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What is Vitamin D dose adequate for deficiency in school going children?
A new Clinical trial finds that maximum daily dose of 2000 IU vitamin D supplementation is adequate for school going children.
In India, there is a lack of information about the adequate daily dose of vitamin D supplementation in school children.
The researchers undertook a study to evaluate the adequacy and efficacy of different doses of vitamin D3 in schoolchildren.
They conducted a single-blind, prospective, randomised clinical trial from North India and found that maximum daily dose of 2000 IU vitamin D3 supplementation is adequate for Indian school children with vitamin D deficiency (VDD).
The new study has been published in British Journal of Nutrition.
Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol .
The FNB has established a Recommended Daily Allowances for vitamin D representing a daily intake that is sufficient to maintain bone health and normal calcium metabolism in healthy children.
| Age | Male | Female | Pregnancy | Lactation |
|---|---|---|---|---|
| 0–12 months* | 400 IU (10 mcg) | 400 IU (10 mcg) | ||
| 1–13 years | 600 IU (15 mcg) | 600 IU (15 mcg) |
The researchers enrolled a total of 1008 vitamin D-deficient (VDD) children, aged 6–16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50nmol/l, and cluster randomised them into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D3 under supervision for 6 months.
Out of the 1008 subjects who completed the study, 938 (93 %) were compliant who were evaluated with VDD (serum 25 hydroxy-vitamin D (25[OH]D), <20 ng/mL; ages, 6-16 years), randomly assigned into 3 groups to receive: A (vitamin D3, 600 IU daily; n=317), B (vitamin D3, 1000 IU daily; n=307), C (vitamin D3, 2000 IU daily; n=314). Calcium, phosphates, alkaline phosphatase, serum 25[OH]D, parathyroid hormone (PTH) and urine calcium-creatinine ratio were evaluated at baseline and post-supplementation.
Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD 30·0)nmol/l), followed by 1000 IU (46·8 (SD 22·5)nmol/l) and 600 IU (36·5 (SD18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia.
It was found that Children with Vitamin D Deficiency benefit maximum with the daily supplementation of 2000 IU of vitamin D3. The researchers concluded whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with Vitamin D Deficiency (VDD) remains debatable.
British Journal of NutritionCalciumchildchildrenDeficiencyDeficientIndian Academy of PediatricsneedneededNorth Indiaparathyroid hormonephosphatesrequirementschool childrenschool goingSufficientsupplementationsupplementsVitamin DVitamin D deficiencyvitamin D3 supplementation
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