Vitamin D in childhood and adolescence: an expert position statement
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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.
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.
KeywordsVitamin D 25-Hydroxyvitamin D Children Adolescents Supplementation
American Academy of Pediatrics
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
Randomized controlled trial
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.
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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