scholarly journals Vitamin D for secondary prevention of acute wheeze attacks in preschool and school-age children

Thorax ◽  
2019 ◽  
Vol 74 (10) ◽  
pp. 977-985 ◽  
Author(s):  
Christos Stefanidis ◽  
Adrian R Martineau ◽  
Chinedu Nwokoro ◽  
Christopher J Griffiths ◽  
Andrew Bush
Keyword(s):  
Vitamin D ◽  
Secondary Prevention ◽  
Vitamin D Supplementation ◽  
Small Sample ◽  
Preschool Age ◽  
School Age Children ◽  
School Age ◽  
Vitamin D Status ◽  
Increased Risk ◽  
Tract Infections

IntroductionVitamin D is best known for its role in bone health; however, the discovery of the vitamin D receptor and the expression of the gene encoding the vitamin D 1α-hydroxylase (CYP27B1) enzyme in a wide variety of tissues including immune cells and respiratory epithelium has led to the discovery of potential roles for vitamin D in the prevention of acute wheeze.MethodsWe review here the literature concerning the relationships between circulating 25-hydroxyvitamin D (25(OH)D) concentration and secondary prevention of acute wheeze attacks in preschool and school-age children.ResultsEpidemiological data suggest that vitamin D insufficiency (25(OH)D <75 nmol/L) is highly prevalent in preschool and school-age children with wheeze. Preschool age children with a history of wheeze attacks and circulating 25(OH)D <75 nmol/L are at increased risk and frequency of future acute wheeze. However, no consistent association between low vitamin D status and risk of acute wheeze is reported in school-age children. Seven randomised controlled trials (RCTs) with relatively small sample sizes (30–430) and variable quality showed inconsistent results regarding the effect of oral vitamin D supplementation during childhood on the risk of asthma attacks, asthma symptom control, inhaled corticosteroid requirements, spirometry and unscheduled healthcare attendances for wheeze. A RCT showed that vitamin D supplementation had no effect on the frequency of unplanned healthcare attendances due to acute wheeze in 22 preschool children.DiscussionAn evidence-based recommendation for the use of vitamin D as a preventive therapy for wheeze attacks cannot be made until results of further trials are available. The assessment of circulating 25(OH)D concentration and the optimisation of vitamin D status to prevent acute respiratory tract infections, and to maintain skeletal and general health in preschool and school-age children with acute wheeze is worthwhile in its own right, but whether this will reduce the risk of acute wheeze attacks is unclear.

scholarly journals Extraskeletal effects of vitamin D

2011 ◽  
Vol 2 (2) ◽  
pp. 87-100
Author(s):  
Maurizio Rossini
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Response To Therapy ◽  
Vitamin D Metabolites ◽  
Upper Respiratory Tract ◽  
Vitamin D Status ◽  
Increased Risk ◽  
Tract Infections

In the last years we observed an increasing number of publications about the vitamin D, due to its recognised therapeutic actions and to the widespread hypovitaminosis D. In addition to the well known skeletal benefits, vitamin D can have multiple effects on other tissues.Muscular apparatus: hypovitaminosis D is associated with myopathy, sarcopenia, muscular strength reduction and increased risk of falls. The vitamin D supplementation increases the muscle functionality indexes. Cardiovascular system: low levels of vitamin D are related to increased levels of cardiovascular risk factors, heart failure, stroke, and cardiovascular mortality, while a good vitamin D status is associated with a decreased incidence of cardiovascular diseases. Diabetes and metabolic syndrome: a good vitamin D status is related to a decreased incidence of type 2 diabetes and metabolic syndrome; a vitamin D supplementation in the early childhood reduces (nearly 30%) the risk of having type 1 diabetes. Cancer: vitamin D deficit is associated with breast, colorectal cancer and melanoma relapses. Low and high levels of 25-hydroxy-vitamin D (25(OH)D) are related to a higher neoplastic mortality. Infectious diseases: hypovitaminosis D is associated with higher incidence of upper respiratory tract infections and worse interferon response in chronic hepatitis C. Vitamin D supplementation decreases the risk of having type A influence. Rheumatic diseases: in rheumatoid arthritis low serum levels of vitamin D metabolites are related to a higher disease activity, while a good vitamin D status is associated with a higher probability of remission or response to therapy and a lower degree of disability. Neurologic diseases: associations between vitamin D deficit and risk of multiple sclerosis, depression, cognitive deficits, and Parkinson’s disease have been reported.There is evidence of the extraskeletal effects of vitamin D, but most derive from observational studies: clinical trials are required the better to determine the therapeutic role of vitamin D.

scholarly journals Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence

2021 ◽  
pp. bmjmilitary-2020-001686
Author(s):  
Iain T Parsons ◽  
R M Gifford ◽  
M J Stacey ◽  
L E Lamb ◽  
M K O'Shea ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Military Studies ◽  
Vitamin D Receptors ◽  
Area Of Interest ◽  
Military Populations ◽  
Tract Infections ◽  
Recruit Training

For most individuals residing in Northwestern Europe, maintaining replete vitamin D status throughout the year is unlikely without vitamin D supplementation and deficiency remains common. Military studies have investigated the association with vitamin D status, and subsequent supplementation, with the risk of stress fractures particularly during recruit training. The expression of nuclear vitamin D receptors and vitamin D metabolic enzymes in immune cells additionally provides a rationale for the potential role of vitamin D in maintaining immune homeostasis. One particular area of interest has been in the prevention of acute respiratory tract infections (ARTIs). The aims of this review were to consider the evidence of vitamin D supplementation in military populations in the prevention of ARTIs, including SARS-CoV-2 infection and consequent COVID-19 illness. The occupational/organisational importance of reducing transmission of SARS-CoV-2, especially where infected young adults may be asymptomatic, presymptomatic or paucisymptomatic, is also discussed.

Vitamin D status in Mexican children 1 to 11 years of age: an update from the Ensanut 2018-19

2021 ◽  
Vol 63 (3 May-Jun) ◽  
pp. 382-393
Author(s):  
Mario E Flores ◽  
Marta Rivera-Pasquel ◽  
Andrys Valdez-Sánchez ◽  
Vanessa De la Cruz-Góngora ◽  
Alejandra Contreras-Manzano ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Dairy Products ◽  
The Body ◽  
School Age Children ◽  
School Age ◽  
Vitamin D Status ◽  
Serum Samples ◽  
Related Factors ◽  
Mexican Children

Objective. To evaluate vitamin D status and deficiency in Mexican children and related factors, with updated data from a representative national survey. Materials and methods. Data and serum samples of child participants were collected in the Ensanut 2018-19. The measurement 25-(OH)-D was obtained through chemiluminescence. Height and weight, as well as dietary information, were measured using a semi-quan­titative food frequency questionnaire and sociodemographic information. Results. Data of 4 691 children aged 1-11 years were analyzed. Vitamin D deficiency (25-OH-D<50 nmol/L) was found in 27.3% of pre-school-age children and 17.2% of school-age children, and was positively associated with the body mass index (BMI). Main dietary sources were milk, eggs and dairy products, which in combination provided >70% of vitamin D intake. Conclusions. Vitamin D deficiency is important in Mexican children. Actions and programs to fight this deficiency are required.

scholarly journals Effect of Maternal Postpartum and Infant Intermittent Vitamin D Supplementation on Infant Vitamin D Status: A Systematic Review and Meta-Analysis of Trials (P11-089-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Karen O'Callaghan ◽  
Mahgol Taghivand ◽  
Anna Zuchniak ◽  
Akpevwe Onoyovwi ◽  
Jill Korsiak ◽  
...  
Keyword(s):  
Vitamin D ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Small Sample ◽  
Risk Of Bias ◽  
World Health ◽  
Control Group ◽  
Cochrane Central Register ◽  
Vitamin D Status ◽  
Statistical Heterogeneity

Abstract Objectives To determine the response of infant (≤ 1 year) circulating 25-hydroxyvitamin D (25(OH)D) to maternal postpartum or infant intermittent vitamin D supplementation in comparison to current recommendations of direct daily oral infant supplementation (400 IU/d). Methods MEDLINE, MEDLINE In-Process, Embase, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched up to December 4th 2018. A systematic search of online trial registries for unpublished, ongoing, or planned trials was also completed. Risk of bias was assessed using the Cochrane Risk Assessment Tool. Meta-analysis was limited to trials with a control group of infants receiving 400 IU vitamin D/d. A weighted mean difference (WMD) and 95% confidence interval (CI) was generated using infant 25(OH)D as a continuous outcome. Random-effects models accounted for within- and between-study variability. Statistical heterogeneity was quantified with the I2 statistic. Results A total of 28 trials were included, representing data from all 6 World Health Organization world regions. Of the 25 trials that specified a calciferol form, the majority (88%) employed vitamin D3. Six trials (21%) had an overall low risk of bias. Six trials qualified for meta-analysis, stratified by maternal (n = 4) and infant (n = 2) administration. Maternal supplementation resulted in a modestly lower infant vitamin D status than daily infant supplementation (WMD =-7.3 nmol/L; 95% CI: -14.0 to -0.6; I2 = 37%, P = 0.17). Comparison of infant intermittent bolus dosing to daily supplementation was limited by a small sample size and substantial heterogeneity, resulting in a wide CI (WMD = 10.2 nmol/L; 95% CI: -42.9 to 63.3; I2 = 96%, P < 0.001). Safety outcomes, including effects on calcium homeostasis, were inconsistently reported. Four ongoing trials were identified as potential contributors to future reviews. Conclusions Evidence to support the use of specific alternative maternal or infant regimens to substitute for current daily infant vitamin D supplementation is weak and inconsistent. Dose-ranging, adequately powered trials are required to establish the efficacy and safety of feasible alternative strategies to prevent infant vitamin D deficiency Funding Sources SickKids C-GCH Growth and Development Fellowship.

scholarly journals Calcium absorption and vitamin D status in school age children

2009 ◽  
Vol 23 (S1) ◽  
Author(s):  
Steven A Abrams ◽  
Penni D Hicks ◽  
Keli M Hawthorne
Keyword(s):  
Vitamin D ◽  
Calcium Absorption ◽  
School Age Children ◽  
School Age ◽  
Vitamin D Status

scholarly journals Vitamin D and Allergy Susceptibility during Gestation and Early Life

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1015
Author(s):  
Daniela Briceno Noriega ◽  
Huub F. J. Savelkoul
Keyword(s):  
Vitamin D ◽  
T Cells ◽  
Epithelial Cells ◽  
Early Life ◽  
Defense Mechanism ◽  
Interleukin 10 ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Epithelial Barrier Function ◽  
Increased Risk

Worldwide, the prevalence of allergies in young children, but also vitamin D deficiency during pregnancy and in newborns is rising. Vitamin D modulates the development and activity of the immune system and a low vitamin D status during pregnancy and in early life might be associated with an increased risk to develop an allergy during early childhood. This review studies the effects of vitamin D during gestation and early life, on allergy susceptibility in infants. The bioactive form of vitamin D, 1,25(OH)2D, inhibits maturation and results in immature dendritic cells that cause a decreased differentiation of naive T cells into effector T cells. Nevertheless, the development of regulatory T cells and the production of interleukin-10 was increased. Consequently, a more tolerogenic immune response developed against antigens. Secondly, binding of 1,25(OH)2D to epithelial cells induces the expression of tight junction proteins resulting in enhanced epithelial barrier function. Thirdly, 1,25(OH)2D increased the expression of anti-microbial peptides by epithelial cells that also promoted the defense mechanism against pathogens, by preventing an invasive penetration of pathogens. Immune intervention by vitamin D supplementation can mitigate the disease burden from asthma and allergy. In conclusion, our review indicates that a sufficient vitamin D status during gestation and early life can lower the susceptibility to develop an allergy in infants although there remains a need for more causal evidence.

scholarly journals VITAMIN D AND DEMENTIA

2015 ◽  
pp. 1-10
Author(s):  
T.J. Littlejohns ◽  
K. Kos ◽  
W.E. Henley ◽  
E. Kuma ◽  
D.J. Llewellyn
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vitamin D ◽  
Longitudinal Studies ◽  
Ventricular Volume ◽  
Vitamin D Supplementation ◽  
Small Sample ◽  
Double Blind ◽  
Cross Sectional ◽  
Increased Risk

Emerging evidence suggests that low vitamin D concentrations are potentially involved in the pathogenesis of dementia. This is of particular interest when considering the high prevalence of vitamin D deficiency in elderly adults and the urgent need to identify modifiable risk factors for dementia. Studies have found that vitamin D is implicated in procognitive and neuroprotective functions, including the reduction of Alzheimer’s disease hallmarks such as amyloid beta and phosphorylated tau. Cross-sectional studies have consistently found that vitamin D concentrations are significantly lower in individuals with Alzheimer’s disease and cognitive impairment compared to healthy controls. Longitudinal studies support an association between low vitamin D concentrations and an increased risk of dementia and cognitive decline. Neuroimaging studies are beginning to uncover the potential neurodegenerative and cerebrovascular mechanisms that underlie these associations such as white matter hyperintensities and enlarged ventricular volume, although there is currently a lack of longitudinal studies. In contrast to observational studies, findings from interventional studies have produced mixed results on the benefits of vitamin D supplementation on dementia and cognitive outcomes. Interpretation of the findings from these studies is hampered by several major methodological limitations, such as small sample sizes, inadequate doses and inclusion of participants unlikely to benefit from vitamin D supplementation. There is a need for large double-blind randomised-control trials investigating whether vitamin D supplementation can halt or delay the risk of dementia-related outcomes in individuals with low vitamin D concentrations.

scholarly journals Diabetes Prevention: Vitamin D Supplementation May Not Provide Any Protection If There Is No Evidence of Deficiency!

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2651 ◽  
Author(s):  
Uwe Gröber ◽  
Michael F. Holick
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
The Metabolic Syndrome ◽  
Supplement Group ◽  
Increased Risk

The results of epidemiological and several interventional studies suggest an association between vitamin D deficiency and an increased risk of developing insulin resistance or type 2 diabetes. Various studies have indicated that a lack of vitamin D must be regarded as a pathogenic factor for type 2 diabetes and the metabolic syndrome, since a vitamin D deficiency (25(OH)D < 20 ng/mL) increases insulin resistance and reduces insulin secretion from beta cells in the pancreas. A recent study by Pittas et al. did not show a clear preventive effect of vitamin D supplementation with respect to the risk of developing type 2 diabetes. In terms of this study, it must be remembered that more than 70% of the participants in both the vitamin D supplement group and the placebo group did not have a vitamin D deficiency. In medical and pharmaceutical practice, more attention should be paid to vitamin D deficiency than has previously been accorded. Vitamin D status can be assessed objectively when necessary by laboratory testing of the serum 25(OH)D levels. Type 2 diabetes patients benefit from improving their vitamin D status with respect to their glucose metabolism and decreased mortality risk. Patients with insulin resistance who are vitamin D deficient should be treated with an appropriate amount of vitamin D to achieve circulating levels of 25(OH)D of 40–60 ng/mL.

scholarly journals Vitamin A and D intake in pregnancy, infant supplementation, and asthma development: the Norwegian Mother and Child Cohort

2018 ◽  
Vol 107 (5) ◽  
pp. 789-798 ◽  
Author(s):  
Christine L Parr ◽  
Maria C Magnus ◽  
Øystein Karlstad ◽  
Kristin Holvik ◽  
Nicolai A Lund-Blix ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
School Age Children ◽  
Prescription Database ◽  
School Age ◽  
Total Vitamin ◽  
Supplement Use ◽  
Increased Risk ◽  
Mother And Child ◽  
In Pregnancy

ABSTRACT Background Western diets may provide excess vitamin A, which is potentially toxic and could adversely affect respiratory health and counteract benefits from vitamin D. Objective The aim of this study was to examine child asthma at age 7 y in relation to maternal intake of vitamins A and D during pregnancy, infant supplementation with these vitamins, and their potential interaction. Design We studied 61,676 school-age children (born during 2002–2007) from the Norwegian Mother and Child Cohort with data on maternal total (food and supplement) nutrient intake in pregnancy (food-frequency questionnaire validated against biomarkers) and infant supplement use at age 6 mo (n = 54,142 children). Linkage with the Norwegian Prescription Database enabled near-complete follow-up (end of second quarter in 2015) for dispensed medications to classify asthma. We used log-binomial regression to calculate adjusted RRs (aRRs) for asthma with 95% CIs. Results Asthma increased according to maternal intake of total vitamin A [retinol activity equivalents (RAEs)] in the highest (≥2031 RAEs/d) compared with the lowest (≤779 RAEs/d) quintile (aRR: 1.21; 95% CI: 1.05, 1.40) and decreased for total vitamin D in the highest (≥13.6 µg/d) compared with the lowest (≤3.5 µg/d) quintile (aRR: 0.81; 95% CI: 0.67, 0.97) during pregnancy. No association was observed for maternal intake in the highest quintiles of both nutrients (aRR: 0.99; 95% CI: 0.83, 1.18) and infant supplementation with vitamin D or cod liver oil. Conclusions Excess vitamin A (≥2.5 times the recommended intake) during pregnancy was associated with increased risk, whereas vitamin D intake close to recommendations was associated with a reduced risk of asthma in school-age children. No association for high intakes of both nutrients suggests antagonistic effects of vitamins A and D. This trial was registered at http://www.clinicaltrials.gov as NCT03197233.

scholarly journals Vitamin D and bone health in early life

2003 ◽  
Vol 62 (4) ◽  
pp. 823-828 ◽  
Author(s):  
Christian Mølgaard ◽  
Kim Fleischer Michaelsen
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Age Distribution ◽  
High Capacity ◽  
Growth Failure ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Increased Risk

Prolonged vitamin D deficiency resulting in rickets is seen mainly during rapid growth. A distinct age distribution has been observed in the Copenhagen area where all registered hospital cases of rickets were either infants and toddlers or adolescents from immigrant families. Growth retardation was only present in the infant and toddler group. A state of deficiency occurs months before rickets is obvious on physical examination. Growth failure, lethargy and irritability may be early signs of vitamin D deficiency. Mothers with low vitamin D status give birth to children with low vitamin D status and increased risk of rickets. Reports showing increasing rates of rickets due to insufficient sunlight exposure and inadequate vitamin D intake are cause for serious concern. Many countries (including the USA from 2003) recommend vitamin D supplementation during infancy to avoid rickets resulting from the low vitamin D content of human milk. Without fortification only certain foods such as fatty fish contain more than low amounts of vitamin D, and many children will depend entirely on sun exposure to obtain sufficient vitamin D. The skin has a high capacity to synthesize vitamin D, but if sun exposure is low vitamin D production is insufficient, especially in dark-skinned infants. The use of serum 25-hydroxyvitamin D to evaluate vitamin D status before development of rickets would be helpful; however, there is no agreement on cut-off levels for deficiency and insufficiency. Furthermore, it is not known how marginal vitamin D insufficiency affects children's bones in the long term.

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