Vitamin D deficiency in Children: An update on its Prevalence, Therapeutics and Knowledge gaps
Journal Title: Indian Journal of Nutrition - Year 2017, Vol 4, Issue 3
Abstract
Background: Vitamin D Deficiency (VDD) is known to have adverse implications from conception throughout lifespan. Vitamin D is important in children mainly because of its profound effect on growth and development and more importantly bone health. Recent evidence suggests maintaining 25(OH)D levels above 20 ng/ml for maximizing health benefits. Despite ample sunshine, VDD is prevalent among 50-90% of Indian children. For understanding functional relevance of this widely prevalent VDD, a comprehensive overview of evidence in children is required. The aim of this article is to review studies related to VDD among children. This paper collates information from various epidemiological studies among children pertaining to prevalence, morbidities and therapeutics thus highlighting the current research gaps and challenges in Indian context. Methods: Literature search with keywords focusing on Vitamin D deficiency, Vitamin D, child health, Pediatric, Hypovitaminosis D and Bone health was carried out through computerized databases- Medline, Embase, PubMed, Cochrane and Google. Results: Data in pediatric age group is heterogeneous with limited evidence in under five age group. The VDD among children may be defined either on basis of a “population based reference value” or a “functional health based reference value”. Functional cut offs refer to the concentration of 25(OH)D at which PTH begins to increase and needs more validation in view of varied response among children. Determinants of circulatory levels of Vitamin D metabolites and evaluation of complete 25(OH)D statuses including Vitamin D Binding Protein (DBP) in children also needs further evidence. Importantly, the use of vitamin D supplements among children should be done cautiously. The Consensus by Indian Academy of Pediatrics may be followed in this context until Indian specific evidence based guidelines are formulated. Conclusion: There is a need to explore Vitamin D paradox with regards to cut offs and risk factors such as genetic, environmental and behavioral factors in Indian children.
Authors and Affiliations
Beena Joshi
Keywords
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