Les apports en calcium en population pédiatrique générale : les recommandations françaises 2022

Abstract

French guidelines for vitamin D supplementation and calcium intakes in general pediatric populations were updated in 2022. Here are the main messages: supplementation for all children from 0 to 18 years, elimination of adjustment for breastfeeding type and skin color from 0 to 2 years, preference for daily supplementation (but intermittent supplementation still possible), identification of 4 risk factors requiring a doubling of doses (i.e., obesity, dark skin, lack of sun exposure and vegan diet), and eventually, the need to prescribe vitamin D as a drug and not as a food supplement. Specific situations were also discussed: premature neonates, children at risk of overdose/deficiency, and children in French overseas territories. The recommendations also stress out the importance of nutritional calcium intake: indeed, there is no point in providing vitamin D without calcium (and vice versa). While a large proportion of the pediatric population is deficient in calcium, the recommendations also suggest daily calcium intakes according to age, and remind that calcium absorption depends on the source of dietary calcium: absorption is 7 times better for dairy products and calcium-rich mineral waters (compared with calcium from plant sources), a fact to keep in mind especially for children following vegan diets. Last, promoting physical activity to optimize peak bone mass and to prevent obesity should also be a daily concern for pediatricians.