Department of Pediatrics, Division of Metabolic Diseases, Ministry of Health Bakirkoy Maternity and Children Education Hospital, Istanbul, Turkey.
Eur J Nutr. 2010 Oct;49(7):395-400. doi: 10.1007/s00394-010-0097-8. Epub 2010 Feb 19.
Vitamin D deficiency in childhood is a significant problem worldwide. Religious, social customs, and lack of food fortification were significant hurdles in the way of the rickets scourge. Recent data support a serum level of 25(OH)D level > 40 ng/mL as the appropriate standard to achieve to prevent rickets. Herein, the current approaches of preventing rickets and optimal level of different vitamin D intakes were evaluated.
A total of 148 fully breastfed, healthy children between age of 2-24 months were investigated by screening serum 25(OH)D from April 1 to May 31, 2006. Three groups were composed according to ages (2-6, 6-12, 12-24 months), and those groups were paired with three subgroups established according to vitamin D intake of ≤300, 400, and 600 IU/day. Vitamin D status was evaluated with regard to cut-off value of 15 ng/mL and 40 mg/dL. The clothing types and vitamin D supplementation of mothers were recorded.
We found that 27.3% of cases in 2-6 months, 8.3% in 6-12 months and 30% in 12-24 months had 25(OH)D <15 ng/mL and 54.5, 33.3, and 50% of cases were <40 ng/dL with 400 IU/day vitamin D intake. With 600 IU/day supplementation, 14.3, 10.3, and 4.8% of cases had 25(OH)D <15 ng/mL, respectively.
Vitamin D intake of 400 IU/day seems to be favorable at the first year in breastfed children but vitamin D deficiency was still evident after prophylaxis. Vitamin D supplementation should be at least 600 IU/day in Turkey, and nutrition policy should focus on the food fortification with vitamin D.
儿童维生素 D 缺乏是一个全球性的严重问题。宗教、社会习俗和食物强化的缺乏是佝偻病肆虐的重要障碍。最近的数据支持血清 25(OH)D 水平>40ng/ml 作为预防佝偻病的适当标准。在此,评估了预防佝偻病的当前方法和不同维生素 D 摄入量的最佳水平。
2006 年 4 月 1 日至 5 月 31 日,通过筛查血清 25(OH)D,对 148 名完全母乳喂养、2-24 个月龄的健康儿童进行了调查。根据年龄(2-6、6-12、12-24 个月)将儿童分为三组,并根据维生素 D 摄入量≤300、400、600IU/天分为三组。根据 15ng/ml 和 40mg/dL 的截止值评估维生素 D 状态。记录母亲的服装类型和维生素 D 补充情况。
我们发现,2-6 个月时 27.3%、6-12 个月时 8.3%、12-24 个月时 30%的儿童 25(OH)D<15ng/ml,400IU/天时 54.5%、33.3%和 50%的儿童<40ng/dL。600IU/天补充时,分别有 14.3%、10.3%和 4.8%的儿童 25(OH)D<15ng/ml。
母乳喂养儿童第一年摄入 400IU/天的维生素 D 似乎是有利的,但预防后仍明显缺乏维生素 D。土耳其儿童的维生素 D 补充量至少应为 600IU/天,营养政策应重点关注食物强化维生素 D。