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Increased Vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter : A double-blind randomized clinical trial

Öhlund, Inger; Lind, Torbjörn; Hernell, Olle; Silfverdal, Sven Arne and Äkeson, Pia Karlsland LU (2017) In American Journal of Clinical Nutrition 106(1). p.105-112
Abstract

Background: Dark skin and low exposure to sunlight increase the risk of Vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of Vitamin D needed to ascertain that most children > 4 y of age attain sufficient serum25-hydroxyVitamin D [S-25(OH)D; i.e.,≥50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (638N) and southern (55°N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based Vitamin D3 supplements that provided 2... (More)

Background: Dark skin and low exposure to sunlight increase the risk of Vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of Vitamin D needed to ascertain that most children > 4 y of age attain sufficient serum25-hydroxyVitamin D [S-25(OH)D; i.e.,≥50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (638N) and southern (55°N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based Vitamin D3 supplements that provided 2 (placebo), 10, or 25 μg/d during 3 winter months. Results: Mean daily Vitamin D intake increased from 6 to 17 mg and 26 mg in the intervention groups supplemented with 10 and 25 mg, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 mg/d attained sufficient concentrations, whereas 25 mg/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair- and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 μg/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH)D/L, intakes of 6 and 20 μg/d are required in fair-skinned children, whereas 14 and 28 μg/d are required in children with dark skin. Conclusion: Children with fair and dark skin require Vitamin D intakes of 20 and 28 μg/d, respectively, to maintain S-25(OH)D ≥50 nmol/L, whereas intakes of 6 and 14 mg/d, respectively, are required to maintain concentrations ≥30 nmol/L during winter. This trial was registered at clinicaltrials.gov as NCT01741324.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Intervention, Latitude, Season, Serum 25-hydroxyVitamin D, Vitamin D
in
American Journal of Clinical Nutrition
volume
106
issue
1
pages
8 pages
publisher
American Society for Clinical Nutrition
external identifiers
  • scopus:85021796095
  • wos:000404593900015
ISSN
0002-9165
DOI
10.3945/ajcn.116.147108
language
English
LU publication?
yes
id
f6b7516c-df92-4f50-b24e-0c4d588cfde1
date added to LUP
2017-07-25 14:25:09
date last changed
2017-09-18 11:39:22
@article{f6b7516c-df92-4f50-b24e-0c4d588cfde1,
  abstract     = {<p>Background: Dark skin and low exposure to sunlight increase the risk of Vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of Vitamin D needed to ascertain that most children &gt; 4 y of age attain sufficient serum25-hydroxyVitamin D [S-25(OH)D; i.e.,≥50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (638N) and southern (55°N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based Vitamin D<sub>3</sub> supplements that provided 2 (placebo), 10, or 25 μg/d during 3 winter months. Results: Mean daily Vitamin D intake increased from 6 to 17 mg and 26 mg in the intervention groups supplemented with 10 and 25 mg, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 mg/d attained sufficient concentrations, whereas 25 mg/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair- and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 μg/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH)D/L, intakes of 6 and 20 μg/d are required in fair-skinned children, whereas 14 and 28 μg/d are required in children with dark skin. Conclusion: Children with fair and dark skin require Vitamin D intakes of 20 and 28 μg/d, respectively, to maintain S-25(OH)D ≥50 nmol/L, whereas intakes of 6 and 14 mg/d, respectively, are required to maintain concentrations ≥30 nmol/L during winter. This trial was registered at clinicaltrials.gov as NCT01741324.</p>},
  author       = {Öhlund, Inger and Lind, Torbjörn and Hernell, Olle and Silfverdal, Sven Arne and Äkeson, Pia Karlsland},
  issn         = {0002-9165},
  keyword      = {Child,Intervention,Latitude,Season,Serum 25-hydroxyVitamin D,Vitamin D},
  language     = {eng},
  month        = {07},
  number       = {1},
  pages        = {105--112},
  publisher    = {American Society for Clinical Nutrition},
  series       = {American Journal of Clinical Nutrition},
  title        = {Increased Vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter : A double-blind randomized clinical trial},
  url          = {http://dx.doi.org/10.3945/ajcn.116.147108},
  volume       = {106},
  year         = {2017},
}