Importance of body weight and skin color in determining appropriate vitamin D3 supplement doses for children and adolescents

Abstract

Background: Deficiencies in vitamin D directly impact children's health and place minority and obese youth at risk for a range of health issues. The Institute of Medicine (IOM) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium has set both a recommended daily allowance (RDA) for vitamin D supplementation and a populationwide sufficiency target for the biomarker of vitamin D status, serum 25-hydroxyvitamin D (25(OH)D). However, new research suggests that the RDA is not sufficient to meet the target biomarker status for individuals who are heavy or who have dark skin. Our objective was to provide appropriate daily vitamin D supplementation levels for these individuals. Methods: Using data derived from the National Health and Nutrition Examination Survey (NHANES) and a recently published dosing formula, we calculated the required supplemental dose of vitamin D to meet the IOM target in children and adolescents. results: To be sure that 95% of the target population meets the IOM's population-wide biomarker target, some individuals require a daily dose of up to 2,000 international units (IUs) of supplemental vitamin D. conclusion: Health professionals should work with their patients to encourage lifelong vitamin D supplement use at a dosage sufficient to obtain adequate 25(OH)D levels.

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach

“…While having a fairly constant absolute vitamin D intake, the intake per kg body weight of patients below the age of 4 years was more than double compared with adolescents, leading to the assumption that body weight might influence serum 25(OH)D levels. Our longitudinal model indeed indicated that an increasing body weight is related to a decreasing serum 25(OH)D. This might be due to the dilution of vitamin D in larger body volumes ( 29 , 30 ) which occurs as children grow and weight increases ( 25 , 31 ) . As increasing age was not sufficiently matched by a concurrent increase in (supplementary) vitamin D intake, a downward trend of serum 25(OH)D with age was observed.…”

Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data

“…Indeed, recent research has established the importance of body weight and skin colour among both adults and children in establishing vitamin D recommendations ( 16 , 17 ) . For example, in 2014 work by Dhaliwal and colleagues identified the dose–response of vitamin D in obese individuals and concluded that those who weigh more may require up to 40 % higher levels of vitamin D intake in comparison to their non-obese counterparts ( 18 ) .…”

“…Work by Ng and colleagues also in 2014 determined the dose–response relationship between vitamin D and 25-hydroxyvitamin D (25(OH)D) concentrations in African-American individuals and found that greater vitamin D intake was required to obtain required concentration levels among African-Americans ( 19 ) ; thus providing additional evidence that darker-skinned individuals have greater vitamin D supplementation needs. Yet another recent publication computed the required supplemental vitamin D dose, by weight and skin colour, to help ensure children and adolescents meet the IOM’s recommendations ( 17 ) . Despite these collective findings, the role of age when accounting for body weight and skin colour remains unclear with regard to recommending vitamin D requirements.…”