Vitamin D supplementation and growth in urban Mongol school children: Results from two randomized clinical trials

Symptomatic vitamin D deficiency is associated with slowed growth in children. It is unknown whether vitamin D repletion in children with asymptomatic serum vitamin D deficiency can restore normal growth. We tested the impact of vitamin D-supplementation on serum concentrations of 25-hydroxyvitamin...

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Bibliographic Details
Published in:PloS one 2017-05, Vol.12 (5), p.e0175237-e0175237
Main Authors: Ganmaa, Davaasambuu, Stuart, Jennifer J, Sumberzul, Nyamjav, Ninjin, Boldbaatar, Giovannucci, Edward, Kleinman, Ken, Holick, Michael F, Willett, Walter C, Frazier, Lindsay A, Rich-Edwards, Janet W
Format: Article
Language:English
Subjects:
25-Hydroxyvitamin D
Adipose tissue
Adolescent
Adolescents
Adults
Age
Air pollution
Analysis
Anthropometry
Arches
Biology
Biology and life sciences
Birth weight
Body fat
Body height
Body mass
Body mass index
Body weight
Bone mass
Bowing
Cancer
Child
Child health
Children
Classrooms
Clinical trials
Diabetes mellitus
Diamonds
Diet
Dietary supplements
Double-Blind Method
Epidemiology
Exposure
Feasibility studies
Female
Food
Genotypes
Growth
Growth disorders
Health aspects
Health care
Health sciences
Hospitals
Human behavior
Humans
Hypersensitivity
Indicators
Infants
Infections
Insulin
Intervention
Laboratories
Male
Medical schools
Medicine
Medicine and health sciences
Metabolism
Milk
Mongolia
Nutrients
Nutrition
Outdoor air quality
People and Places
Physical Sciences
Pigmentation
Placebos
Protective clothing
Public health
Rickets
Rural areas
Skin
Social Sciences
Synthesis
Teenagers
Tuberculosis
Ultraviolet radiation
Urban Population
Vitamin D
Vitamin D - administration & dosage
Vitamin D - blood
Vitamin deficiency
Winter
Womens health
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Summary:Symptomatic vitamin D deficiency is associated with slowed growth in children. It is unknown whether vitamin D repletion in children with asymptomatic serum vitamin D deficiency can restore normal growth. We tested the impact of vitamin D-supplementation on serum concentrations of 25-hydroxyvitamin D [25(OH)D] and short-term growth in Mongol children, with very low serum vitamin D levels in winter. We conducted two randomized, double-blind, placebo-controlled trials in urban school age children without clinical signs of rickets. The Supplementation Study was a 6-month intervention with an 800 IU vitamin D3 supplement daily, compared with placebo, in 113 children aged 12-15 years. A second study, the Fortification Study, was a 7-week intervention with 710 ml of whole milk fortified with 300 IU vitamin D3 daily, compared with unfortified milk, in 235 children aged 9-11 years. At winter baseline, children had low vitamin D levels, with a mean (±SD) serum 25-hydroxyvitamin D [25(OH)D] concentration of 7.3 (±3.9) ng/ml in the Supplementation Study and 7.5 (±3.8) ng/ml in the Fortification Study. The serum levels increased in both vitamin D groups-by 19.8 (±5.1) ng/ml in the Supplementation Study, and 19.7 (±6.1) ng/ml in the Fortification Study. Multivariable analysis showed a 0.9 (±0.3 SE) cm greater increase in height in the vitamin-D treated children, compared to placebo treated children, in the 6-month Supplementation Study (p = 0.003). Although the children in the 7-week Fortification Study intervention arm grew 0.2 (±0.1) cm more, on average, than placebo children this difference was not statistically significant (p = 0.2). There were no significant effects of vitamin D supplements on differences in changes in weight or body mass index in either trial. For the Fortification Study, girls gained more weight than boys while taking vitamin D 3 (p-value for interaction = 0.03), but sex was not an effect modifier of the relationship between vitamin D3 and change in either height or BMI in either trial. Correcting vitamin D deficiency in children with very low serum vitamin D levels using 800 IU of vitamin D3 daily for six months increased growth, at least in the short-term, whereas, in a shorter trial of 300 IU of D fortified milk daily for 7 weeks did not.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0175237