European Journal of Pediatrics

, Volume 174, Issue 5, pp 565–576 | Cite as

Vitamin D in childhood and adolescence: an expert position statement

  • Giuseppe SaggeseEmail author
  • Francesco Vierucci
  • Annemieke M. Boot
  • Justyna Czech-Kowalska
  • Giovanna Weber
  • Carlos A. CamargoJr
  • Eric Mallet
  • Margherita Fanos
  • Nick J. Shaw
  • Michael F. Holick


Vitamin D is a key hormone in the regulation of calcium and phosphorus metabolism and plays a pivotal role in bone health, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur. Great interest has been placed in recent years on vitamin D’s extraskeletal actions. However, while recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious and autoimmune diseases, the actual impact of vitamin D status on the global health of children and adolescents, other than bone, remains a subject of debate. In the meantime, pediatricians still need to evaluate the determinants of vitamin D status and consider vitamin D supplementation in children and adolescents at risk of deficiency. This review is the result of an expert meeting that was held during the congress “Update on vitamin D and bone disease in childhood” convened in Pisa, Italy, in May 2013.

Conclusion: The collaboration of the international group of experts produced this “state of the art” review on vitamin D in childhood and adolescence. After dealing with vitamin D status and its determinants, the review outlines the current debate on vitamin D’s health benefits, concluding with a practical approach to vitamin D supplementation during childhood and adolescence.

What is Known:

Vitamin D deficiency is a worldwide health problem.

Vitamin D deficiency affects not only musculoskeletal health but also a potentially wide range of acute and chronic diseases.

What is New:

We reviewed the literature focusing on randomized controlled trials of vitamin D supplementation during childhood and adolescence.

This review will help pediatricians to appreciate the clinical relevance of an adequate vitamin D status and it will provide a practical approach to vitamin D supplementation.


Vitamin D 25-Hydroxyvitamin D Children Adolescents Supplementation 



1,25-dihydroxyvitamin D


25-hydroxyvitamin D


American Academy of Pediatrics


Atopic dermatitis


Acute respiratory infection


Bone mineral density


Body mass index


European Society of Paediatric Gastroenterology Hepatology and Nutrition


Institute of Medicine


National Health and Nutrition Examination Survey


Parathyroid hormone


Randomized controlled trial


Ultraviolet B


Vitamin D receptor

Conversion factors (International Units–Conventional Units)

25-Hydroxyvitamin D

nmol/L = ng/mL * 2.496


Conflict of interest

The authors declare that they have no competing interests.

Authors’ contributions

GS, FV, AMB, JCK, GW, CAC Jr, MF, NJS, and MFH prepared the manuscript and searched the literature. Particularly, GS, FV, and MF wrote the sections “Prevalence of hypovitaminosis D and definition of vitamin D status” and “Vitamin D supplementation during childhood and adolescence”; GW and MFH wrote the section “Determinants of vitamin D status”; NJS and AMB wrote the section “Skeletal consequences of vitamin D deficiency”; MFH and CAC Jr wrote the section “Extraskeletal consequences of vitamin D deficiency”; JCK wrote the section “Vitamin D status in pregnancy and neonatal age”; NJS wrote the section “Treatment of vitamin D deficiency.” All the authors reviewed the manuscript.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Giuseppe Saggese
    • 1
    Email author
  • Francesco Vierucci
    • 2
  • Annemieke M. Boot
    • 3
  • Justyna Czech-Kowalska
    • 4
  • Giovanna Weber
    • 5
  • Carlos A. CamargoJr
    • 6
  • Eric Mallet
    • 7
  • Margherita Fanos
    • 1
  • Nick J. Shaw
    • 8
  • Michael F. Holick
    • 9
  1. 1.Department of Pediatrics, Pediatric Endocrine UnitUniversity Hospital of PisaPisaItaly
  2. 2.Pediatric UnitSan Luca HospitalLuccaItaly
  3. 3.Division of Endocrinology, Department of Pediatrics, Beatrix Children’s HospitalUniversity of GroningenGroningenNetherlands
  4. 4.Department of Neonatology and Neonatal Intensive CareThe Children’s Memorial Health InstituteWarsawPoland
  5. 5.Department of Pediatrics, San Raffaele Scientific IstituteVita-salute San Raffaele UniversityMilanItaly
  6. 6.Department of Emergency Medicine, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  7. 7.Department of PediatricsUniversity Hospital Charles NicolleRouenFrance
  8. 8.Department of Endocrinology and DiabetesBirmingham Children’s HospitalBirminghamUK
  9. 9.Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, and the Vitamin D, Skin, and Bone Research LaboratoryBoston University Medical CenterBostonUSA

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