Vitamin D deficiency in children and adolescents: Epidemiology, impact and treatment

  • Susanna Y. Huh
  • Catherine M. GordonEmail author


Vitamin D deficiency is highly prevalent among children and adolescents worldwide. The high rates of vitamin D deficiency during childhood are of major public health relevance, given the growing evidence that vitamin D deficiency may play a key role in the pathophysiology of many chronic diseases beyond rickets, including autoimmune conditions, cardiovascular diseases, and cancer. Identification, treatment, and prevention of vitamin D deficiency in childhood may therefore have profound health effects throughout the life span. In this review, we discuss the definitions, epidemiology, clinical implications, and treatment of vitamin D deficiency in children and adolescents.


Vitamin D Rickets Epidemiology Infants Children Adolescents 



This work was supported in part by The Allen Foundation Inc., the McCarthy Family Foundation, Grant RO1 HD43869 from the National Institutes of Health, and Project 5-T71-MC-00009-14 from the Maternal and Child Health Bureau.


  1. 1.
    Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest. 2006;116:2062–72.PubMedGoogle Scholar
  2. 2.
    DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004;80:1689S–96S.PubMedGoogle Scholar
  3. 3.
    Calvo MS, Whiting SJ, Barton CN. Vitamin D fortification in the United States and Canada: current status and data needs. Am J Clin Nutr. 2004;80:1710S–6S.PubMedGoogle Scholar
  4. 4.
    Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr. 2005;135:317–22.PubMedGoogle Scholar
  5. 5.
    Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006;81:353–73.PubMedGoogle Scholar
  6. 6.
    Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy; 1997.Google Scholar
  7. 7.
    Gartner LM, Greer FR. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics. 2003;111:908–10.PubMedGoogle Scholar
  8. 8.
    Specker BL, Ho ML, Oestreich A, Yin TA, Shui QM, Chen XC, Tsang RC. Prospective study of vitamin D supplementation and rickets in China. J Pediatr. 1992;120:733–9.PubMedGoogle Scholar
  9. 9.
    Holick MF, Dawson-Hughes B. Nutrition and bone health. Totowa, NJ: Humana; 2004. p. xviii, 702 p.Google Scholar
  10. 10.
    Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005;16:713–6.PubMedGoogle Scholar
  11. 11.
    Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMedGoogle Scholar
  12. 12.
    Cheng S, Tylavsky F, Kroger H, Karkkainen M, Lyytikainen A, Koistinen A, Mahonen A, Alen M, Halleen J, Vaananen K, Lamberg-Allardt C. Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr. 2003;78:485–92.PubMedGoogle Scholar
  13. 13.
    Abrams SA, Griffin IJ, Hawthorne KM, Gunn SK, Gundberg CM, Carpenter TO. Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents. J Clin Endocrinol Metab. 2005;90:5576–81.PubMedGoogle Scholar
  14. 14.
    Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann A. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr. 2007;85:649–50.PubMedGoogle Scholar
  15. 15.
    Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 2004;158:531–7.PubMedGoogle Scholar
  16. 16.
    Gordon CM, Feldman H, Sinclair L, Williams A, Cox J. Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med. 2008 (in press).Google Scholar
  17. 17.
    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.PubMedGoogle Scholar
  18. 18.
    Hickey L, Gordon CM. Vitamin D deficiency: new perspectives on an old disease. Curr Opin Endocrinol Diabetes. 2004;11:18–25.Google Scholar
  19. 19.
    Weisberg P, Scanlon KS, Li R, Cogswell ME. Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. Am J Clin Nutr. 2004;80:1697S–705S.PubMedGoogle Scholar
  20. 20.
    Gessner BD, Plotnik J, Muth PT. 25-Hydroxyvitamin D levels among healthy children in Alaska. J Pediatr. 2003;143:434–7.PubMedGoogle Scholar
  21. 21.
    Ziegler EE, Hollis BW, Nelson SE, Jeter JM. Vitamin D deficiency in breastfed infants in Iowa. Pediatrics. 2006;118:603–10.PubMedGoogle Scholar
  22. 22.
    Lee JM, Smith JR, Philipp BL, Chen TC, Mathieu J, Holick MF. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila). 2007;46:42–4.Google Scholar
  23. 23.
    Sullivan SS, Rosen CJ, Halteman WA, Chen TC, Holick MF. Adolescent girls in Maine are at risk for vitamin D insufficiency. J Am Diet Assoc. 2005;105:971–4.PubMedGoogle Scholar
  24. 24.
    Rajakumar K, Fernstrom JD, Janosky JE, Greenspan SL. Vitamin D insufficiency in preadolescent African-American children. Clin Pediatr (Phila). 2005;44:683–92.Google Scholar
  25. 25.
    Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 2002;30:771–7.PubMedGoogle Scholar
  26. 26.
    Lawson M, Thomas M. Vitamin D concentrations in Asian children aged 2 years living in England: population survey. BMJ. 1999;318:28.PubMedGoogle Scholar
  27. 27.
    Guillemant J, Le HT, Maria A, Allemandou A, Peres G, Guillemant S. Wintertime vitamin D deficiency in male adolescents: effect on parathyroid function and response to vitamin D3 supplements. Osteoporos Int. 2001;12:875–9.PubMedGoogle Scholar
  28. 28.
    Nicolaidou P, Hatzistamatiou Z, Papadopoulou A, Kaleyias J, Floropoulou E, Lagona E, Tsagris V, Costalos C, Antsaklis A. Low vitamin D status in mother-newborn pairs in Greece. Calcif Tissue Int. 2006;78:337–42.PubMedGoogle Scholar
  29. 29.
    El-Hajj Fuleihan G, Nabulsi M, Choucair M, Salamoun M, Hajj Shahine C, Kizirian A, Tannous R. Hypovitaminosis D in healthy schoolchildren. Pediatrics. 2001;107:E53.PubMedGoogle Scholar
  30. 30.
    Pehlivan I, Hatun S, Aydogan M, Babaoglu K, Gokalp AS. Maternal vitamin D deficiency and vitamin D supplementation in healthy infants. Turk J Pediatr. 2003;45:315–20.PubMedGoogle Scholar
  31. 31.
    Du X, Greenfield H, Fraser DR, Ge K, Trube A, Wang Y. Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am J Clin Nutr. 2001;74:494–500.PubMedGoogle Scholar
  32. 32.
    Lehtonen-Veromaa M, Mottonen T, Irjala K, Karkkainen M, Lamberg-Allardt C, Hakola P, Viikari J. Vitamin D intake is low and hypovitaminosis D common in healthy 9- to 15-year-old Finnish girls. Eur J Clin Nutr. 1999;53:746–51.PubMedGoogle Scholar
  33. 33.
    Outila TA, Karkkainen MU, Lamberg-Allardt CJ. Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr. 2001;74:206–10.PubMedGoogle Scholar
  34. 34.
    Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. CMAJ. 2007;177:161–6.PubMedGoogle Scholar
  35. 35.
    Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007;137:447–52.PubMedGoogle Scholar
  36. 36.
    Tylavsky FA, Ryder KA, Lyytikainen A, Cheng S. Vitamin D, parathyroid hormone, and bone mass in adolescents. J Nutr. 2005;135:2735S–8S.PubMedGoogle Scholar
  37. 37.
    Pappa HM, Grand RJ, Gordon CM. Report on the vitamin D status of adult and pediatric patients with inflammatory bowel disease and its significance for bone health and disease. Inflamm Bowel Dis. 2006;12:1162–74.PubMedGoogle Scholar
  38. 38.
    Lo CW, Paris PW, Clemens TL, Nolan J, Holick MF. Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. Am J Clin Nutr. 1985;42:644–9.PubMedGoogle Scholar
  39. 39.
    Pappa HM, Gordon CM, Saslowsky TM, Zholudev A, Horr B, Shih MC, Grand RJ. Vitamin D status in children and young adults with inflammatory bowel disease. Pediatrics. 2006;118:1950–61.PubMedGoogle Scholar
  40. 40.
    Rovner AJ, Stallings VA, Schall JI, Leonard MB, Zemel BS. Vitamin D insufficiency in children, adolescents, and young adults with cystic fibrosis despite routine oral supplementation. Am J Clin Nutr. 2007;86:1694–9.PubMedGoogle Scholar
  41. 41.
    Donovan DS Jr, Papadopoulos A, Staron RB, Addesso V, Schulman L, McGregor C, Cosman F, Lindsay RL, Shane E. Bone mass and vitamin D deficiency in adults with advanced cystic fibrosis lung disease. Am J Respir Crit Care Med. 1998;157:1892–9.PubMedGoogle Scholar
  42. 42.
    Grey V, Lands L, Pall H, Drury D. Monitoring of 25-OH vitamin D levels in children with cystic fibrosis. J Pediatr Gastroenterol Nutr. 2000;30:314–9.PubMedGoogle Scholar
  43. 43.
    Shane E, Silverberg SJ, Donovan D, Papadopoulos A, Staron RB, Addesso V, Jorgesen B, McGregor C, Schulman L. Osteoporosis in lung transplantation candidates with end-stage pulmonary disease. Am J Med. 1996;101:262–9.PubMedGoogle Scholar
  44. 44.
    Crawford BA, Labio ED, Strasser SI, McCaughan GW. Vitamin D replacement for cirrhosis-related bone disease. Nat Clin Pract Gastroenterol Hepatol. 2006;3:689–99.PubMedGoogle Scholar
  45. 45.
    Holick MF. Vitamin D for health and in chronic kidney disease. Semin Dial. 2005;18:266–75.PubMedGoogle Scholar
  46. 46.
    McGrath J. Does ‘imprinting’ with low prenatal vitamin D contribute to the risk of various adult disorders. Med Hypotheses. 2001;56:367–71.PubMedGoogle Scholar
  47. 47.
    Chesney RW. Rickets: the third wave. Clin Pediatr (Phila). 2002;41:137–9.Google Scholar
  48. 48.
    Binet A, Kooh SW. Persistence of Vitamin D-deficiency rickets in Toronto in the 1990s. Can J Public Health. 1996;87:227–30.PubMedGoogle Scholar
  49. 49.
    DeLucia MC, Mitnick ME, Carpenter TO. Nutritional rickets with normal circulating 25-hydroxyvitamin D: a call for reexamining the role of dietary calcium intake in North American infants. J Clin Endocrinol Metab. 2003;88:3539–45.PubMedGoogle Scholar
  50. 50.
    Kreiter SR, Schwartz RP, Kirkman HN Jr, Charlton PA, Calikoglu AS, Davenport ML. Nutritional rickets in African American breast-fed infants. J Pediatr. 2000;137:153–7.PubMedGoogle Scholar
  51. 51.
    Cosgrove L, Dietrich A. Nutritional rickets in breast-fed infants. J Fam Pract. 1985;21:205–9.PubMedGoogle Scholar
  52. 52.
    Prentice A, Schoenmakers I, Laskey MA, de Bono S, Ginty F, Goldberg GR. Nutrition and bone growth and development. Proc Nutr Soc. 2006;65:348–60.PubMedCrossRefGoogle Scholar
  53. 53.
    Zamora SA, Rizzoli R, Belli DC, Slosman DO, Bonjour JP. Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. J Clin Endocrinol Metab. 1999;84:4541–4.PubMedGoogle Scholar
  54. 54.
    Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, Arden NK, Godfrey KM, Cooper C. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 2006;367:36–43.PubMedGoogle Scholar
  55. 55.
    Lehtonen-Veromaa MK, Mottonen TT, Nuotio IO, Irjala KM, Leino AE, Viikari JS. Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr. 2002;76:1446–53.PubMedGoogle Scholar
  56. 56.
    Camargo CA Jr, Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR, Kleinman K, Gillman MW. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr. 2007;85:788–95.PubMedGoogle Scholar
  57. 57.
    Devereux G, Litonjua AA, Turner SW, Craig LC, McNeill G, Martindale S, Helms PJ, Seaton A, Weiss ST. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr. 2007;85:853–9.PubMedGoogle Scholar
  58. 58.
    Fronczak CM, Baron AE, Chase HP, Ross C, Brady HL, Hoffman M, Eisenbarth GS, Rewers M, Norris JM. In utero dietary exposures and risk of islet autoimmunity in children. Diabetes Care. 2003;26:3237–42.PubMedGoogle Scholar
  59. 59.
    Brekke HK, Ludvigsson J. Vitamin D supplementation and diabetes-related autoimmunity in the ABIS study. Pediatr Diabetes. 2007;8:11–4.PubMedGoogle Scholar
  60. 60.
    Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001;358:1500–3.PubMedGoogle Scholar
  61. 61.
    Willer CJ, Dyment DA, Sadovnick AD, Rothwell PM, Murray TJ, Ebers GC. Timing of birth and risk of multiple sclerosis: population based study. BMJ. 2005;330:120.PubMedGoogle Scholar
  62. 62.
    Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296:2832–8.PubMedGoogle Scholar
  63. 63.
    Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab. 2003;88:157–61.PubMedGoogle Scholar
  64. 64.
    Need AG, Morris HA, Horowitz M, Nordin C. Effects of skin thickness, age, body fat, and sunlight on serum 25-hydroxyvitamin D. Am J Clin Nutr. 1993;58:882–5.PubMedGoogle Scholar
  65. 65.
    Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.PubMedGoogle Scholar
  66. 66.
    Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among US adults. Diabetes Care. 2005;28:1228–30.PubMedGoogle Scholar
  67. 67.
    Hitman GA, Mannan N, McDermott MF, Aganna E, Ogunkolade BW, Hales CN, Boucher BJ. Vitamin D receptor gene polymorphisms influence insulin secretion in Bangladeshi Asians. Diabetes. 1998;47:688–90.PubMedGoogle Scholar
  68. 68.
    Barger-Lux MJ, Heaney RP, Hayes J, DeLuca HF, Johnson ML, Gong G. Vitamin D receptor gene polymorphism, bone mass, body size, and vitamin D receptor density. Calcif Tissue Int. 1995;57:161–2.PubMedGoogle Scholar
  69. 69.
    Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutr Rev. 2006;64:479–86.PubMedGoogle Scholar
  70. 70.
    Haagensen AL, Feldman HA, Ringelheim J, Gordon CM. Low prevalence of vitamin D deficiency among adolescents with anorexia nervosa. Osteoporos Int. 2007 (in press).Google Scholar
  71. 71.
    Isaia G, Giorgino R, Adami S. High prevalence of hypovitaminosis D in female type 2 diabetic population. Diabetes Care. 2001;24:1496.PubMedGoogle Scholar
  72. 72.
    Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care. 2004;27:2813–8.PubMedGoogle Scholar
  73. 73.
    Lind L, Hanni A, Lithell H, Hvarfner A, Sorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8:894–901.PubMedGoogle Scholar
  74. 74.
    Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79:820–5.PubMedGoogle Scholar
  75. 75.
    Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92:2017–29.PubMedGoogle Scholar
  76. 76.
    Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, Hu FB. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;29:650–6.PubMedGoogle Scholar
  77. 77.
    Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care. 2007;30:980–6.PubMedGoogle Scholar
  78. 78.
    Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC, Curhan GC. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49:1063–9.PubMedGoogle Scholar
  79. 79.
    Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens. 2007;20:713–9.PubMedGoogle Scholar
  80. 80.
    Aksoy H, Akcay F, Kurtul N, Baykal O, Avci B. Serum 1,25 dihydroxy vitamin D (1,25(OH)2D3), 25 hydroxy vitamin D (25(OH)D) and parathormone levels in diabetic retinopathy. Clin Biochem. 2000;33:47–51.PubMedGoogle Scholar
  81. 81.
    Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998;352:709–10.PubMedGoogle Scholar
  82. 82.
    Reis JP, von Muhlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care. 2007;30:1549–55.PubMedGoogle Scholar
  83. 83.
    Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM, van Dam RM. Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med. 2007;261:558–65.PubMedGoogle Scholar
  84. 84.
    Gale CR, Robinson SM, Harvey NC, Javaid MK, Jiang B, Martyn CN, Godfrey KM, Cooper C. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr. 2007 (in press).Google Scholar
  85. 85.
    Reinehr T, de Sousa G, Alexy U, Kersting M, Andler W. Vitamin D status and parathyroid hormone in obese children before and after weight loss. Eur J Endocrinol. 2007;157:225–32.PubMedGoogle Scholar
  86. 86.
    Smotkin-Tangorra M, Purushothaman R, Gupta A, Nejati G, Anhalt H, Ten S. Prevalence of vitamin D insufficiency in obese children and adolescents. J Pediatr Endocrinol Metab. 2007;20:817–23.PubMedGoogle Scholar
  87. 87.
    Barba G, Troiano E, Russo P, Venezia A, Siani A. Inverse association between body mass and frequency of milk consumption in children. Br J Nutr. 2005;93:15–9.PubMedGoogle Scholar
  88. 88.
    Berkey CS, Rockett HR, Willett WC, Colditz GA. Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents. Arch Pediatr Adolesc Med. 2005;159:543–50.PubMedGoogle Scholar
  89. 89.
    Phillips SM, Bandini LG, Cyr H, Colclough-Douglas S, Naumova E, Must A. Dairy food consumption and body weight and fatness studied longitudinally over the adolescent period. Int J Obes Relat Metab Disord. 2003;27:1106–13.PubMedGoogle Scholar
  90. 90.
    Berwick M, Armstrong BK, Ben-Porat L, Fine J, Kricker A, Eberle C, Barnhill R. Sun exposure and mortality from melanoma. J Natl Cancer Inst. 2005;97:195–9.PubMedGoogle Scholar
  91. 91.
    Chang ET, Smedby KE, Hjalgrim H, Porwit-MacDonald A, Roos G, Glimelius B, Adami HO. Family history of hematopoietic malignancy and risk of lymphoma. J Natl Cancer Inst. 2005;97:1466–74.PubMedCrossRefGoogle Scholar
  92. 92.
    Sabour H, Hossein-Nezhad A, Maghbooli Z, Madani F, Mir E, Larijani B. Relationship between pregnancy outcomes and maternal vitamin D and calcium intake: a cross-sectional study. Gynecol Endocrinol. 2006;22:585–9.PubMedGoogle Scholar
  93. 93.
    Maxwell JD, Ang L, Brooke OG, Brown IR. Vitamin D supplements enhance weight gain and nutritional status in pregnant Asians. Br J Obstet Gynaecol. 1981;88:987–91.PubMedGoogle Scholar
  94. 94.
    McGrath JJ, Keeping D, Saha S, Chant DC, Lieberman DE, O’Callaghan MJ. Seasonal fluctuations in birth weight and neonatal limb length; does prenatal vitamin D influence neonatal size and shape? Early Hum Dev. 2005;81:609–18.PubMedGoogle Scholar
  95. 95.
    Brooke OG, Brown IR, Bone CD, Carter ND, Cleeve HJ, Maxwell JD, Robinson VP, Winder SM. Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth. Br Med J. 1980;280:751–4.PubMedGoogle Scholar
  96. 96.
    Brooke OG, Butters F, Wood C. Intrauterine vitamin D nutrition and postnatal growth in Asian infants. Br Med J (Clin Res Ed). 1981;283:1024.CrossRefGoogle Scholar
  97. 97.
    Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size. J Clin Endocrinol Metab. 2006;91:906–12.PubMedGoogle Scholar
  98. 98.
    Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92:3517–22.PubMedGoogle Scholar
  99. 99.
    Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B. Correlation between vitamin D(3) deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev. 2007;24:27–32.Google Scholar
  100. 100.
    Hypponen E, Hartikainen AL, Sovio U, Jarvelin MR, Pouta A. Does vitamin D supplementation in infancy reduce the risk of pre-eclampsia? Eur J Clin Nutr. 2007;61:1136–9.PubMedGoogle Scholar
  101. 101.
    Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study. Arthritis Rheum. 2004;50:72–7.PubMedGoogle Scholar
  102. 102.
    Greer FR. Issues in establishing vitamin D recommendations for infants and children. Am J Clin Nutr. 2004;80:1759S–62S.PubMedGoogle Scholar
  103. 103.
    Holick MF, Shao Q, Liu WW, Chen TC. The vitamin D content of fortified milk and infant formula. N Engl J Med. 1992;326:1178–81.PubMedCrossRefGoogle Scholar
  104. 104.
    Hollis BW, Wagner CL. Assessment of dietary vitamin D requirements during pregnancy and lactation. Am J Clin Nutr. 2004;79:717–26.PubMedGoogle Scholar
  105. 105.
    Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004;80:1752S–8S.PubMedGoogle Scholar
  106. 106.
    Moore CE, Murphy MM, Holick MF. Vitamin D intakes by children and adults in the United States differ among ethnic groups. J Nutr. 2005;135:2478–85.PubMedGoogle Scholar
  107. 107.
    Moore C, Murphy MM, Keast DR, Holick MF. Vitamin D intake in the United States. J Am Diet Assoc. 2004;104:980–3.PubMedGoogle Scholar
  108. 108.
    Davenport ML, Uckun A, Calikoglu AS. Pediatrician patterns of prescribing vitamin supplementation for infants: do they contribute to rickets? Pediatrics. 2004;113:179–80.PubMedGoogle Scholar
  109. 109.
    Markestad T, Halvorsen S, Halvorsen KS, Aksnes L, Aarskog D. Plasma concentrations of vitamin D metabolites before and during treatment of vitamin D deficiency rickets in children. Acta Paediatr Scand. 1984;73:225–31.PubMedGoogle Scholar
  110. 110.
    Mawer EB, Stanbury W, Robinson MJ, James J, Close C. Vitamin D nutrition and vitamin D metabolism in the premature human neonate. Clin Endocrinol (Oxf). 1986;25:641–9.Google Scholar
  111. 111.
    Key LL Jr. Nutritional Rickets. Trends Endocrinol Metab. 1991;2:81.Google Scholar
  112. 112.
    Cesur Y, Caksen H, Gundem A, Kirimi E, Odabas D. Comparison of low and high dose of vitamin D treatment in nutritional vitamin D deficiency rickets. J Pediatr Endocrinol Metab. 2003;16:1105–9.PubMedGoogle Scholar
  113. 113.
    Kruse K. Pathophysiology of calcium metabolism in children with vitamin D-deficiency rickets. J Pediatr. 1995;126:736–41.PubMedGoogle Scholar
  114. 114.
    Venkataraman PS, Tsang RC, Buckley DD, Ho M, Steichen JJ. Elevation of serum 1,25-dihydroxyvitamin D in response to physiologic doses of vitamin D in vitamin D-deficient infants. J Pediatr. 1983;103:416–9.PubMedGoogle Scholar
  115. 115.
    Shah BR, Finberg L. Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method. J Pediatr. 1994;125:487–90.PubMedGoogle Scholar
  116. 116.
    Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89:5387–91.PubMedGoogle Scholar
  117. 117.
    Trang HM, Cole DE, Rubin LA, Pierratos A, Siu S, Vieth R. Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. Am J Clin Nutr. 1998;68:854–8.PubMedGoogle Scholar
  118. 118.
    Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, Reitz R, Ameri A, Tannenbaum AD. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentration of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2007 (in press).Google Scholar
  119. 119.
    Stephenson A, Brotherwood M, Robert R, Atenafu E, Corey M, Tullis E. Cholecalciferol significantly increases 25-hydroxyvitamin D concentrations in adults with cystic fibrosis. Am J Clin Nutr. 2007;85:1307–11.PubMedGoogle Scholar
  120. 120.
    Jacobus CH, Holick MF, Shao Q, Chen TC, Holm IA, Kolodny JM, Fuleihan GE, Seely EW. Hypervitaminosis D associated with drinking milk. N Engl J Med. 1992;326:1173–7.PubMedCrossRefGoogle Scholar
  121. 121.
    Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med. 2001;345:66–7.PubMedGoogle Scholar
  122. 122.
    Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69:842–56.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Division of Gastroenterology and NutritionChildren’s Hospital BostonBostonUSA
  2. 2.Divisions of Adolescent Medicine and EndocrinologyChildren’s Hospital BostonBostonUSA

Personalised recommendations