title: 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.
  
  
  RESULTS
  There were no significant clinical signs of rickets. 25 hydroxyvitamin D (25(OH)D) (mean and SEM, total analyses n=572) after birth (n=28) was 36(7) nmol/L, at 1 month 64(4) nmol/L (n=70, p<0.0001), 91(5) nmol/L at 3 months (n=95, p<0.0001), 65(8) nmol/L at 8 months (n=21, p=0.005) and ranged between 33 and 109 nmol/L until 12 months. Less than 0.2% of analyses revealed pathological levels for calcium or phosphate. Alkaline phosphatase (ALP) levels (n=690) were >1500 U/L (95th percentile) in 3.6%. Participants were on breastmilk or vitamin D-free formula, with solids added from 6 months of age. There were seasonal variations in 25(OH)D levels with a rise during spring and autumn. Thus this analysis is unique as sun exposure and supplementation can be considered as the only vitamin D sources.
  
  
  CONCLUSIONS
  We conclude that universal supplementation with 400 IU of vitamin D3 during the first year of life is safe and provides sufficient 25(OH)D levels in Germany.
authors.affiliation: Princess Margaret Hospital for Children, Department of Endocrinology and Diabetes, Roberts Road, Subiaco, Perth, WA 6020.
authors.forename: Aris
authors.initials: A
authors.lastname: Siafarikas
authors.affiliation: Paediatric Practice, Burglengenfeld.
authors.forename: Alfons
authors.initials: A
authors.lastname: Deichl
authors.affiliation: Institute for Nutritional Physiology, Friedrich Schiller University, Jena.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahreis
authors.affiliation: Paediatric Practice, Ribnitz-Damgarten.
authors.forename: Angela
authors.initials: A
authors.lastname: Pieplow
authors.affiliation: Formerly Children's Hospital, Friedrich Schiller University, Jena.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Vogel
authors.affiliation: Formerly Children's Hospital, Friedrich Schiller University, Jena.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Kauf
authors.affiliation: General Practice, Halle/Saale.
authors.forename: Anna-Elisabeth
authors.initials: AE
authors.lastname: Kapuhs
authors.affiliation: Paediatric Practice, Halle/Saale.
authors.forename: Elke
authors.initials: E
authors.lastname: Badeke
authors.affiliation: Formerly Children's Hospital of Görlitz, Görlitz.
authors.forename: Günter
authors.initials: G
authors.lastname: Berger
authors.affiliation: Formerly Children's Hospital of Wismarr, Wismar.
authors.forename: Hans
authors.initials: H
authors.lastname: Kändler
authors.affiliation: Charité-University Medicine Berlin, Institute for Experimental Paediatric Endocrinology, Berlin.
authors.forename: Volker
authors.initials: V
authors.lastname: Hesse
mesh_terms: D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D014807:Vitamin D
keywords: 400 units of vitamin D3 per day; former East Germany; population-based analysis; universal vitamin D supplementation; vitamin D-free diet