Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of vitamin D supplementation on child and adolescent overweight/obesity: a systematic review and meta-analysis of randomized controlled trials

  • Research
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

The global prevalence of overweight and obesity in children and adolescents has been increasing. Child and adolescent overweight/obesity has been demonstrated to be partially associated with vitamin D deficiency. This systematic review and meta-analysis aims to assess the efficacy of vitamin D supplementation on child and adolescent overweight/obesity. PubMed, Embase, Cochrane Library, and Web of science were searched from inception to June 20th, 2022. Randomized controlled trials (RCTs) assessing the efficacy of vitamin D on child and adolescent overweight/obesity were included. The Cochrane bias risk assessment tool was used to assess the bias risk of included studies, and subgroup analysis was conducted based on different administration dosages. All data-analyses were performed using R 4.2.1. There were 1502 articles retrieved, and 10 eligible studies were finally included, with a total of 595 participants. Meta-analysis showed no differences in LDL, TC, TG, BMI, ALP, Ca, and PTH between vitamin-D (Vit-D) group and placebo, while Vit-D group resulted in improved HOMA-IR[WMD =  − 0.348, 95%CI (− 0.477, − 0.219), p = 0.26]. Subgroup-analysis showed no significant difference in the increase of 25-(OH)-D between subgroups (p = 0.39), whereas the serum 25-(OH)-D level was increased under different Vit-D doses [WMD = 6.973, 95%CI (3.072, 10.873)]. High daily dose (≥ 4000 IU/d) of Vit-D might decrease CRP and increase HDL levels.

   Conclusion: High dose of Vit-D supplementation (over 4000 IU/d) would reduce several cardiometabolic risk indicators and improve insulin resistance. More high-quality and large-scale RCTs are needed to provide more robust evidence.

What is Known:

• Vit-D deficiency is common in overweight/obesity (OW/OB) children and adolescents.

• Previous randomized studies on the benefit of Vit-D supplementation to OW/OB children and adolescents are inconsistent.

What is New:

• This is the first meta-analysis conducted to assess the efficacy of Vit-D supplementation on child and adolescent OW/OB.

• High dose of Vit-D supplementation is beneficial to cardiovascular metabolism, and improve insulin resistance on child and adolescent OW/OB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

MD:

Mean difference

OB:

Obesity

OW:

Overweight

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

RCTs:

Randomized controlled trials

Vit-D:

Vitamin-D

WC:

Waist circumference

WHR:

Waist-hip ratio

25(OH)D:

25 Hydroxyvitamin D

BMI:

Body mass index

HOMA-IR:

Homeostasis model assessment-insulin resistance

CRP:

C-reactive protein

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

TG:

Triglyceride

TC:

Total cholesterol

PTH:

Parathyroid hormone

ALP:

Alkaline phosphatase

Ca:

Calcium

References

  1. Jebeile H, Kelly AS, O’Malley G, Baur LA (2022) Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol 10:351–365

    CAS  Google Scholar 

  2. NCD Risk Factor Collaboration (NCD-RisC) (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 390:2627–2642

    Google Scholar 

  3. Lobstein TBH (2019) Atlas of childhood obesity. World Obesity Federation, London

    Google Scholar 

  4. Horesh A, Tsur AM, Bardugo A, Twig G (2021) Adolescent and childhood obesity and excess morbidity and mortality in young adulthood-a systematic review. Curr Obes Rep 10:301–310

    Google Scholar 

  5. Jebeile H, Cardel MI, Kyle TK, Jastreboff AM (2021) Addressing psychosocial health in the treatment and care of adolescents with obesity. Obesity (Silver Spring) 29:1413–1422

    Google Scholar 

  6. Smith JD, Fu E, Kobayashi MA (2020) Prevention and management of childhood obesity and its psychological and health comorbidities. Annu Rev Clin Psychol 16:351–378

    Google Scholar 

  7. Radhakishun N, van Vliet M, von Rosenstiel I, Weijer O, Diamant M, Beijnen J, Brandjes D (2015) High prevalence of vitamin D insufficiency/deficiency in Dutch multi-ethnic obese children. Eur J Pediatr 174:183–190

    CAS  Google Scholar 

  8. Pacifico L, Anania C, Osborn JF, Ferraro F, Bonci E, Olivero E, Chiesa C (2011) Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol 165:603–611

    CAS  Google Scholar 

  9. Voortman T, van den Hooven EH, Heijboer AC, Hofman A, Jaddoe VW, Franco OH (2015) Vitamin D deficiency in school-age children is associated with sociodemographic and lifestyle factors. J Nutr 145:791–798

    CAS  Google Scholar 

  10. Durá-Travé T, Gallinas-Victoriano F, Chueca-Guindulain MJ, Berrade-Zubiri S (2017) Prevalence of hypovitaminosis D and associated factors in obese Spanish children. Nutr Diab 7:e248

    Google Scholar 

  11. Pourshahidi LK (2015) Vitamin D and obesity: current perspectives and future directions. Proc Nutr Soc 74:115–124

    CAS  Google Scholar 

  12. Drincic AT, Armas LA, Van Diest EE, Heaney RP (2012) Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring) 20:1444–1448

    CAS  Google Scholar 

  13. Blum M, Dolnikowski G, Seyoum E, Harris SS, Booth SL, Peterson J, Saltzman E, Dawson-Hughes B (2008) Vitamin D(3) in fat tissue. Endocrine 33:90–94

    CAS  Google Scholar 

  14. Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A (2017) Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord 18:215–225

    CAS  Google Scholar 

  15. Cuda SE, Censani M (2018) Pediatric obesity algorithm: a practical approach to obesity diagnosis and management. Front Pediatr 6:431

    Google Scholar 

  16. Wimalawansa SJ (2018) Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J Steroid Biochem Mol Biol 175:177–189

    CAS  Google Scholar 

  17. Fu J, Han L, Zhao Y, Li G, Zhu Y, Li Y, Li M, Gao S, Willi SM (2019) Vitamin D levels are associated with metabolic syndrome in adolescents and young adults: The BCAMS study. Clin Nutr 38:2161–2167

    CAS  Google Scholar 

  18. Denova-Gutiérrez E, Muñoz-Aguirre P, López D, Flores M, Medeiros M, Tamborrel N, Clark P (2019) Low serum vitamin d concentrations are associated with insulin resistance in Mexican children and adolescents. Nutrients 11

  19. Corica D, Zusi C, Olivieri F, Marigliano M, Piona C, Fornari E, Morandi A, Corradi M, Miraglia Del Giudice E, Gatti D, Rossini M, Bonadonna RC, Maffeis C (2019) Vitamin D affects insulin sensitivity and β-cell function in obese non-diabetic youths. Eur J Endocrinol 181:439–450

    CAS  Google Scholar 

  20. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928

    Google Scholar 

  21. Vinet A, Morrissey C, Perez-Martin A, Goncalves A, Raverdy C, Masson D, Gayrard S, Carrere M, Landrier JF, Amiot MJ (2021) Effect of vitamin D supplementation on microvascular reactivity in obese adolescents: A randomized controlled trial. Nutr Metab Cardiovasc Dis 31:2474–2483

    CAS  Google Scholar 

  22. Namakin K, Hosseini M, Zardast M, Mohammadifard M (2021) Vitamin D Effect on ultrasonography and laboratory indices and biochemical indicators in the blood: an interventional study on 12 to 18-year-old children with fatty liver. Pediatr Gastroenterol Hepatol Nutr 24:187–196

    Google Scholar 

  23. Samaranayake D, Adikaram SGS, Atapattu N, Kendaragama K, Senevirathne JTN, Jayasekera HD, Wickramasinghe VP (2020) Vitamin D supplementation in obese Sri Lankan children: a randomized controlled trial. BMC Pediatr 20:426

    CAS  Google Scholar 

  24. Brzeziński M, Jankowska A, Słomińska-Frączek M, Metelska P, Wiśniewski P, Socha P, Szlagatys-Sidorkiewicz A (2020) Long-term effects of vitamin D supplementation in obese children during integrated weight-loss programme-a double blind randomized placebo-controlled trial. Nutrients 12

  25. Sethuraman U, Zidan MA, Hanks L, Bagheri M, Ashraf A (2018) Impact of vitamin D treatment on 25 hydroxy vitamin D levels and insulin homeostasis in obese African American adolescents in a randomized trial. J Clin Transl Endocrinol 12:13–19

    Google Scholar 

  26. Brar PC, Contreras M, Fan X, Visavachaipan N (2018) Effect of one time high dose “stoss therapy” of vitamin D on glucose homeostasis in high risk obese adolescents. Arch Endocrinol Metab 62:193–200

    Google Scholar 

  27. Shah S, Wilson DM, Bachrach LK (2015) Large doses of vitamin D fail to increase 25-hydroxyvitamin D levels or to alter cardiovascular risk factors in obese adolescents: a pilot study. J Adolesc Health 57:19–23

    Google Scholar 

  28. Nader NS, Aguirre Castaneda R, Wallace J, Singh R, Weaver A, Kumar S (2014) Effect of vitamin D3 supplementation on serum 25(OH)D, lipids and markers of insulin resistance in obese adolescents: a prospective, randomized, placebo-controlled pilot trial. Horm Res Paediatr 82:107–112

    CAS  Google Scholar 

  29. Belenchia AM, Tosh AK, Hillman LS, Peterson CA (2013) Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. Am J Clin Nutr 97:774–781

    CAS  Google Scholar 

  30. Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M (2014) Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr (Rio J) 90:28–34

    Google Scholar 

  31. Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M (2021) Vitamin D and obesity: current evidence and controversies. Curr Obes Rep 10:162–180

    Google Scholar 

  32. Asghari G, Yuzbashian E, Wagner CL, Park Y, Mirmiran P, Hosseinpanah F (2021) Daily vitamin D(3) in overweight and obese children and adolescents: a randomized controlled trial. Eur J Nutr 60:2831–2840

    CAS  Google Scholar 

  33. Reis JP, von Mühlen D, Miller ER 3rd, Michos ED, Appel LJ (2009) Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics 124:e371-379

    Google Scholar 

  34. Delvin EE, Lambert M, Levy E, O’Loughlin J, Mark S, Gray-Donald K, Paradis G (2010) Vitamin D status is modestly associated with glycemia and indicators of lipid metabolism in French-Canadian children and adolescents. J Nutr 140:987–991

    CAS  Google Scholar 

  35. Jafari T, Fallah AA, Barani A (2016) Effects of vitamin D on serum lipid profile in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Clin Nutr 35:1259–1268

    CAS  Google Scholar 

  36. Cai B, Luo X, Zhang P, Luan Y, Cai X, He X (2021) Effect of vitamin D supplementation on markers of cardiometabolic risk in children and adolescents: a meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 31:2800–2814

    CAS  Google Scholar 

  37. Pereira-Santos M, Costa PR, Assis AM, Santos CA, Santos DB (2015) Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev 16:341–349

    CAS  Google Scholar 

  38. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930

    CAS  Google Scholar 

  39. Zakharova I, Klimov L, Kuryaninova V, Nikitina I, Malyavskaya S, Dolbnya S, Kasyanova A, Atanesyan R, Stoyan M, Todieva A, Kostrova G, Lebedev A (2019) Vitamin D insufficiency in overweight and obese children and adolescents. Front Endocrinol (Lausanne) 10:103

    Google Scholar 

  40. Lee S, Clark SA, Gill RK, Christakos S (1994) 1,25-Dihydroxyvitamin D3 and pancreatic beta-cell function: vitamin D receptors, gene expression, and insulin secretion. Endocrinology 134:1602–1610

    CAS  Google Scholar 

  41. Sooy K, Schermerhorn T, Noda M, Surana M, Rhoten WB, Meyer M, Fleischer N, Sharp GW, Christakos S (1999) Calbindin-D(28k) controls [Ca(2+)](i) and insulin release. Evidence obtained from calbindin-d(28k) knockout mice and beta cell lines. J Biol Chem 274:34343–34349

    CAS  Google Scholar 

  42. Pathak K, Soares MJ, Calton EK, Zhao Y, Hallett J (2014) Vitamin D supplementation and body weight status: a systematic review and meta-analysis of randomized controlled trials. Obes Rev 15:528–537

    CAS  Google Scholar 

  43. Perna S (2019) Is vitamin D supplementation useful for weight loss programs? A systematic review and meta-analysis of randomized controlled trials. Medicina (Kaunas) 55

  44. Emadzadeh M, Rashidmayvan M, Sahebi R, Sadeghi R, Ferns GA, Ghayour-Mobarhan M (2020) The effect of vitamin D fortified products on anthropometric indices: a systematic review and meta-analysis. Complement Ther Clin Pract 41:101242

    Google Scholar 

Download references

Acknowledgements

We would like to thank the researchers and study participants for their contributions.

Author information

Author notes

  1. Hao Gou and Ya Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

    Hao Gou, Ya Wang, Weijia He & Xiangjuan Sun

  2. Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China

    Yan Liu & Cai Peng

Authors
  1. Hao Gou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ya Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cai Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Weijia He
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xiangjuan Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Hao Gou, Ya Wang, and Xiangjuan Sun. The first draft of the manuscript was written by Hao Gou and Ya Wang, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Xiangjuan Sun.

Ethics declarations

Ethics approval

N/A.

Consent to participate

N/A.

Consent for publication

N/A.

Conflict of interest

The authors declare no competing interests.

Additional information

Communicated by Daniele De Luca

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 237 KB)

Supplementary file2 (PDF 446 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gou, H., Wang, Y., Liu, Y. et al. Efficacy of vitamin D supplementation on child and adolescent overweight/obesity: a systematic review and meta-analysis of randomized controlled trials. Eur J Pediatr 182, 255–264 (2023). https://doi.org/10.1007/s00431-022-04673-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-022-04673-8

Keywords

Search

Navigation