Vitamin D in European children – no consensus on “adequate” levels

Vitamin D in European children—statement from the European Academy of Paediatrics (EAP)

European Journal of Pediatrics, pp 1–3, First Online: 12 April 2017

doi:10.1007/s00431-017-2903-2

Zachi Grossman, Adamos Hadjipanayis adamos@paidiatros.com, Tom Stiris, Stefano del Torso, Jean-Christophe Mercier, Arunas Valiulis, Raanan Shamir

* Quick restoration of vitamin D in children – 10,000 IU per kg loading dose was not enough – Jan 2017 * Note - the study on this page only indicates 400 IU * Many US kids have less than 40 ng of Vitamin D – 99 out of 100 blacks, 91 out of 100 whites – Jan 2017 * Many groups define optimal Vitamin D as > 40 nanograms * Takes a year to restore children and youths to good levels of vitamin D without loading dose - RCT Dec 2016 * A year is a very long time for an infant Infant-Child category starts with {include} {include} 1. # Items in both categories Infant-child and Europe are listed here: {category} 1. # Items in both categories Infant-child and High-Risk are listed here: {category} 1. # Items in both categories Infant-child and Testing are listed here: {category}

Vitamin D is synthesized in human skin upon sun exposure and is also a nutrient. It regulates calcium and phosphate metabolism and is essential for the maintenance of bone health. Vitamin D supplementation during infancy, in order to prevent rickets, is universally accepted. Many human cell types carry vitamin D receptor, this being a drive for conducting studies on the possible association between vitamin D status and other diseases.

Studies have affirmed that a considerable number of healthy European children may be vitamin D deficient, especially in high-risk groups (darker pigmented skin, living in areas with reduced sun exposure and other disorders). However, the definition of deficiency is unclear due to inter assay differences and due to a lack of consensus as to what is an “adequate” 25(OH)D level.

Therefore, there is no justification for routine screening for vitamin D deficiency in healthy children.

An evaluation of vitamin D status is justified in children belonging to high-risk groups. All infants up to 1 year of age should receive an oral supplementation of 400 IU/day of vitamin D. Beyond this age, seasonal variation of sunlight should be taken into account when considering a national policy of supplementation or fortification.

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