2至8岁健康儿童膳食维生素D剂量反应：一项使用强化食品的12周随机对照试验

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.

作者信息

Brett Neil R, Lavery Paula, Agellon Sherry, Vanstone Catherine A, Maguire Jonathon L, Rauch Frank, Weiler Hope A

机构信息

School of Dietetics and Human Nutrition, McGill University, Sainte Anne de Bellevue, Quebec, Canada;

Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Pediatrics, University of Toronto, Toronto, Canada; and.

出版信息

Am J Clin Nutr. 2016 Jan;103(1):144-52. doi: 10.3945/ajcn.115.115956. Epub 2015 Dec 16.

DOI:10.3945/ajcn.115.115956

PMID:26675772

Abstract

BACKGROUND

Vitamin D is fundamental for bone health. A high proportion of Canadian 2- to 8-y-olds do not meet the Estimated Average Requirement (EAR) of 400 IU/d.

OBJECTIVE

The objective was to determine whether vitamin D intakes consistent with the EAR or Recommended Dietary Allowance (RDA), through fortification of additional dairy products, would result in higher vitamin D status in young children.

DESIGN

Participants aged 2-8 y (n = 77; Montreal, Canada) were randomly assigned to 1 of 3 dietary vitamin D targets (control; EAR: 400 IU/d; or RDA: 600 IU/d) for 12 wk (January to April 2014). Anthropometric measurements, demographic characteristics, dietary intakes, fasting serum parathyroid hormone, 25-hydroxyvitamin D [25(OH)D], and ionized calcium were compared by using mixed-model ANOVA.

RESULTS

Participants' mean ± SD age was 5.1 ± 1.9 y; 54.5% were boys with body mass index z scores of 0.50 ± 0.85. Compliance was 85% overall. No differences were observed in baseline dietary vitamin D intakes or serum 25(OH)D. At 12 wk, the EAR and RDA groups had significantly higher vitamin D intakes [median (IQR): control, 227 (184-305) IU/d; EAR, 410 (363-516) IU/d; and RDA, 554 (493-653) IU/d; P < 0.05] and serum 25(OH)D concentrations (control: 55.8 ± 12.3 nmol/L; EAR: 64.1 ± 10.0 nmol/L; and RDA: 63.7 ± 12.4 nmol/L; P < 0.05) than the control group. Ninety-six percent of children in the EAR and RDA groups and 67% of the control group had 25(OH)D concentrations ≥50 nmol/L.

CONCLUSION

Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D ≥50 nmol/L during periods of minimal ultraviolet B radiation exposure. This trial was registered at clinicaltrials.gov as NCT02097160 and had Health Canada Temporary Marketing Authorization Letters for both products (TM-13-0432 and TM-13-0433).

摘要

背景

维生素D对骨骼健康至关重要。加拿大很大一部分2至8岁的儿童未达到每日400国际单位的估计平均需求量（EAR）。

目的

目的是确定通过强化其他乳制品使维生素D摄入量符合EAR或推荐膳食摄入量（RDA）是否会使幼儿的维生素D状况更好。

设计

2至8岁的参与者（n = 77；加拿大蒙特利尔）被随机分配到3个膳食维生素D目标之一（对照组；EAR：400国际单位/天；或RDA：600国际单位/天），为期12周（2014年1月至4月）。通过混合模型方差分析比较人体测量学指标、人口统计学特征、膳食摄入量、空腹血清甲状旁腺激素、25-羟基维生素D [25(OH)D]和离子钙。

结果

参与者的平均年龄±标准差为5.1±1.9岁；54.5%为男孩，体重指数z评分为0.50±0.85。总体依从率为85%。基线膳食维生素D摄入量或血清25(OH)D未观察到差异。在12周时，EAR组和RDA组的维生素D摄入量[中位数（四分位间距）：对照组，227（184 - 305）国际单位/天；EAR组，410（363 - 516）国际单位/天；RDA组，554（493 - 653）国际单位/天；P < 0.05]和血清25(OH)D浓度（对照组：55.8±12.3纳摩尔/升；EAR组：64.1±10.0纳摩尔/升；RDA组：63.7±12.4纳摩尔/升；P < 0.05）均显著高于对照组。EAR组和RDA组96%的儿童以及对照组67%的儿童25(OH)D浓度≥50纳摩尔/升。

结论

在紫外线B辐射暴露最少的时期，通过强化其他乳制品增加幼儿的维生素D摄入量会使血清25(OH)D浓度显著升高，且血清25(OH)D≥50纳摩尔/升的儿童比例显著增加。该试验在clinicaltrials.gov上注册为NCT02097160，两种产品均获得了加拿大卫生部的临时销售授权书（TM - 13 - 0432和TM - 13 - 0433）。