Abstract
Vitamin D is a key nutrient for both healthy children and those with chronic illnesses. Understanding its roles in health and disease has become one of the most important issues in the nutritional management of children. Formal guidelines related to nutrient requirements for vitamin D in healthy children, recommending dietary intakes of 400 IU per day for infants and 600 IU per day for children over 1 year of age, were released by the Institute of Medicine in November 2010. However, application of these guidelines to children with acute and chronic illnesses is less clear. In this Review, we consider major illness categories and specific examples of conditions in children that might be affected by vitamin D. This information can be used in developing both model systems of investigation and clinical trials of vitamin D in children with acute and chronic illnesses.
Key Points
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Healthy children >1 year of age require a dietary intake of 600 IU per day of vitamin D; specific requirements for obese, African American or Hispanic children have not been established
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Low maternal levels of vitamin D and low calcium intake during pregnancy might lead to severe neonatal hypocalcaemia
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Current data fails to show a clear association between maternal vitamin D levels during pregnancy and type 1 diabetes mellitus in their offspring
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Half of all children admitted to intensive care units are vitamin D deficient (<50 nmol/l); more studies are needed to assess the benefit of vitamin D supplementation
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Chronic conditions, including asthma, cystic fibrosis, inflammatory bowel disease and tuberculosis, are associated with vitamin D deficiency and supplemental vitamin D might be beneficial, although further studies are needed
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Evidence from patients with hereditary 1,25-dihydroxyvitamin-D-resistant rickets reveals that calcium absorption is highly vitamin-D-dependent from infancy to the end of puberty, after which other vitamin-D-independent mechanisms regulate calcium absorption
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Acknowledgements
This work is supported by the US Department of Agriculture (USDA)/Agricultural Research Service (ARS) Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital, Houston, TX, USA. Contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.
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S. A. Abrams and D. Tiosano contributed to writing the article, researched data for the article, provided a substantial contribution to discussion of the content and reviewed and/or edited the manuscript before submission. J. Coss-Bu contributed to writing the article, researched data for the article and provided a substantial contribution to discussion of the content.
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Abrams, S., Coss-Bu, J. & Tiosano, D. Vitamin D: effects on childhood health and disease. Nat Rev Endocrinol 9, 162–170 (2013). https://doi.org/10.1038/nrendo.2012.259
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DOI: https://doi.org/10.1038/nrendo.2012.259
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