Abstract
Vitamin D supplementation in infancy is recommended to prevent rickets. At the population level, its effects on bone mineralisation are largely unknown. We aimed to explore whether adherence to national vitamin D supplementation guidelines (10 µg/d up to the age of 2 years), supplementation at the ages of 5 and 7 years, and serum 25-hydroxyvitamin D (s-25(OH)D) at various time points associated with bone mineral density (BMD) at the age of 7 years in the Odense Child Cohort, Denmark (n 1194). High adherence was defined as supplementation with 10 µg of vitamin D 6-7 times per week during ≥80 % of the observation time. s-25(OH)D was analysed using LC-MS/MS. Total-body-less-head (TBLH) BMD was measured by dual-energy X-ray absorptiometry. At the median age of 18·1 months, 53·9 % (n 475/881) reported high adherence. The median s-25(OH)D was 64·7, 78·8, 46·0 and 71·8 nmol/l in early pregnancy, late pregnancy, cord blood and at 5 years, respectively. The mean TBLH BMD at the median age of 7·1 years was 0·613 (SD 0·049) g/cm2 (z-score +0·363 (SD 0·824)). In adjusted analyses, vitamin D supplementation up to 18 months, and at 5 and 7 years, was not associated with TBLH BMD. Similarly, no robust associations were found between TBLH BMD and s-25(OH)D at any time point. No associations were found for TBLH bone mineral concentration or bone area. In this population with relatively high s-25(OH)D concentrations, no consistent associations were found between adherence to vitamin D supplementation recommendations or vitamin D status in pregnancy or childhood, and bone mineralisation at the age of 7 years.
Highlights
Vitamin D and Ca are important for ensuring optimal bone accretion in childhood and thereby maximising peak bone mass, which may prevent osteoporosis and bone fractures later in life[1,2,3,4]
In the Danish population-based Odense Child Cohort (OCC), where vitamin D status in pregnancy and childhood is relatively high, we have previously found that s-25(OH)D measured in early and late pregnancy and in cord blood was neither associated with offspring skull parameters, nor total length or height up to 3 years of age[27,28]
We examined the association between the use of vitamin D supplementation in pregnancy and at the age of 5 years and s-25(OH)D in early pregnancy, late pregnancy and at the age of 5 years, respectively, by applying multiple linear regression adjusting for the same covariates as in model 3
Summary
Vitamin D and Ca are important for ensuring optimal bone accretion in childhood and thereby maximising peak bone mass, which may prevent osteoporosis and bone fractures later in life[1,2,3,4]. According to a recent global consensus report, a daily vitamin D supplementation of 15 μg is recommended for all pregnant women to prevent hypocalcaemia, dental enamel malformations and congenital rickets in offspring[6]. All infants should, irrespective of diet, use vitamin D supplementation (10 μg per day from birth to the age of 12 months) to prevent nutritional rickets. In Denmark, a daily vitamin D supplementation of 10 μg has until January 2020 been recommended for pregnant women and all children up to the age of 24 months, regardless of vitamin D intake through diet and fortified formula milk, to support maximal bone growth[7,8].
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