Vitamin D and child health in the 21st century.

CONTEXT

Vitamin D has emerged as a topic of great interest among researchers. Recent evidence indicates that today the world is facing vitamin D deficiency pandemic. Sensitizing pediatricians to widespread vitamin D deficiency in children and benefits accrued from its correction would go a long way as far as clinical practice and public health is concerned.

EVIDENCE ACQUISITION

We performed a literature search using PubMed/medline, EMBASE and ScienceDirect databases indexed under the Medical Subject Heading (MeSH) terms; Vitamin D OR Vitamin D deficiency combined with the terms children OR pediatric OR child health. The literature search was limited to articles in last 35 years and written in the English language. All articles having direct relevance to to the present review were searched. Reference lists of all articles were also reviewed. Emphasis was placed on pediatric literature, although sentinel adult studies relevant to this article have been included. Latest editions of standard texts were also searched.

RESULTS

Vitamin D deficiency is highly prevalent throughout the world including India. Though some evidence suggests a role of hypovitaminosis D in pathophysiology of many clinical situations other than rickets and osteomalacia like autoimmune diseases, cardiovascular diseases, infections, cancers, fetal health, and exercise performance, some authorities feel there is a lack of unequivocal evidence in favour of nonskeletal health benefits of vitamin D.

CONCLUSIONS

Widespread subclinical and pre-rachitic vitamin D deficiency in children should be diagnosed by serum 25(OH)D levels and these levels should be maintained above 20 ng/mL to obtain optimal health benefits. There is a need for large randomized clinical trials to investigate the nonskeletal benefits of vitamin D deficiency.