Serum 25-hydroxyvitamin D requirements to prevent nutritional rickets in Nigerian children on a low-calcium diet—a multivariable reanalysis

Sempos, Christopher T.; Durazo‐Arvizu, Ramón; Fischer, Philip R.; Munns, Craig F; Pettifor, John Μ.; Thacher, Tom D.

doi:10.1093/ajcn/nqab048

Cited by 28 publications

(21 citation statements)

References 29 publications

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“…Several limitations of the study should be acknowledged. Calcium supplementation was provided to all women to mitigate effects of the habitually low dietary calcium intakes that are common in Bangladesh, yet this co-intervention may have compensated for the relative vitamin D deficiency of women in the control group and therefore attenuated intervention effects ( 48 , 49 ). Supplementation began in the second trimester, and thus coincided with the period in which the majority of maternal–fetal calcium transfer and fetal bone mineral deposition occurs ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial

Callaghan

Shanta

Fariha

et al. 2022

The American Journal of Clinical Nutrition

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Background Maternal vitamin D status during pregnancy and lactation is a modifiable factor that may influence offspring musculoskeletal outcomes. However, few randomized trials have tested the effects of prenatal or postpartum vitamin D supplementation on offspring bone and muscle development. Objective To examine hypothesized effects of improvements in early-life vitamin D status on childhood musculoskeletal health in Dhaka, Bangladesh. Design In a previously-completed double-blind dose-ranging trial, healthy pregnant women (n = 1300) were recruited at 17-24 weeks’ gestation and randomized to a prenatal; postpartum regimen of 0;0, 4200;0, 16800;0, 28000;0 or 28000;28000 IU cholecalciferol (vitamin D3)/week until 26 weeks postpartum. In this new report, we describe additional follow-up at 4 years of age (n = 642) for longer-term outcomes. Bone mineral content (BMC) and areal density (aBMD) were measured by dual-energy X-ray absorptiometry. Grip strength was tested using a hand-held dynamometer. The primary comparison was children of women assigned to 28000 IU/week prenatally versus placebo. Differences were expressed as means and 95% confidence intervals (95% CIs). Results Total-body-less-head (TBLH) BMC, TBLH aBMD, and grip strength were similar in the combined high-dose prenatal (28000;0 and 28000;28000 IU/week) versus placebo groups (mean difference [95% CI] = 0.61g [-10.90, 12.13], 0.0004g/cm2 [-0.0089, 0.0097] and 0.02kg [-0.26, 0.31] respectively). In dose-ranging analyses, TBLH BMC and aBMD, whole body (WB) BMC and aBMD, and grip strength in each of the prenatal vitamin D groups were not significantly different from placebo (P>0.05 for all comparisons). Only head aBMD was greater in children of women assigned to the 28000;28000 IU regimen versus placebo (mean difference [95% CI] = 0.024g/cm2 [0.0009, 0.047], P = 0.042); the effect was attenuated upon adjustment for child height, weight, and sex (P = 0.11). Conclusions Maternal prenatal, with or without postpartum, vitamin D supplementation does not improve child BMC, aBMD or grip strength at 4 years of age. Trial registration: www.clinicaltrials.gov NCT03537443

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Section: Discussionmentioning

confidence: 99%

Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial

Callaghan

Shanta

Fariha

et al. 2022

The American Journal of Clinical Nutrition

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“…In most adult populations, vitamin D deficiency is unlikely to be a rate‐limiting constraint on calcium absorption, as only very low concentrations of 25‐hydroxyvitamin D (25(OH)D) are associated with impaired calcium absorption 13,14 . The effect of vitamin D on calcium absorption in children is not clearly established 15 . Calcium retention is higher in children than adults, especially during periods of rapid growth when bone mineral accretion is high.…”

Section: Factors Influencing Calcium Requirementsmentioning

confidence: 99%

“…3). Risk of rickets appears to be highest for children with both low vitamin D levels and calcium intake, 15 but a severe deficiency of either nutrient can also lead to rickets. Evidence suggests that as calcium intakes decrease, there is a greater necessity for a child to meet vitamin D requirements to maintain normal calcium homeostasis.…”

Section: Outcomes Of Inadequate Calcium Intakementioning

confidence: 99%

Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes

Shlisky

Mandlik

Askari

et al. 2022

Annals of the New York Academy of Sciences

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Dietary calcium deficiency is considered to be widespread globally, with published estimates suggesting that approximately half of the world's population has inadequate access to dietary calcium. Calcium is essential for bone health, but inadequate intakes have also been linked to other health outcomes, including pregnancy complications, cancers, and cardiovascular disease. Populations in low-and middle-income countries (LMICs) are at greatest risk of low calcium intakes, although many individuals in high-income countries (HICs) also do not meet recommendations. Paradoxically, many LMICs with lower calcium intakes show lower rates of osteoporotic fracture as compared with HICs, though data are sparse. Calcium intake recommendations vary across agencies and may need to be customized based on other dietary factors, health-related behaviors, or the risk of calcium-related health outcomes. The lack of standard methods to assess the calcium status of an individual or population has challenged efforts to estimate the prevalence of calcium deficiency and the global burden of related adverse health consequences. This paper aims to consolidate available evidence related to the global prevalence of inadequate calcium intakes and associated health outcomes, with the goal of providing a foundation for developing policies and population-level interventions to safely improve calcium intake and status where necessary.

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“…This threshold is not absolute as it is based on older studies using less accurate assays. Recent data suggest that the threshold is higher in combination with poor calcium intake [ 17 ]. If vitamin D deficiency is in fact defined by serum concentrations of 25OHD, we could call it “calcifediol deficiency”.…”

Section: Vitamin D or Calcifediol Deficiency?mentioning

confidence: 99%

Calcifediol (25OH Vitamin D3) Deficiency: A Risk Factor from Early to Old Age

Bouillon

LʼAbbate

Rosero³

2022

Nutrients

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Vitamin D deficiency is the main cause of nutritional rickets in children and osteomalacia in adults. There is consensus that nutritional access to vitamin D can be estimated by measuring serum concentrations of 25OHD and vitamin D deficiency can thus be considered as calcifediol deficiency. However, the threshold for vitamin D/calcifediol sufficiency remains a matter of debate. Vitamin D/calcifediol deficiency has been associated with musculoskeletal effects but also multiple adverse extra-skeletal consequences. If these consequences improve or if they can be treated with vitamin D supplementation is still unclear. Observational studies suggest a higher infection risk in people with low calcifediol levels. There is also a consistent association between serum calcifediol and cardiovascular events and deaths, but large-scale, long-term intervention studies did not show any benefit on cardiovascular outcomes from supplementation, at least not in subjects without clear vitamin D deficiency. Cancer risk also did not change with vitamin D treatment, although there are some data that higher serum calcifediol is associated with longer survival in cancer patients. In pregnant women, vitamin D supplementation decreases the risk of pre-eclampsia, gestational diabetes mellitus, and low birth weight. Although preclinical studies showed that the vitamin D endocrine system plays a role in certain neural cells as well as brain structure and function, there is no evidence to support a beneficial effect of vitamin D in neurodegenerative diseases. Vitamin D supplementation may marginally affect overall mortality risk especially in elderly subjects with low serum calcifediol concentrations.

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Serum 25-hydroxyvitamin D requirements to prevent nutritional rickets in Nigerian children on a low-calcium diet—a multivariable reanalysis

Cited by 28 publications

References 29 publications

Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial

Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial

Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes

Calcifediol (25OH Vitamin D3) Deficiency: A Risk Factor from Early to Old Age

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