Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review (original) (raw)
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The Epidemiology of Vitamin D and Calcium Deficiency
Nestl� Nutrition Workshop Series: Pediatric Program, 2004
At the time of weaning, the infant's food and nutrient intake changes radically from that derived from breast-milk to that derived from complementary foods. In developing countries particularly, this change may have serious consequences for the provision of nutrients, especially for micronutrients and vitamins. Two nutrients of particular importance for bone health are calcium and vitamin D. At the 52nd Nestle Workshop on Micronutrient Deficiencies, I discussed the pathogenesis of rickets in young infants due to maternal and infant deficiencies. Here I will discuss the epidemiology of vitamin D and calcium deficiency in the infant older than 6 months of age and young children.
Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength. Vitamin D deficiency is widely prevalent worldwide. In adults, vitamin D deficiency has been implicated in numerous health conditions including osteoporosis, cancer, diabetes, and autoimmune diseases. Considerable changes have occurred in lifestyles and childhood activities in the past years. Studies have shown that the children population is at high risks of vitamin D deficiency. The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel. In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel, through a very comprehensive review of previous reports and research studies done during the last years. We found reports on vitamin D deficiency in children, which was associated with metabolic syndromes and obesity. It was more prevalent in children who spend less time on outdoor activities, in obese children, and in cases when there was imbalance between nutritional intakes and requirements. Vitamin D deficiency is common even in children living in sunny places like Israel. Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population, it is also common in the children, and can be associated with different illnesses. We encourage supplementation of vitamin D to special populations (pregnant and lactating women, infants, and high risk groups). We also encourage implementation of international food fortification programs. Core tip: Vitamin D is known to be a key regulator of bone metabolism and muscle strength. Vitamin D deficiency is widely prevalent worldwide. In this article we emphasize that vitamin D status may be also related to a number of non-skeletal diseases, including cardiovascular events, cancer, diabetes, and autoimmune diseases. Obesity has also been recently associated with vitamin D insufficiency. We demonstrate that the pediatric population is also at high risks of vitamin D deficiency. Studies that investigated the status of vitamin D deficiency in Israel, which is a known multi-cultural sunny country, revealed a high prevalence of vitamin D deficiency. Haimi M, Kremer R. Vitamin D deficiency/insufficiency from childhood to adulthood: Insights from a sunny country. World J Clin Pediatr 2017; 6(1): 1-9 Available from:
Vitamin D deficiency in adolescents
Indian Journal of Endocrinology and Metabolism, 2014
In general, a serum 25(OH) D at concentration less than 25 nmol/L (10 ng/mL) is a useful marker of the risk of clinical defi ciency, but the terminology and cutoffs used to defi ne less than desirable vitamin D status is controversial. It includes terms such as insuffi ciency, inadequate level, defi ciency (VDD) and hypovitaminosis D and may result in subclinical conditions with chronic latent manifestations, the most recognized of which is osteoporosis. The 25(OH) D cutoffs to defi ne this condition vary and have recently been defi ned as desirable level at 20 ng/ml (50 nmol/L), and the Endocrine Society Guidelines set at 30 ng/ml (75 nmol/L). [1,2] PREVALENCE OF VDD IN ADOLESCENTS WORLDWIDE Adequate vitamin D status is essential for active calcium absorption in the gut and for bone development and remodeling. While bone disease secondary to VDD (rickets and osteomalcia) is almost eradicated in western populations, its prevalence remains unacceptably high in Asia, Africa and the Middle-east. [3,4] In a review conducted
Amerta Nutrition, 2021
Latar Belakang: Stunting dan penurunan densitas tulang merupakan salah satu masalah gizi yang umum diderita oleh remaja. Hal ini terjadi akibat kurangnya asupan zat gizi yang adekuat terutama vitamin D yang berfungsi untuk pertumbuhan tulang dan mineralisasi jaringan. Jumlah yang terbatas dari makanan dan faktor pigmentasi kulit menjadi penyebab terjadinya defisiensi vitamin D sehingga dibutuhkan upaya suplementasi untuk memenuhi kebutuhan tersebut.Tujuan: Untuk menganalisis efek suplementasi vitamin D terhadap pertumbuhan linier remaja.Metode: Penelusuran artikel pada tinjauan pustaka ini dilakukan menggunakan mesin pencarian melalui Medline, PubMed, EBSCO, ELSEVIER, Cambridge Core, dan WILEY. Artikel memuat teks penuh, berbahasa inggris dan tahun terbit mulai dari 2010 hingga 2020. Kata kunci pencarian yang dimasukkan adalah vitamin D supplementation, adolescent or teenagers, linear growth, dan Bone Mass Density (BMD).Hasil: Hasil skrining menemukan 12 artikel yang memenuhi kriter...
Vitamin D deficiency/insufficiency from childhood to adulthood: Insights from a sunny country
World Journal of Clinical Pediatrics, 2017
Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength. Vitamin D deficiency is widely prevalent worldwide. In adults, vitamin D deficiency has been implicated in numerous health conditions including osteoporosis, cancer, diabetes, and autoimmune diseases. Considerable changes have occurred in lifestyles and childhood activities in the past years. Studies have shown that the children population is at high risks of vitamin D deficiency. The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel. In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel, through a very comprehensive review of previous reports and research studies done during the last years. We found reports on vitamin D deficiency in children, which was associated with metabolic syndromes and obesity. It was more prevalent in children who spend less time on outdoor activities, in obese children, and in cases when there was imbalance between nutritional intakes and requirements. Vitamin D deficiency is common even in children living in sunny places like Israel. Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population, it is also common in children, and can be associated with different illnesses. We encourage supplementation of vitamin D to special populations (pregnant and lactating women, infants, and high risk groups). We also encourage implementation of international food fortification programs.
Vitamin D status of apparently healthy early adolescents in Amravati City of Maharashtra, India
2013
Introduction/Background: Although vitamin D deficiency has been documented as a frequent problem in studies of young adults, elderly persons and children in other countries, there are limited data on the prevalence of this nutritional deficiency among healthy Indian adolescents. This study was conducted to determine the prevalence of vitamin D status in adolescents aged 13 to 15 years.
Vitamin D status and determinants in Indian children and adolescents: a multicentre study
Scientific Reports, 2022
Studies performed on Indian children to assess vitamin-D status have been on small sample sizes, limited to specific geographical locations and used non-standard methods to measure 25(OH)D 3. This multicentre study assessed 25(OH)D 3 concentrations from dried blood spots (DBS) in 5-18-year-old Indian children and adolescents using a standardized protocol and identified factors contributing towards vitamin D deficiency. Cross-sectional, observational school-based study was conducted by multi-stage stratified random sampling. A city and nearby village were selected from 6 Indian states covering wide geographical areas. Demography, anthropometry, body-composition, dietary-intakes and DBS samples were collected. 25(OH)D 3 was assessed from DBS using Liquid chromatography with tandem-mass spectrometry. Vitamin-D status was assessed in 2500 children; with additional data collected on a subset (n = 669) to assess predictors. Mean vitamin-D concentration was 45.8 ± 23.9 nmol/L, 36.8% of subjects had sufficient vitamin-D (> 50 nmol/L); rural subjects and boys had higher concentrations (p < 0.05). On regression analysis, younger age, female-gender, overweight and urban residence significantly contributed to deficiency. More than half the Indian children/ adolescents were vitamin-D deficient or insufficient. Our study reinforces vitamin-D deficiency as a major public health problem and the need for supplementation, food fortification and educating the population as initiatives required to improve sufficiency status. Vitamin D is a secosterol with a major role in maintaining calcium and phosphorus homeostasis. Vitamin D affects calcium homeostasis by its action on the kidney, intestine and bone 1. Vitamin D also has direct and indirect effects on growth plates, bone and bone cells 1. The extra-skeletal role of vitamin D has been suggested in various organs and ailments like skin (psoriasis, skin cancer), muscle function, cardiomyopathy, immune system (respiratory tract infection, inflammatory bowel disorder, allergy), colorectal carcinoma, cardiovascular risk factors (hypertension, diabetes, obesity, metabolic syndrome), neurological disorders and reproductive function 1. It is generally accepted that serum 25-hydroxyvitamin D (25(OH)D) is a reliable measure of an individual's vitamin D status. Serum total 25(OH)D concentration is the sum of the 25(OH)D 3 and 25(OH)D 2 concentrations. Various methods such as Radioimmunoassay (RIA), Chemiluminescence immunoassay, Enzyme-Linked Immunosorbent Assay (ELISA), and protein binding assays are used for measurement of 25(OH)D concentrations. However, High-Performance Liquid Chromatography (HPLC) or tandem mass spectrometry are considered to be the gold standard for the assessment of 25(OH)D 3 2. Thus, liquid chromatography-tandem mass spectrometry (LC-MS/ MS) is the widely accepted reference method for 25(OH)D measurement, however, it requires expensive equipment and expertise and is seldom used in low-or middle-income countries such as India 3. The Indian Academy of Paediatrics Guidelines and the Global Consensus on Prevention as well as Management of Nutritional Rickets recommend that 25(OH)D concentrations of over 50nmols/L (20ngm/ml) are sufficient, between 30 and 50 nmols/L (12-20 ngm/ml) are insufficient and below 30 nmols/L (12 ngm/ml) are in the deficiency range in children and adolescents 3,4. A systematic review published in 2014 suggests that vitamin D deficiency and insufficiency are a major public health problem globally irrespective of age, even in populations residing in countries where it is assumed that UV radiation is adequate and in industrialized countries where fortification has been implemented for years 5. It is estimated that about 1 billion people across all ethnicities and age groups have low vitamin D concentrations worldwide 6. In India, approximately 490 million people are
Vitamin D Deficiency in Children and Adolescents
Journal of Clinical Research in Pediatric Endocrinology, 2012
Ori gi nal Ar tic le 2 5 In tro duc ti on Vitamin D deficiency is an important public health problem in both developed and developing countries, with a reported worldwide prevalence of 30-80% in children and adults (1,2,3). The role of vitamin D in bone mineralization is well-documented. However, only recently, numerous studies have reported a link between vitamin D deficiency and several chronic disorders such as type 1 diabetes mellitus (T1DM), systemic lupus erythematosus (SLE), multiple sclerosis (MS), cardiovascular disease (CVD) and several malignancies (4,5,6,7,8). These recent findings have led to greater emphasis on treatment of vitamin D deficiency and/or vitamin D supplementation. Prevalence studies on vitamin D deficiency and/or insufficiency in the Turkish population, especially among prepubertal children over 3 years of age, are relatively scarce (9). The aim of this study was to determine the frequency of deficiency and insufficiency of vitamin D in a sample of Turkish children and adolescents and to investigate the factors associated with low vitamin D status. Methods This study was undertaken by the Fatih University Pediatrics Department and conducted in the University hospital, situated in Ankara, Turkey. We retrospectively reviewed the records of a total of 440 children and adolescents aged between 0 and 16 years who had presented to the outpatient clinic between January 2008 and January 2010. All patients were subjected to a careful physical examination. Weights were measured using a calibrated digital scale. Height measurements were done in ABS TRACT Ob jec ti ve: Vitamin D deficiency is an important health problem in both developed and developing countries. Recent reports on the extraskeletal effects of vitamin D have led to increased interest in prevalence studies on states of deficiency/insufficiency of vitamin D. The aim of this study was to determine the frequency of vitamin D deficiency and insufficiency in children and adolescents residing in Ankara, Turkey and to investigate the factors associated with low vitamin D status. Methods: A total of 440 children and adolescents aged between 0 and 16 years were enrolled in this study. The subjects were divided into three groups according to their vitamin D status (deficiency ≤15 ng/mL; insufficiency: 15-20 ng/mL; sufficiency ≥20 ng/mL) and also according to their age (preschool<5 years; middle childhood: 5-10 years; adolescence: 11-16 years). Results: Overall, 40% of the subjects were found to have 25 hydroxy vitamin D [25(OH)D] levels of less than 20 ng/mL. The levels indicated a deficiency state in 110 subjects (25%) and insufficiency-in 66 (15%). The rate of vitamin D deficiency was higher in girls, regardless of age. 25(OH)D levels correlated negatively with age (r=-0.48, p<0.001), body mass index (BMI) (r=-0.20, p=0.001) and intact parathyroid hormone (iPTH) level (r=-0.31, p=0.001). A positive correlation was observed between 25(OH)D and serum ferritin levels (r=0.15, p=0.004). Conclusions: The high frequency of vitamin D deficiency in childhood (especially among adolescent girls) indicates a need for supplementation and nutritional support.
Vitamin D deficiency in children and adolescents: Epidemiology, impact and treatment
Reviews in Endocrine and Metabolic Disorders, 2008
Vitamin D deficiency is highly prevalent among children and adolescents worldwide. The high rates of vitamin D deficiency during childhood are of major public health relevance, given the growing evidence that vitamin D deficiency may play a key role in the pathophysiology of many chronic diseases beyond rickets, including autoimmune conditions, cardiovascular diseases, and cancer. Identification, treatment, and prevention of vitamin D deficiency in childhood may therefore have profound health effects throughout the life span. In this review, we discuss the definitions, epidemiology, clinical implications, and treatment of vitamin D deficiency in children and adolescents.
Journal of diabetes and metabolic disorders, 2016
This cross-sectional population-based study was conducted to elucidate the prevalence of vitamin D deficiency, bone turnover marker's variation and its influencing factors among adolescents of Tehran. Totally 444 middle and high school (53.6 % in high school) students (both girls and boys) were recruited. A short food frequency questionnaire designed to estimate dietary calcium and vitamin D consumption. Serum levels of calcium, phosphorus, parathyroid hormone (PTH), bone specific alkaline phosphates, 25 (OH) vitamin D, osteocalcin, cross-linked C-telopeptide (CTX), total protein, albumin and creatinine were determined. Vitamin D deficiency was prevalent in adolescents and only 22.4 % of students had normal serum vitamin D. Results revealed that vitamin D insufficiency reported in 34.2 % of students and vitamin D deficiency was in 43.3 % of them. Serum vitamin D, osteocalcin, CTX and bone specific alkaline phosphates were significantly higher in boys in all different ages. Serum...