Skip to main content
Erschienen in: European Journal of Pediatrics 12/2013

01.12.2013 | Original Article

Vitamin D fortification of growing up milk prevents decrease of serum 25-hydroxyvitamin D concentrations during winter: a clinical intervention study in Germany

verfasst von: Jürgen Hower, Anette Knoll, Kristin L. Ritzenthaler, Claudia Steiner, Regina Berwind

Erschienen in: European Journal of Pediatrics | Ausgabe 12/2013

Einloggen, um Zugang zu erhalten

Abstract

Vitamin D plays an important role in human health. Current recommendations for vitamin D intake and endogenous supply through sun exposure are not met in German pre-school children, and suboptimal serum 25-hydroxyvitamin D concentrations, especially during the winter months, are common. Consequently, vitamin D supplementation or fortification have gained increased acceptance. The KiMi trial (Kindermilch = growing up milk) was a prospective, randomized, and double-blind study in which young children (2–6 years of age, n = 92) were assigned to receive either vitamin D-fortified growing up milk (2.85 μg/100 ml) or semi skimmed cow's milk without added vitamin D. Daily consumption of fortified growing up milk contributed to the prevention of an otherwise frequently observed decrease in serum 25-hydroxyvitamin D concentration during winter (before winter: median 21.5 ng/mL (10.1–43.0 ng/mL) intervention vs. median 18.4 ng/mL (11.0–44.9 ng/mL) control; after winter: median 24.8 ng/mL (7.0–48.2 ng/mL) intervention vs. median 13.6 ng/mL (7.0–36.8 ng/mL) control) and proved to be safe during summer (median 27.6 ng/mL (18.8–40.5 ng/mL) intervention vs. median 27.4 ng/mL (17.8–38.7 ng/mL) control). Due to the high prevalence of vitamin D deficiency, fortification of growing up milk with vitamin D at a level used in this study could be an effective measure to improve vitamin D status.
Fußnoten
1
Conversion factor for vitamin D absorption: 1 μg vitamin D = 40 IU
 
2
Conversion factor for 25(OH)D: 1 ng/mL = 2.5 nmol/L
 
Literatur
1.
Zurück zum Zitat Atas E, Karademir F, Ersen A, Meral C, Aydinoz S, Suleymanoglu S, Gultepe M, Gocmen I (2013) Comparison between daily supplementation doses of 200 versus 400 IU of vitamin D in infants. Eur J Pediatr. Epub ahead of Print. Atas E, Karademir F, Ersen A, Meral C, Aydinoz S, Suleymanoglu S, Gultepe M, Gocmen I (2013) Comparison between daily supplementation doses of 200 versus 400 IU of vitamin D in infants. Eur J Pediatr. Epub ahead of Print.
2.
Zurück zum Zitat Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28PubMed Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28PubMed
3.
Zurück zum Zitat Black LJ, Seamans KM, Cashman KD, Kiely M (2012) An updated systematic review and meta-analysis of the efficacy of vitamin D food fortification. J Nutr 142:1102–1108PubMedCrossRef Black LJ, Seamans KM, Cashman KD, Kiely M (2012) An updated systematic review and meta-analysis of the efficacy of vitamin D food fortification. J Nutr 142:1102–1108PubMedCrossRef
4.
Zurück zum Zitat Böhles HJ, Fusch C, Genzel-Boroviczeny O, Jochum F, Kauth T, Kersting M, Koletzko B, Lentze MJ, Mihatsch WA, Przyrembel H, Wabitsch M (2011) Zusammensetzung und Gebrauch von Milchgetränken für Kleinkinder. Aktualisierte Empfehlungen der Ernährungskomission der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ). Monatsschr Kinderheilkd Böhles HJ, Fusch C, Genzel-Boroviczeny O, Jochum F, Kauth T, Kersting M, Koletzko B, Lentze MJ, Mihatsch WA, Przyrembel H, Wabitsch M (2011) Zusammensetzung und Gebrauch von Milchgetränken für Kleinkinder. Aktualisierte Empfehlungen der Ernährungskomission der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ). Monatsschr Kinderheilkd
5.
Zurück zum Zitat Braegger C, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, Hojsak I, Mihatsch W, Molgaard C, Shamir R, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition. (2013) Vitamin D in the healthy paediatric population: a position paper by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2013 Mar 6. [Epub ahead of print] Braegger C, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, Hojsak I, Mihatsch W, Molgaard C, Shamir R, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition. (2013) Vitamin D in the healthy paediatric population: a position paper by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2013 Mar 6. [Epub ahead of print]
6.
Zurück zum Zitat Calvo MS, Whiting SJ (2006) Public health strategies to overcome barriers to optimal vitamin D status in populations with special needs. J Nutr 136:1135–1139PubMed Calvo MS, Whiting SJ (2006) Public health strategies to overcome barriers to optimal vitamin D status in populations with special needs. J Nutr 136:1135–1139PubMed
7.
Zurück zum Zitat Camargo CA Jr, Ganmaa D, Frazier AL, Kirchberg FF, Stuart JJ, Kleinman K, Sumberzul N, Rich-Edwards JW (2012) Randomized trial of vitamin d supplementation and risk of acute respiratory infection in mongolia. Pediatrics 130:e561–e567PubMedCrossRef Camargo CA Jr, Ganmaa D, Frazier AL, Kirchberg FF, Stuart JJ, Kleinman K, Sumberzul N, Rich-Edwards JW (2012) Randomized trial of vitamin d supplementation and risk of acute respiratory infection in mongolia. Pediatrics 130:e561–e567PubMedCrossRef
8.
Zurück zum Zitat Cheng S, Tylavsky F, Kroger H, Karkkainen M, Lyytikainen A, Koistinen A, Mahonen A, Alen M, Halleen J, Vaananen K, Lamberg-Allardt C (2003) Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr 78:485–492PubMed Cheng S, Tylavsky F, Kroger H, Karkkainen M, Lyytikainen A, Koistinen A, Mahonen A, Alen M, Halleen J, Vaananen K, Lamberg-Allardt C (2003) Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr 78:485–492PubMed
9.
Zurück zum Zitat Committee to Review Dietary Reference Intakes for Vitamin D and Calcium FaNB (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington (DC) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium FaNB (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington (DC)
10.
Zurück zum Zitat Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G (1991) Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 115:505–512PubMedCrossRef Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G (1991) Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 115:505–512PubMedCrossRef
11.
Zurück zum Zitat Deutsche Gesellschaft für Ernährung ÖGfE, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung (Hrsg.) (2012) Referenzwerte für die Nährstoffzufuhr - Vitamin D. In: Deutsche Gesellschaft für Ernährung ÖGfE, Schweizerische Gesellschaft für Ernährungsforschung und Gesellschaft für Ernährung (ed), Frankfurt/M Deutsche Gesellschaft für Ernährung ÖGfE, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung (Hrsg.) (2012) Referenzwerte für die Nährstoffzufuhr - Vitamin D. In: Deutsche Gesellschaft für Ernährung ÖGfE, Schweizerische Gesellschaft für Ernährungsforschung und Gesellschaft für Ernährung (ed), Frankfurt/M
12.
Zurück zum Zitat Elmadfa I, Meyer A, Nowak V, Hasenegger V, Putz P, Verstraeten R, Remaut-DeWinter AM et al (2009) European nutrition and health report 2009. Forum Nutr 62:1–405PubMedCrossRef Elmadfa I, Meyer A, Nowak V, Hasenegger V, Putz P, Verstraeten R, Remaut-DeWinter AM et al (2009) European nutrition and health report 2009. Forum Nutr 62:1–405PubMedCrossRef
13.
Zurück zum Zitat Forschungsinstitut für Kinderernährung (FKE) (2009) Empfehlungen für die Ernährung von Kindern und Jugendlichen. Die optimierte Mischkost OptimiX. . Dortmund Forschungsinstitut für Kinderernährung (FKE) (2009) Empfehlungen für die Ernährung von Kindern und Jugendlichen. Die optimierte Mischkost OptimiX. . Dortmund
14.
Zurück zum Zitat Gombart AF (2009) The vitamin d-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 4:1151–1165PubMedCrossRef Gombart AF (2009) The vitamin d-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 4:1151–1165PubMedCrossRef
15.
Zurück zum Zitat Graham D, Kira G, Conaglen J, McLennan S, Rush E (2009) Vitamin D status of Year 3 children and supplementation through schools with fortified milk. Public Health Nutr 12:2329–2334PubMedCrossRef Graham D, Kira G, Conaglen J, McLennan S, Rush E (2009) Vitamin D status of Year 3 children and supplementation through schools with fortified milk. Public Health Nutr 12:2329–2334PubMedCrossRef
16.
Zurück zum Zitat Holick MF (2005) The vitamin D epidemic and its health consequences. J Nutr 135:2739S–2748SPubMed Holick MF (2005) The vitamin D epidemic and its health consequences. J Nutr 135:2739S–2748SPubMed
17.
Zurück zum Zitat Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87:1080S–1086SPubMed Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87:1080S–1086SPubMed
18.
Zurück zum Zitat Houghton LA, Gray AR, Szymlek-Gay EA, Heath AL, Ferguson EL (2011) Vitamin d-fortified milk achieves the targeted serum 25-hydroxyvitamin D concentration without affecting that of parathyroid hormone in New Zealand toddlers. J Nutr 141:1840–1846PubMedCrossRef Houghton LA, Gray AR, Szymlek-Gay EA, Heath AL, Ferguson EL (2011) Vitamin d-fortified milk achieves the targeted serum 25-hydroxyvitamin D concentration without affecting that of parathyroid hormone in New Zealand toddlers. J Nutr 141:1840–1846PubMedCrossRef
19.
Zurück zum Zitat Hower J (2008) Winterlicher Vitamin d-Mangel bei Kindern und Jugendlichen. Eine Praxisstudie aus Mühlheim an der Ruhr (51°N). Kinder- und Jugendarzt 8:552–555 Hower J (2008) Winterlicher Vitamin d-Mangel bei Kindern und Jugendlichen. Eine Praxisstudie aus Mühlheim an der Ruhr (51°N). Kinder- und Jugendarzt 8:552–555
20.
Zurück zum Zitat Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A (2009) Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 63:473–477PubMedCrossRef Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A (2009) Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 63:473–477PubMedCrossRef
21.
Zurück zum Zitat Kersting M (2008) Die Zufuhr von Kalzium und Vitamin D – Ergebnisse der DONALD-Studie. Kinderarztl Prax 79:296–299 Kersting M (2008) Die Zufuhr von Kalzium und Vitamin D – Ergebnisse der DONALD-Studie. Kinderarztl Prax 79:296–299
22.
Zurück zum Zitat Leis KS, McNally JD, Montgomery MR, Sankaran K, Karunanayake C, Rosenberg AM (2012) Vitamin D intake in young children with acute lower respiratory infection. Zhongguo Dang Dai Er Ke Za Zhi 14:1–6PubMed Leis KS, McNally JD, Montgomery MR, Sankaran K, Karunanayake C, Rosenberg AM (2012) Vitamin D intake in young children with acute lower respiratory infection. Zhongguo Dang Dai Er Ke Za Zhi 14:1–6PubMed
23.
Zurück zum Zitat Marchisio P, Consonni D, Baggi E, Zampiero A, Bianchini S, Terranova L, Tirelli S, Esposito S, Principi N (2013) Vitamin D Supplementation Reduces the Risk of Acute Otitis Media in Otitis-Prone Children. Pediatr Infect Dis J. Epub ahead of print. Marchisio P, Consonni D, Baggi E, Zampiero A, Bianchini S, Terranova L, Tirelli S, Esposito S, Principi N (2013) Vitamin D Supplementation Reduces the Risk of Acute Otitis Media in Otitis-Prone Children. Pediatr Infect Dis J. Epub ahead of print.
24.
Zurück zum Zitat Mensink GB, Bauch A, Vohmann C, Stahl A, Six J, Kohler S, Fischer J, Heseker H (2007) EsKiMo—the nutrition module in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:902–908PubMedCrossRef Mensink GB, Bauch A, Vohmann C, Stahl A, Six J, Kohler S, Fischer J, Heseker H (2007) EsKiMo—the nutrition module in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:902–908PubMedCrossRef
25.
Zurück zum Zitat Mensink GB, Fletcher R, Gurinovic M, Huybrechts I, Lafay L, Serra-Majem L, Szponar L, Tetens I, Verkaik-Kloosterman J, Baka A, Stephen AM (2013) Mapping low intake of micronutrients across Europe. Br J Nutr:1–19. Epub ahead of print. Mensink GB, Fletcher R, Gurinovic M, Huybrechts I, Lafay L, Serra-Majem L, Szponar L, Tetens I, Verkaik-Kloosterman J, Baka A, Stephen AM (2013) Mapping low intake of micronutrients across Europe. Br J Nutr:1–19. Epub ahead of print.
26.
Zurück zum Zitat Rich-Edwards JW, Ganmaa D, Kleinman K, Sumberzul N, Holick MF, Lkhagvasuren T, Dulguun B, Burke A, Frazier AL (2011) Randomized trial of fortified milk and supplements to raise 25-hydroxyvitamin D concentrations in schoolchildren in Mongolia. Am J Clin Nutr 94:578–584PubMedCrossRef Rich-Edwards JW, Ganmaa D, Kleinman K, Sumberzul N, Holick MF, Lkhagvasuren T, Dulguun B, Burke A, Frazier AL (2011) Randomized trial of fortified milk and supplements to raise 25-hydroxyvitamin D concentrations in schoolchildren in Mongolia. Am J Clin Nutr 94:578–584PubMedCrossRef
27.
Zurück zum Zitat Strand MA, Perry J, Zhao J, Fischer PR, Yang J, Li S (2009) Severe vitamin d-deficiency and the health of North China children. Matern Child Health J 13:144–150PubMedCrossRef Strand MA, Perry J, Zhao J, Fischer PR, Yang J, Li S (2009) Severe vitamin d-deficiency and the health of North China children. Matern Child Health J 13:144–150PubMedCrossRef
28.
Zurück zum Zitat Thierfelder W, Dortschy R, Hintzpeter B, Kahl H, Scheidt-Nave C (2007) Biochemical measures in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:757–770PubMedCrossRef Thierfelder W, Dortschy R, Hintzpeter B, Kahl H, Scheidt-Nave C (2007) Biochemical measures in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:757–770PubMedCrossRef
29.
Zurück zum Zitat Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 91:1255–1260PubMedCrossRef Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H (2010) Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 91:1255–1260PubMedCrossRef
30.
Zurück zum Zitat Wabitsch M (2011) Vitamin-d-Versorgung im Säuglings-, Kindes- und Jugendalter. Monatsschr Kinderheilkd 6:1–7 Wabitsch M (2011) Vitamin-d-Versorgung im Säuglings-, Kindes- und Jugendalter. Monatsschr Kinderheilkd 6:1–7
31.
Zurück zum Zitat Wayse V, Yousafzai A, Mogale K, Filteau S (2004) Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur J Clin Nutr 58:563–567PubMedCrossRef Wayse V, Yousafzai A, Mogale K, Filteau S (2004) Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur J Clin Nutr 58:563–567PubMedCrossRef
32.
Zurück zum Zitat Zittermann A (2010) The estimated benefits of vitamin D for Germany. Mol Nutr Food Res 54:1164–1171PubMed Zittermann A (2010) The estimated benefits of vitamin D for Germany. Mol Nutr Food Res 54:1164–1171PubMed
Metadaten
Titel
Vitamin D fortification of growing up milk prevents decrease of serum 25-hydroxyvitamin D concentrations during winter: a clinical intervention study in Germany
verfasst von
Jürgen Hower
Anette Knoll
Kristin L. Ritzenthaler
Claudia Steiner
Regina Berwind
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Pediatrics / Ausgabe 12/2013
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-013-2092-6

Weitere Artikel der Ausgabe 12/2013

European Journal of Pediatrics 12/2013 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.