The effectiveness of hypovitaminosis d prevention in infants: The role of feeding, dose and duration effect of cholecalciferol medications use

Abstract

Vitamin D deficiency is widespread around the world, but, in spite of its high relevance, the question about cholecalciferol medications optimal dose for infants remains unsolved. Objective of the research – to study effect of feeding type, dose and duration of preventive supplementation of cholecalciferol on vitamin D provision in Russian children during first year of life. The study included 496 healthy children aged from 1 to 12 months, living in different regions of the Russian Federation. Vitamin D level was evaluated by calcidiol level in serum. Deficiency was stated at 25 (OH) D less than 20 ng/ml; insufficiency – 21–29 ng/ml; normal level – 30–100 ng/ml, 100 ng/ml was regarded as excessive level of vitamin D. Study period from november 2013 to march 2014 and november–december 2015. During the period of minimum insolation in adequate supply of vitamin D was observed in more than half (52,8%) of Russian infants. Without medical prophylaxis of vitamin D deficiency serum level of 25 (OH)D in breastfed infants was 12,1 (6,3–21,6) ng/ml, which is significantly lower than in formula-fed infants – 26,7 (20,7–32,2) ng/ml (p<0,001). With cholecalciferol supplementation calcidiol median in breastfed infants is 2,2 higher (p<0,001), and on artificial feeding is almost 1,5 higher (p<0,001) compared with children who do not receive vitamin D medications. 25 (OH) D in infants during first year of life is clearly correlated with dose of cholecalciferol (r=0,27, p<0,001), and dosage of 1000–1500 IU/day significantly improves supplementation level without overdose risk (compared to 500 IU/day dose). The study revealed direct correlation between duration of cholecalciferol medications use and serum calcidiol level (r=0,23, p<0,001). Duration of prophylactic use longer than 8 weeks has significant advantages over the shorter course (p<0,001). The systematic use of foods rich with vitamin D and cholecalciferol medications may increase vitamin D provision, which can be considered in formation of individual programs of vitamin D deficiency prevention during the first year of life