a serum concentration below 25 nmol/l to indicate severe deficiency is recommended. Vitamin D deficiency occurs quite commonly among healthy European infants, children and adolescents, especially in certain risk groups including breast-fed infants not adhering to the current recommendation for vitamin D supplementation, children and adolescents with dark skin living in Northern countries, as well as children and adolescents without adequate sun exposure, and obese children. Infants should receive an oral supplementation of 400 IU/day of vitamin D. The implementation should be promoted and supervised by paediatricians and other healthcare professionals. Healthy children and adolescents should be encouraged to follow a healthy lifestyle associated with a normal body mass index and including a varied diet with vitamin D containing foods (fish, eggs, dairy products) and adequate outdoor activities with associated sun exposure. For children in risk groups identified above an oral supplementation of vitamin D must be considered beyond one year of age. National Authorities should adopt policies aimed at improving vitamin D status using measures such as dietary recommendations, food fortification, vitamin D supplementation and judicious sun exposure, depending on local circumstances.

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    • "Given these conflicting results and the high prevalence of both asthma and vitamin D deficiency in many countries [26,27], we aimed to systematically review the evidence for the epidemiological association between low levels of serum vitamin D and asthma diagnosis in children. "
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    ABSTRACT: Background There is conflicting evidence about the association between low vitamin D levels in children and development of asthma in later life. The objective of this study was to systematically review the evidence for an epidemiological association between low serum levels of vitamin D and the diagnosis of asthma in children. Methods We used the Cochrane methodology for conducting systematic reviews. The search strategy included an electronic search of MEDLINE and EMBASE in February 2013. Two reviewers completed, in duplicate and independently, study selection, data abstraction, and assessment of risk of bias. Results Of 1081 identified citations, three cohort studies met eligibility criteria. Two studies found that low serum vitamin D level is associated with an increased risk of developing asthma late in childhood, while the third study found no association with either vitamin D2 or vitamin D3 levels. All three studies suffer from major methodological shortcomings that limit our confidence in their results. Conclusions Available epidemiological evidence suggests a potential association between low serum levels of vitamin D and the diagnosis of asthma in children. High quality studies are needed to reliably answer the question of interest.
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