Cross-sectional analysis of universal vitamin D supplementation in former East Germany during the first year of life

Abstract

Background: Universal vitamin D supplementation is controversial. Preventative examinations and public health initiatives in former East Germany that included vitamin D prophylaxis for children were regulated by official recommendations and guidelines. The aim of this study is to analyse the impact of a standardised nationwide guideline for universal supplementation with 400 International Units (IU) vitamin D3/day during the first year of life on clinical and biochemical parameters and the influence of surrounding factors. Methods: This is a cross-sectional analysis looking at data from a field study of 3481 term-born children during their first year of life that was conducted in 1989.

Factors Affecting Vitamin D Status in Infants

“…It has been observed that 25(OH)D concentrations in infants are lowest in spring, probably due to the low UV levels in winter. Siafarikas et al, in a large ( n = 3481) cross-sectional study of infants under 12 months old, observed that vitamin D concentrations were lowest in March (i.e., after winter in the northern hemisphere) ( p = 0.01) [58]. These findings were corroborated by a large Chinese cross-sectional study [59].…”

“…Modelling has shown that, in the same conditions (season, skin pigmentation, skin exposed, and time spent outdoors), the amount of vitamin D produced by a patient in Darwin (latitude 12° S) is eight times greater than that produced by one in Hobart (latitude 42° S) [60]. The study by Siafarikas et al spanned multiple latitudes in East Germany and found that mean serum 25(OH)D concentrations were higher in the south than in the north (78 nmol/L at 54.1° N, 83 nmol/L at 51.5° N, and 88 nmol/L at 50.6° N) [58].…”

Pediatric endocrinology is pediatrics is public health

“…Alkaline phosphatase levels (n = 690) were >1500 U/L (95th percentile) in 3.6%. It is conclude that supplementation with 400 IU of vitamin D3 during the first year of life is safe and provides sufficient 25(OH)D levels in an environment of moderate sun exposure as is the case in Germany [17].…”

Deficiencia e insuficiencia de vitamina D en lactantes sanos recibiendo suplementación estándar

“…Al igual que en otros estudios realizados en niños mayores y adultos, en este estudio se reproduce la variación estacional de los niveles de VD, aumentando en forma clara en el periodo de verano-otoño 24 . Por lo anterior se puede extrapolar que la exposición solar incidiría en lactantes menores aun cuando las recomendaciones son de no exponer.…”