title: Vitamin D in the healthy European paediatric population.
abstract: In recent years, reports suggesting a resurgence of vitamin D deficiency in the Western world, combined with various proposed health benefits for vitamin D supplementation, have resulted in increased interest from health care professionals, the media, and the public. The aim of this position paper is to summarise the published data on vitamin D intake and prevalence of vitamin D deficiency in the healthy European paediatric population, to discuss the health benefits of vitamin D and to provide recommendations for the prevention of vitamin D deficiency in this population. Vitamin D plays a key role in calcium and phosphate metabolism and is essential for bone health. There is insufficient evidence from interventional studies to support vitamin D supplementation for other health benefits in infants, children, and adolescents. The pragmatic use of a serum concentration >50 nmol/L to indicate sufficiency and a serum concentration <25 nmol/L to indicate severe deficiency is recommended. Vitamin D deficiency occurs commonly among healthy European infants, children, and adolescents, especially in certain risk groups, including breast-fed infants, not adhering to the present recommendation for vitamin D supplementation, children and adolescents with dark skin living in northern countries, children and adolescents without adequate sun exposure, and obese children. Infants should receive an oral supplementation of 400 IU/day of vitamin D. The implementation should be promoted and supervised by paediatricians and other health care professionals. Healthy children and adolescents should be encouraged to follow a healthy lifestyle associated with a normal body mass index, including a varied diet with vitamin D-containing foods (fish, eggs, dairy products) and adequate outdoor activities with associated sun exposure. For children in risk groups identified above, an oral supplementation of vitamin D must be considered beyond 1 year of age. National authorities should adopt policies aimed at improving vitamin D status using measures such as dietary recommendations, food fortification, vitamin D supplementation, and judicious sun exposure, depending on local circumstances.
authors.affiliation: Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, Zurich, Switzerland. Christian.Braegger@kispi.uzh.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Braegger
authors.forename: Cristina
authors.initials: C
authors.lastname: Campoy
authors.forename: Virginie
authors.initials: V
authors.lastname: Colomb
authors.forename: Tamas
authors.initials: T
authors.lastname: Decsi
authors.forename: Magnus
authors.initials: M
authors.lastname: Domellof
authors.forename: Mary
authors.initials: M
authors.lastname: Fewtrell
authors.forename: Iva
authors.initials: I
authors.lastname: Hojsak
authors.forename: Walter
authors.initials: W
authors.lastname: Mihatsch
authors.forename: Christian
authors.initials: C
authors.lastname: Molgaard
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.forename: Johannes
authors.initials: J
authors.lastname: van Goudoever
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D001846:Bone Development; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects*; D019587:Dietary Supplements / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005527:Food, Fortified / Q000009:adverse effects; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D007223:Infant; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012958:Societies, Scientific; D013472:Sunlight / Q000009:adverse effects; D014807:Vitamin D / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D014807:Vitamin D