1 Paediatric and International Nutrition, Department of Nutrition, Exercise and Sports, Faculty of Science, Københavns Universitet2 Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, Zurich3 Department of Paediatrics, University of Granada, Granada4 Hospital Necker, Paris5 University of Pecs6 Department of Clinical Sciences, Paediatrics, Umeå University, Umeå7 MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London8 Children's Hospital Zagreb, Zagreb9 Department of Paediatrics, Deaconry Hospital, Schwaebisch Hall10 Schneider Children's Medical Centre of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv11 Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille12 Paediatrics, VU University Medical Center Amsterdam and Paediatrics, Emma Children's Hospital-AMC, Amsterdam13 unknown14 University of Pecs15 Paediatric and International Nutrition, Department of Nutrition, Exercise and Sports, Faculty of Science, Københavns Universitet
In recent years, reports suggesting a resurgence of vitamin D deficiency in the Western world, combined with various proposed health benefits for vitamin D supplementation have resulted in increased interest from healthcare professionals, the media and the public. The aim of this position paper is to summarize the published data on vitamin D intake and prevalence of vitamin D deficiency in the healthy European paediatric population, to discuss health benefits of vitamin D and to provide recommendations for the prevention of vitamin D deficiency in this population. Vitamin D plays a key role in calcium and phosphate metabolism and is essential for bone health. There is insufficient evidence from interventional studies to support vitamin D supplementation for other health benefits in infants, children and adolescents. The pragmatic use of a serum concentration above 50 nmol/l to indicate sufficiency and a serum concentration below 25 nmol/l to indicate severe deficiency is recommended. Vitamin D deficiency occurs quite commonly among healthy European infants, children and adolescents, especially in certain risk groups including breast-fed infants not adhering to the current recommendation for vitamin D supplementation, children and adolescents with dark skin living in Northern countries, as well as children and adolescents without adequate sun exposure, and obese children. Infants should receive an oral supplementation of 400 IU/day of vitamin D. The implementation should be promoted and supervised by paediatricians and other healthcare professionals. Healthy children and adolescents should be encouraged to follow a healthy lifestyle associated with a normal body mass index and including a varied diet with vitamin D containing foods (fish, eggs, dairy products) and adequate outdoor activities with associated sun exposure. For children in risk groups identified above an oral supplementation of vitamin D must be considered beyond one year of age. National Authorities should adopt policies aimed at improving vitamin D status using measures such as dietary recommendations, food fortification, vitamin D supplementation and judicious sun exposure, depending on local circumstances.
Journal of Pediatric Gastroenterology and Nutrition, 2013, Vol 56, Issue 6, p. 692-701