Calcium and vitamin D intakes in children: a randomized controlled trial

Linda Cosenza, Vincenza Pezzella, Rita Nocerino, Margherita Di Costanzo, Anna Coruzzo, Annalisa Passariello, Ludovica Leone, Marcella Savoia, Antonio Del Puente, Antonella Esposito, Gianluca Terrin, Roberto Berni Canani, Linda Cosenza, Vincenza Pezzella, Rita Nocerino, Margherita Di Costanzo, Anna Coruzzo, Annalisa Passariello, Ludovica Leone, Marcella Savoia, Antonio Del Puente, Antonella Esposito, Gianluca Terrin, Roberto Berni Canani

Abstract

Background: Calcium (Ca(2+)) and vitamin D (VitD) play an important role in child health. We evaluated the daily intake of Ca(2+) and VitD in healthy children. Moreover, we demonstrate the efficacy of Ca(2+) and VitD supplementation.

Methods: Daily Ca(2+) and VitD intake was evaluated in consecutive healthy children through a validated questionnaire. Subjects with <70% of dietary reference intakes (DRIs) of Ca(2+) and VitD were invited to participate in a prospective randomized trial with 2 groups of nutritional intervention: Group 1, dietary counseling aiming to optimize daily Ca(2+) and VitD intake plus administration of a commercially available Ca(2+) and VitD supplementation product; Group 2, dietary counseling alone. At the enrollment (T0) and after 4 months (T1) serum 25(OH) Vitamin D levels were assessed.

Results: We evaluated 150 healthy children (male 50%, mean age 10 years); at baseline a low VitD intake was observed in all subjects (median 0.79 μg/die, IQR 1.78; range 0.01-5.02); this condition was associated with Ca(2+) intake <70% of the DRIs in 82 subjects (55%). At baseline serum 25(OH)D levels were low (<30 ng/ml) in all study subjects and after 4 months of nutritional intervention, a normalization of serum 25(OH)D levels (≥30 ng/ml) was observed in all children in Group 1 and in only one subject in Group 2 [Group 1: T1 33.8 ng/ml (IQR 2.5) vs Group 2: T1 24.5 ng/ml (IQR 5.2), p <0.001].

Conclusions: Adequate Ca(2+) and VitD intakes are difficult to obtain through dietary counseling alone in pediatric subjects. Oral supplementation with of Ca(2+) and VitD is a reliable strategy to prevent this condition.

Trial registration: The study was registered in Clinical Trials Protocol Registration System (ID number: NCT01638494).

Figures

Figure 1
Figure 1
Serum 25(OH)D levels observed at baseline (T0) and after four months of nutritional interventions (T1) in the two study groups.

References

    1. Stallings VA. Calcium and bone health in children: a review. Am J Ther. 1997;47:259–273.
    1. Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children and adolescents. Pediatrics. 2008;122:1142–1152. doi: 10.1542/peds.2008-1862.
    1. Pettifor JM, Prentice A. The role of Vitamin D in paediatric bone health. Best Pract Res Clin Endocrinol Metab. 2011;25:573–584. doi: 10.1016/j.beem.2011.06.010.
    1. Holick MF. Vitamin D Deficiency. NEJM. 2007;357:266–281. doi: 10.1056/NEJMra070553.
    1. Mutlu A, Mutlu GY, Özsu E. Vitamin D deficiency in children and adolescents with type 1 diabetes. J Clin Res Pediatr Endocrinol. 2011;3:179–183.
    1. Hewison M. Antibacterial effects of vitamin D. Nat Rev Endocrinol. 2011;7:337–345. doi: 10.1038/nrendo.2010.226.
    1. Simon KC, Munger KL, Ascherio A. Vitamin D and multiple sclerosis: epidemiology, immunology, and genetics. Curr Opin Neurol. 2012;25:246–251. doi: 10.1097/WCO.0b013e3283533a7e.
    1. Monticielo OA, Teixeira TD, Chies JA. Vitamin D and polymorphisms of VDR gene in patients with systemic lupus erythematosus. Clin Rheumatol. 2012;31:1411–1421. doi: 10.1007/s10067-012-2021-5.
    1. Cross HS, Nittke T, Kallay E. Colonic vitamin D metabolism: implications for the pathogenesis of inflammatory bowel disease and colorectal cancer. Mol Cell Endocrinol. 2011;347:70–79. doi: 10.1016/j.mce.2011.07.022.
    1. Buttigliero C, Monagheddu C, Petroni P. Prognostic role of vitamin d status and efficacy of vitamin D supplementation in cancer patients: a systematic review. Oncologist. 2011;16:1215–1227. doi: 10.1634/theoncologist.2011-0098.
    1. Cacopardo B, Camma C, Petta S. Diagnostic and therapeutical role of vitamin D in chronic hepatitis C virus infection. Front Biosc. 2012;4:1276–1286.
    1. Maalmi H, Berraïes A, Tangour E. The impact of vitamin D deficiency on immune T cells in asthmatic children: a case–control study. J Asthma Allergy. 2012;5:11–19.
    1. Reis JP, von Mühlen D, Miller ER 3rd, Michos ED, Appel LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics. 2009;124(3):e371–e379. doi: 10.1542/peds.2009-0213.
    1. Kumar J, Muntner P, Kaskel FJ, Hailpern SM, Melamed ML. Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics. 2009;124(3):e362–e370. doi: 10.1542/peds.2009-0051.
    1. Holick MF. Vitamin D: extraskeletal health. Rheum Dis Clin North Am. 2012;38:141–160. doi: 10.1016/j.rdc.2012.03.013.
    1. Holick MF. The D-lightful vitamin D for child health. J Parenter Enteral Nutr. 2012;36(1 Suppl):9S–19S. doi: 10.1177/0148607111430189.
    1. Ross AC. The 2011 report on dietary reference intake of calcium and vitamin D from The Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–58. doi: 10.1210/jc.2010-2704.
    1. Marrone G, Rosso I, Moretti R, Valent F, Romanello C. Is vitamin D status known among children living in Northern Italy? Eur J Nutr. 2012;51(2):143–149. doi: 10.1007/s00394-011-0200-9.
    1. Engelsen O. The relationship between ultraviolet radiation exposure and vitamin D status. Nutrients. 2010;2:482–495. doi: 10.3390/nu2050482.
    1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S–1688S.
    1. Unuvar T, Buyukgebiz A. Nutritional rickets and vitamin D deficiency in infants, children and adolescents. Pediatr Endocrinol Rev. 2010;7:283–291.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться