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Vitamin D and bone health in early life

Published online by Cambridge University Press:  07 March 2007

Christian Mølgaard  and
Kim Fleischer Michaelsen
Kim Fleischer Michaelsen
Affiliation:
Department of Human Nutrition, LMC Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark
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Abstract

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Prolonged vitamin D deficiency resulting in rickets is seen mainly during rapid growth. A distinct age distribution has been observed in the Copenhagen area where all registered hospital cases of rickets were either infants and toddlers or adolescents from immigrant families. Growth retardation was only present in the infant and toddler group. A state of deficiency occurs months before rickets is obvious on physical examination. Growth failure, lethargy and irritability may be early signs of vitamin D deficiency. Mothers with low vitamin D status give birth to children with low vitamin D status and increased risk of rickets. Reports showing increasing rates of rickets due to insufficient sunlight exposure and inadequate vitamin D intake are cause for serious concern. Many countries (including the USA from 2003) recommend vitamin D supplementation during infancy to avoid rickets resulting from the low vitamin D content of human milk. Without fortification only certain foods such as fatty fish contain more than low amounts of vitamin D, and many children will depend entirely on sun exposure to obtain sufficient vitamin D. The skin has a high capacity to synthesize vitamin D, but if sun exposure is low vitamin D production is insufficient, especially in dark-skinned infants. The use of serum 25-hydroxyvitamin D to evaluate vitamin D status before development of rickets would be helpful; however, there is no agreement on cut-off levels for deficiency and insufficiency. Furthermore, it is not known how marginal vitamin D insufficiency affects children's bones in the long term.

Keywords

Vitamin DBoneEarly life
Type
Meeting Report
Information
Proceedings of the Nutrition Society , Volume 62 , Issue 4 , November 2003 , pp. 823 - 828
Copyright
Copyright © The Nutrition Society 2003

References

Agarwal, KS, Mughal, MZ, Upadhyay, P, Berry, JL, Mawer, EB & Puliyel, JM (2002) The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi India. Archives of Disease in Childhood 87, 111–113.CrossRefGoogle ScholarPubMed
Ahmed, I, Atiq, M, Iqbal, J, Khurshid, M & Whittaker, P (1995) Vitamin D deficiency rickets in breast-fed infants presenting with hypocalcaemic seizures. Acta Paediatrica 84, 941–942.CrossRefGoogle ScholarPubMed
Ala Houhala, M, Koskinen, T, Koskinen, M & Visakorpi, JK (1988a) Double blind study on the need for vitamin D supplementation in prepubertal children. Acta Paediatrica Scandinavica 77, 89–93.CrossRefGoogle ScholarPubMed
Ala Houhala, M, Koskinen, T, Parviainen, MT & Visakorpi, JK (1988b) 25-Hydroxyvitamin D and vitamin D in human milk: effects of supplementation and season. American Journal of Clinical Nutrition 48, 1057–1060.CrossRefGoogle ScholarPubMed
Ala Houhala, M, Koskinen, T, Terho, A, Koivula, T & Visakorpi, J (1986) Maternal compared with infant vitamin D supplementation. Archives of Disease in Childhood 61, 1159–1163.CrossRefGoogle ScholarPubMed
Anatoliotaki, M, Tsilimigaki, A, Tsekoura, T, Schinaki, A, Stefanaki, S & Nikolaidou, P (2003) Congenital rickets due to maternal vitamin D deficiency in a sunny island of Greece. Acta Paediatrica 92, 389–391.CrossRefGoogle Scholar
Baxter-Jones, ADG, Mirwald, RL, McKay, HA & Bailey, DA (2003) A longitudinal analysis of sex differences in bone mineral accrual in healthy 8–19-year-old boys and girls. Annals of Human Biology 30, 160–175.CrossRefGoogle ScholarPubMed
Biser-Rohrbaugh, A & Hadley-Miller, N (2001) Vitamin D deficiency in breast-fed toddlers. Journal of Pediatric Orthopaedics 21, 508–511.CrossRefGoogle ScholarPubMed
Clemens, TL, Adams, JS, Henderson, SL & Holick, MF (1982) Increased skin pigment reduces the capacity of skin to synthesise vitamin D. Lancet i, 74–76.CrossRefGoogle Scholar
Dagnelie, PC, Vergote, FJ, Van Staveren, WA, van den Berg, H, Dingjan, PG & Hautvast, JG (1990) High prevalence of rickets in infants on macrobiotic diets. American Journal of Clinical Nutrition 51, 202–208.CrossRefGoogle ScholarPubMed
Dawodu, A, Agarwal, M, Hossain, M, Kochiyil, J & Zayed, R (2003) Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: A justification for vitamin D supplementation of breast-feeding infants. Journal of Pediatrics 142, 169–173.CrossRefGoogle Scholar
Department of Health (1998) Nutrition and Bone Health: With Particular Reference to Calcium and Vitamin D, 1st ed. London: The Stationery Office.Google Scholar
Etzel, RA, Balk, SJ, Bearer, CF, Miller, MD, Shannon, MW, Shea, KM, Falk, H, Goldman, LR, Miller, RW, Rogan, W & Coven, B (1999) Ultraviolet light: A hazard to children. Pediatrics 104, 328–333.Google Scholar
Flensborg, EW & Thandrup, E (1953) Rickets and tetany in the paediatric departments in Greater Copenhagen 1946–1951. Ugeskrift For Laeger 115, 1237–1244.Google Scholar
Food and Nutrition Board/Institute of Medicine (1997) Vitamin D Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, pp. 250–287. Washington, DC: National Academy Press.Google Scholar
Fraser, DR (1995) Vitamin D (review). Lancet 345, 104–107.CrossRefGoogle Scholar
Gartner, LM & Greer, FR (2003) Prevention of rickets and vitamin D deficiency: New guidelines for vitamin D intake. Pediatrics 111, 908–910.CrossRefGoogle ScholarPubMed
Goel, KM & Arneil, GC (1985) Rickets, old and new. In Pediatric Nutrition, pp.219–244 [Arneil, GC, Metcoff, J, editors]. London: Butterworths.Google Scholar
Guillemant, J, Taupin, P, Le, HT, Taright, N, Allemandou, A, Peres, G & Guillemant, S (1999) Vitamin D status during puberty in French healthy male adolescents. Osteoporosis International 10, 222–225.CrossRefGoogle ScholarPubMed
Henriksen, C, Brunvand, L, Stoltenberg, C, Trygg, K, Haug, E & Pedersen, JI (1995) Diet and vitamin D status among pregnant Pakistani women in Oslo. European Journal of Clinical Nutrition 49, 211–218.Google ScholarPubMed
Holick, MF (1999) Vitamin D. In Modern Nutrition in Health and Disease,pp.329–345 [Shils, ME, Olson, JA, Shike, M, Ross, AC, editors]. Baltimore, MD: Williams & Wilkins.Google Scholar
Holick, MF (editor) (2002) Calcium and vitamin D in human health. In Calcium in Childhood, pp. 83–93. Vevey, Switzerland: Nestlé Nutrition.Google Scholar
Kreiter, SR, Schwartz, RP, Kirkman, HN, Charlton, PA, Calikoglu, AS & Davenport, ML (2000) Nutritional rickets in African American breast-fed infants. Journal of Pediatrics 137, 153–157.CrossRefGoogle ScholarPubMed
Lehtonen-Veromaa, MKM, Mottonen, TT, Nuotio, IO, Irjala, KMA, Leino, AE & Viikari, JSA (2002) Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. American Journal of Clinical Nutrition 76, 1446–1453.CrossRefGoogle ScholarPubMed
Lund, B & Sørensen, OH (1979) Measurement of 25-hydroxyvitamin D in serum and its relation to sunshine, age and vitamin D intake in the Danish population. Scandinavian Journal of Clinical and Laboratory Investigation 39, 23–30.CrossRefGoogle Scholar
Markestad, T (1983) Effect of season and vitamin D supplementation on plasma concentrations of 25-hydroxyvitamin D in Norwegian infants. Acta Paediatrica 72, 817–821.CrossRefGoogle Scholar
Michaelsen, KF, Weaver, L, Branca, F & Robertson, A (editors) (2000) Vitamins. In Feeding and Nutrition of Infants and Young Children. WHO Regional Publications European Series no. 87, pp.76–80. Copenhagen, Denmark: WHO European Regional Office.Google Scholar
Namgung, R, Tsang, RC, Specker, BL, Sierra, RI & Ho, ML (1994) Low bone mineral content and high serum osteocalcin and 1,25-dihydroxyvitamin D in summer- versus winter-born newborn infants: an early fetal effect? Journal of Pediatric Gastroenterolgy and Nutrition 19, 220–227.Google Scholar
Narchi, H El Jamil, M & Kulaylat, N (2001) Symptomatic rickets in adolescence. Archives of Disease in Childhood 84, 501–503.CrossRefGoogle ScholarPubMed
Nishimura, K, Shima, M, Tsugawa, N, Matsumoto, S, Hirai, H, Santo, Y, Nakajima, S, Iwata, M, Takagi, T, Kanda, Y, Kanzaki, T, Okano, T & Ozono, K (2003) Long-term hospitalization during pregnancy is a risk factor for vitamin D deficiency in neonates. Journal of Bone and Mineral Metabolism 21, 103–108.CrossRefGoogle ScholarPubMed
Okonofua, F, Gill, DS, Alabi, ZO, Thomas, M, Bell, JL & Dandona, P (1991) Rickets in Nigerian children: a consequence of calcium malnutrition. Metabolism 40, 209–213.CrossRefGoogle ScholarPubMed
Oliveri, B, Cassinelli, H, Mautalen, C & Ayala, M (1996) Vitamin D prophylaxis in children with a single dose of 150000 IU of vitamin D. European Journal of Clinical Nutrition 50, 807–810.Google ScholarPubMed
Pedersen, P, Michaelsen, KF & Mølgaard, C (2003) Children with nutritional rickets referred to hospitals in Copenhagen during a 10-year period. Acta Paediatrica 92, 87–90.CrossRefGoogle ScholarPubMed
Polskin, LJ, Kramer, B & Sobel, AE (1945) Secretion of vitamin D in milks of women fed fish liver oil. Pediatric Research 2, 451–466.Google Scholar
Prentice, A (2003) Micronutrients and the bone mineral content of the mother, fetus and newborn. Journal of Nutrition 133, Suppl., 1693S–1699S.CrossRefGoogle ScholarPubMed
Shaw, NJ & Pal, BR (2002) Vitamin D deficiency in UK Asian families: activating a new concern. Archives of Disease in Childhood 86, 147–149.CrossRefGoogle ScholarPubMed
Specker, BL (1994) Do North American women need supplemental vitamin D during pregnancy or lactation?. American Journal of Clinical Nutrition 59, Suppl., 484S–490S.CrossRefGoogle ScholarPubMed
Specker, BL, Tsang, RC & Hollis, BW (1985) Effect of race and diet on human-milk vitamin D and 25-hydroxyvitamin D. American Journal of Disease in Children 139, 1134–1137.Google Scholar
Trang, HM, Cole, DEC, Rubin, LA, Pierratos, A, Siu, S & Vieth, R (1998) Evidence that vitamin D-3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D-2. American Journal of Clinical Nutrition 68, 854–858.CrossRefGoogle Scholar
Utiger, RD (1998) The need for more vitamin D. New England Journal of Medicine 338, 828–829.CrossRefGoogle ScholarPubMed
van den Berg, H (1997) Bioavailability of European. Journal of Clinical Nutrition 51,Suppl., S76–S79.Google Scholar
van der Wielen, RPJ, Lüwik, MRH,van der Berg, H, de Groot, LCPGM, Haller, J, Moreiras, O & Van Staveren, WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346, 207–210.CrossRefGoogle ScholarPubMed
Zeghoud, F, Vervel, C, Guillozo, H, Walrant-Debray, O, Boutignon, H & Garabédian, M (1997) Subclinical vitamin D deficiency in neonates: definition and response to vitamin D supplements. American Journal of Clinical Nutrition 65, 771–778.CrossRefGoogle ScholarPubMed