Calcium Plus Vitamin D Supplementation During the Third Trimester of Pregnancy in Adolescents Accustomed to Low Calcium Diets Does Not Affect Infant Bone Mass at Early Lactation in a Randomized Controlled Trial ,

Diogenes, Maria Eduarda L; Bezerra, Flávia Fioruci; Rezende, Elaine P; Donangelo, Carmen M.

doi:10.3945/jn.114.208140

Cited by 30 publications

(57 citation statements)

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“…Our findings of associations between maternal vitamin D biomarkers and fetal markers of bone metabolism appear to be inconsistent with two recent randomized controlled trials [42,43] which demonstrated no effects of maternal vitamin D 3 supplementation (1,000 IU/d [43] and 200 IU/d [42]) on fetal bone measurements as compared to a placebo group. The reasons for these inconsistencies are unclear but may be due to differences in the intake of bone-related nutrients.…”

Section: Discussioncontrasting

confidence: 99%

“…The reasons for these inconsistencies are unclear but may be due to differences in the intake of bone-related nutrients. For example, dietary calcium was not reported in one study [43] and the supplementation group had very low vitamin D intake (234 IU/d from food and the supplement) in the other study [42]. In addition, genetic variants that might alter bone metabolism were not assessed in either study which may obscure study findings.…”

Section: Discussionmentioning

confidence: 99%

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Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Park

Brannon

West

et al. 2017

Bone

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Vitamin D plays a central role in calcium homeostasis; however, its relationship with bone turnover during pregnancy remains unclear due to a lack of studies that have rigorously controlled for other nutrients known to influence bone metabolism. Similarly, prior investigations of the effect of pregnancy on bone turnover relative to the nonpregnant state may have been confounded by varying intakes of these nutrients. Nested within a controlled intake study, the present investigation sought to quantify associations between maternal vitamin D biomarkers and biochemical markers of bone turnover among pregnant (versus nonpregnant) women and their fetuses under conditions of equivalent and adequate intakes of vitamin D and related nutrients. Changes in markers of bone turnover across the third trimester were also examined. Healthy pregnant (26–29 wk gestation; n=26) and nonpregnant (n=21) women consumed 511IU vitamin D/d, 1.6g calcium/d, and 1.9g phosphorus/d for 10 weeks while participating in a controlled feeding study featuring two choline doses. Based on linear mixed models adjusted for influential covariates (e.g., BMI, ethnicity, and season), pregnant women had 50–150% higher (P<0.001) concentrations of bone resorption markers than nonpregnant women. Among pregnant women, increases in maternal 25(OH)D across the study period were associated (P<0.020) with lower osteocalcin and deoxypyridinoline at study-end, and higher fetal osteocalcin. In addition, maternal free 25(OH)D, 1,25(OH)2D, and 24,25(OH)2D tended to be negatively associated (P≤0.063) with maternal NTx at study-end, and maternal free 25(OH)D and 24,25(OH)2D were positively associated (P≤0.021) with fetal CTx. Similarly, maternal 3-epi-25(OH)D3 was negatively related (P≤0.037) to maternal NTx and deoxypyridinoline at study-end. These declines in bone resorption markers resulting from higher vitamin D biomarker concentrations among pregnant women coincided with increases in their albumin-corrected serum calcium concentrations, indicating that calcium transfer to the fetus was uncompromised. Notably, none of these associations achieved statistical significance among nonpregnant women. Overall, our study findings suggest that achieving higher maternal concentrations of vitamin D biomarkers might attenuate third-trimester bone resorption while ensuring sufficient calcium delivery to the fetus.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Park

Brannon

West

et al. 2017

Bone

View full text Add to dashboard Cite

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“…To-date, the effect of vitamin D supplementation during pregnancy on neonatal anthropometric and bone parameters is still a matter of debate. While the neutral results described here-in replicate findings of a study from Brazil, that administered 200 IU of vitamin D with 600 mg of calcium daily, or placebo ( Diogenes et al, 2015 ), other trials from the UK showed a potential beneficial effect with a vitamin D dose of 1000 IU/d, with a trend for a higher neonatal bone mineral content (BMC) at forearm ( Congdon et al, 1983 ), or a higher whole body BMC, in neonates born in the winter season ( Cooper et al, 2016 ). Indeed, baseline 25(OH)D level vitamin D dose administered, and the timing at which supplementation was started, seem to be important modulators of response, and this needs to be taken into consideration.…”

Section: Randomized Trials Of Vitamin D Supplementation In Different supporting

confidence: 82%

Vitamin D in the Middle East and North Africa

et al. 2018

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PurposeThe Middle East and North Africa (MENA) region registers some of the lowest serum 25‑hydroxyvitamin D [25(OH)D] concentrations, worldwide. We describe the prevalence and the risk factors for hypovitaminosis D, completed and ongoing clinical trials, and available guidelines for vitamin D supplementation in this region.MethodsThis review is an update of previous reviews published by our group in 2013 for observational studies, and in 2015 for randomized controlled trials (RCTs) from the region. We conducted a comprehensive search in Medline, PubMed, and Embase, and the Cochrane Library, using MeSH terms and keywords relevant to vitamin D, vitamin D deficiency, and the MENA region, for the period 2012–2017 for observational studies, and 2015–2017 for RCTs. We included large cross-sectional studies with at least 100 subjects/study, and RCTs with at least 50 participants per arm.ResultsWe identified 41 observational studies. The prevalence of hypovitaminosis D, defined as a 25‑hydroxyvitamin D [25(OH)D] level below the desirable level of 20 ng/ml, ranged between 12–96% in children and adolescents, and 54–90% in pregnant women. In adults, it ranged between 44 and 96%, and the mean 25(OH)D varied between 11 and 20 ng/ml. In general, significant predictors of low 25(OH)D levels were female gender, increasing age and body mass index, veiling, winter season, use of sun screens, lower socioeconomic status, and higher latitude.We retrieved 14 RCTs comparing supplementation to control or placebo, published during the period 2015-2017: 2 in children, 8 in adults, and 4 in pregnant women. In children and adolescents, a vitamin D dose of 1000–2000 IU/d was needed to maintain serum 25(OH)D level at target. In adults and pregnant women, the increment in 25(OH)D level was inversely proportional to the dose, ranging between 0.9 and 3 ng/ml per 100 IU/d for doses ≤2000 IU/d, and between 0.1 and 0.6 ng/ml per 100 IU/d for doses ≥3000 IU/d. While the effect of vitamin D supplementation on glycemic indices is still controversial in adults, vitamin D supplementation may be protective against gestational diabetes mellitus in pregnant women. In the only identified study in the elderly, there was no significant difference between 600 IU/day and 3750 IU/day doses on bone mineral density. We did not identify any fracture studies.The available vitamin D guidelines in the region are based on expert opinion, with recommended doses between 400 and 2000 IU/d, depending on the age category, and country.ConclusionHypovitaminosis D is prevalent in the MENA region, and doses of 1000–2000 IU/d may be necessary to reach a desirable 25(OH)D level of 20 ng/ml. Studies assessing the effect of such doses of vitamin D on major outcomes, and confirming their long term safety, are needed.

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“…Six studies were identified that had supplemented the diet of pregnant adolescents and measured growth and development‐related outcomes. Two of these studies involved calcium supplementation, one involved supplementation with calcium plus vitamin D, two involved supplementation with zinc, and one included four intervention arms in females of childbearing age (i.e. including adults as well as adolescents), with supplementation of: (1) folic acid; (2) folic acid and iron; (3) folic acid, iron, and zinc; and (4) multiple micronutrients .…”

Section: Evidence From Intervention Studiesmentioning

confidence: 99%

Adolescent pregnancy, nutrition, and health outcomes in low‐ and middle‐income countries: what we know and what we don't know

Johnson

Moore

2015

BJOG

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Calcium Plus Vitamin D Supplementation During the Third Trimester of Pregnancy in Adolescents Accustomed to Low Calcium Diets Does Not Affect Infant Bone Mass at Early Lactation in a Randomized Controlled Trial ,

Cited by 30 publications

References 28 publications

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Vitamin D in the Middle East and North Africa

Adolescent pregnancy, nutrition, and health outcomes in low‐ and middle‐income countries: what we know and what we don't know

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