title: Is daily 400 IU of vitamin D supplementation appropriate for every country: a cross-sectional study.
abstract: BACKGROUND
  Vitamin D deficiency in childhood is a significant problem worldwide. Religious, social customs, and lack of food fortification were significant hurdles in the way of the rickets scourge. Recent data support a serum level of 25(OH)D level > 40 ng/mL as the appropriate standard to achieve to prevent rickets. Herein, the current approaches of preventing rickets and optimal level of different vitamin D intakes were evaluated.
  
  
  METHODS
  A total of 148 fully breastfed, healthy children between age of 2-24 months were investigated by screening serum 25(OH)D from April 1 to May 31, 2006. Three groups were composed according to ages (2-6, 6-12, 12-24 months), and those groups were paired with three subgroups established according to vitamin D intake of ≤300, 400, and 600 IU/day. Vitamin D status was evaluated with regard to cut-off value of 15 ng/mL and 40 mg/dL. The clothing types and vitamin D supplementation of mothers were recorded.
  
  
  RESULTS
  We found that 27.3% of cases in 2-6 months, 8.3% in 6-12 months and 30% in 12-24 months had 25(OH)D <15 ng/mL and 54.5, 33.3, and 50% of cases were <40 ng/dL with 400 IU/day vitamin D intake. With 600 IU/day supplementation, 14.3, 10.3, and 4.8% of cases had 25(OH)D <15 ng/mL, respectively.
  
  
  CONCLUSIONS
  Vitamin D intake of 400 IU/day seems to be favorable at the first year in breastfed children but vitamin D deficiency was still evident after prophylaxis. Vitamin D supplementation should be at least 600 IU/day in Turkey, and nutrition policy should focus on the food fortification with vitamin D.
authors.affiliation: Department of Pediatrics, Division of Metabolic Diseases, Ministry of Health Bakirkoy Maternity and Children Education Hospital, Istanbul, Turkey. hasanonal@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Onal
authors.forename: Erdal
authors.initials: E
authors.lastname: Adal
authors.forename: Seçil
authors.initials: S
authors.lastname: Alpaslan
authors.forename: Atilla
authors.initials: A
authors.lastname: Ersen
authors.forename: Ahmet
authors.initials: A
authors.lastname: Aydin
mesh_terms: D001942:Breast Feeding; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D019587:Dietary Supplements / Q000592:standards*; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008297:Male; D018673:Nutrition Policy; D011634:Public Health; D012279:Rickets / Q000517:prevention & control; D014421:Turkey; D014807:Vitamin D / Q000097:blood* / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000517:prevention & control*
chemical_list: D014807:Vitamin D