Skip to main content

Advertisement

SpringerLink
Log in

Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets

  • Recommendations
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

An Erratum to this article was published on 30 March 2022

This article has been updated

Abstract

Justification

The emerging literature on prevalence of vitamin D deficiency in India, prevention and treatment strategies of rickets, and extra-skeletal benefits of vitamin D suggest the need for revising the existing guidelines for prevention and treatment of vitamin D deficiency in India.

Objectives

To review the emerging literature on vitamin D prevalence and need for universal vitamin D supplementation. To suggest optimum vitamin D therapy for treatment of asymptomatic and symptomatic vitamin D deficiency, and rickets. To evaluate the extra-skeletal health benefits of vitamin D in children.

Process

A National consultative committee was formed that comprised of clinicians, epidemiologists, endocrinologists, and nutritionists. The Committee conducted deliberations on different aspects of vitamin D deficiency and rickets through ten online meetings between March and September, 2021. A draft guideline was formulated, which was reviewed and approved by all Committee members.

Recommendations

The group reiterates the serum 25-hydroxy vitamin D cutoffs proposed for vitamin D deficiency, insufficiency, and sufficiency as <12 ng/mL, 12–20 ng/mL and >20 ng/mL, respectively. Vitamin D toxicity is defined as serum 25OHD >100 ng/mL with hypercalcemia and/or hypercalciuria. Vitamin D supplementation in doses of 400 IU/day is recommended during infancy; however, the estimated average requirement in older children and adolescents (400–600 IU/day, respectively) should be met from diet and natural sources like sunlight. Rickets and vitamin D deficiency should be treated with oral cholecalciferol, preferably in a daily dosing schedule (2000 IU below 1 year of age and 3000 IU in older children) for 12 weeks. If compliance to daily dosing cannot be ensured, intermittent regimens may be prescribed for children above 6 months of age. Universal vitamin D supplementation is not recommended in childhood pneumonia, diarrhea, tuberculosis, HIV and non-infectious conditions like asthma, atopic dermatitis, and developmental disorders. Serum 25-hydroxy vitamin D level of >20 ng/mL should be maintained in children with conditions at high-risk for vitamin deficiency, like nephrotic syndrome, chronic liver disease, chronic renal failure, and intake of anticonvulsants or glucocorticoids.

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

Similar content being viewed by others

Change history

References

  1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80:1678S–88S.

    Article  CAS  PubMed  Google Scholar 

  2. Shah D, Gupta P. Vitamin D Deficiency: Is the pandemic for real? Indian J Community Med. 2015;40:215–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Munns CF, Shaw N, Kiely M, et al. Global Consensus Recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016;101:394–415.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Holick MF. Health benefits of vitamin D and sunlight: a D-bate. Nat Rev Endocrinol. 2011;7:73–5.

    Article  CAS  PubMed  Google Scholar 

  5. From Indian Academy of Pediatrics ‘Guideline for vitamin D and calcium in children’ Committee., Khadilkar A, Khadilkar V, Chinnappa J, et al. Prevention and treatment of vitamin D and calcium deficiency in children and adolescents: Indian Academy of Pediatrics (IAP) Guidelines. Indian Pediatr. 2017;54:567–73.

    Article  Google Scholar 

  6. Ministry of Health and Family Welfare, Government of India. Comprehensive National Nutrition Survey (CNNS) 2016–2018. Accessed March 9, 2020. Available at: https://nhm.gov.in/WriteReadData/l892s/1405796031571201348.pdf

  7. Centre for Evidence based medicine. OCEBM Levels of Evidence. Accessed March 12, 2021. Available at URL: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence

  8. Khadilkar AV. Vitamin D deficiency in Indian adolescents. Indian Pediatr. 2010; 47:755–6.

    Article  CAS  PubMed  Google Scholar 

  9. Marwaha RK, Tandon T, Reddy DRH, et al. Vitamin D and bone mineral density status in healthy school children in North India. Am J Clin Nutr. 2005; 82:477–82.

    Article  CAS  PubMed  Google Scholar 

  10. Bhalala U, Desai M, Parekh P, et al. Subclinical hypovitaminosis D among exclusively breastfed young infants. Pediatr. 2007;44: 897–901.

    CAS  Google Scholar 

  11. Khadilkar A, Das G, Sayyad M, et al. Low calcium intake and hypovitaminosis D in adolescent girls. Arch Dis Child. 2007;92: 1045–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Harinarayan CV, Ramalakshmi T, Prasad UV, et al. Vitamin D status in Andhra Pradesh: a population -based study. Indian J Med Res. 2008;127:211–8.

    CAS  PubMed  Google Scholar 

  13. Puri S, Marwaha RK, Agarwal N, et al. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: Relation to nutrition and lifestyle. Br J Nutr. 2008;99:876–82.

    Article  CAS  PubMed  Google Scholar 

  14. Sahu M, Bhatia V, Aggarwal A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol. 2009;70:680–4.

    Article  CAS  Google Scholar 

  15. Mehrotra P, Marwaha RK, Aneja S, et al. Hypovitaminosis D and hypocalcemic seizures in infancy. Indian Pediatr. 2010;47: 581–5.

    Article  CAS  PubMed  Google Scholar 

  16. Jain V, Gupta N, Kalaivani M, et al. Vitamin D deficiency in healthy breastfed term infants at 3 months and their mothers in India: Seasonal variation and determinants. Indian J Med Res. 2011;133:267–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Khadgawat R, Marwaha RK, Garg MK, et al. Impact of vitamin D fortified milk supplementation on vitamin D status of healthy school children aged 10–14 years. Osteoporos Int. 2013;24: 2335–43.

    Article  CAS  PubMed  Google Scholar 

  18. Garg MK, Tandon N, Marwaha RK, et al. The relationship between serum 25-hydroxyvitamin D, parathormone and bone mineral density in Indian population. Clin Endocrinol. 2014; 80:41–6.

    Article  CAS  Google Scholar 

  19. Angurana SK, Angurana RS, Mahajan G, et al. Prevalence of vitamin D deficiency in apparently healthy children in North India. J Pediatr Endocrinol Metab. 2014;27:1151–6.

    CAS  PubMed  Google Scholar 

  20. Basu S, Gupta R, Mitra M, Ghosh A. A prevalence of vitamin D deficiency in a pediatric hospital of eastern India. Ind J Clin Biochem. 2015;30:167–73.

    Article  CAS  Google Scholar 

  21. Kumar P, Shenoi A, Kumar RK, et al. Vitamin D deficiency among women in labour and cord blood of newborns. Indian Pediatr. 2015;52:530–1.

    PubMed  Google Scholar 

  22. Naik KD, Preetha R, Ramachandran AM, et al. Cord blood vitamin D levels of term neonates. Indian Pediatr. 2015;52:75–6.

    PubMed  Google Scholar 

  23. Sharawat I, Sitaraman S, Dawman L. Prevalence of vitamin D deficiency among healthy school children in Jaipur district, Rajasthan, India. Int J Pediatr. 2015;N-42,801.

    Google Scholar 

  24. Kapil U, Pandey RM, Goswami R, et al. Prevalence of vitamin D deficiency and associated risk factors among children residing at high altitude in Shimla district, Himachal Pradesh, India. Indian J Endocrinol Metab. 2017;21:178–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Meena P, Dabas A, Shah D, et al. Sunlight exposure and vitamin D status in breastfed infants. Indian Pediatr. 2017;54:105–111.

    Article  PubMed  Google Scholar 

  26. Chowdhury R, Taneja S, Bhandari N, et al. Vitamin D deficiency predicts infection in young north Indian children: a secondary data analysis. PLoS One. 2017; 12: e0170509.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Ananada Kesavan TM, Thuruthiyath N, Thomas EP. Subclinical vitamin D deficiency in children from Thrissur, Kerala. Indian Pediatr. 2018;55:434–435.

    Google Scholar 

  28. Mandlik R, Kajale N, Ekbote V, et al. Determinants of vitamin D status in Indian school children. Indian J Endocrinol Metab. 2018;22:244–248.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Marwaha RK, Mithal A, Bhari N, et al. Supplementation with three different daily doses of vitamin D3 in healthy pre-pubertal schoolgirls: A cluster randomized trial. Indian Pediatr. 2018; 55:951–56.

    Article  PubMed  Google Scholar 

  30. Sarma D, Saikia UK, Baro A. Vitamin D status of school children in and around Guwahati. Indian J Endocrinol Metab. 2019;23: 81–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Ray R, Dabas A, Shah D, et al. Seasonal variation in 25-hydroxyvitamin D and its association with clinical morbidity in healthy infants from Northern India. Indian Pediatr. 2019;56: 1020–24.

    Article  PubMed  Google Scholar 

  32. Aparna P, Muthathal S, Nongkynrih B, et al. Vitamin D deficiency in India. J Family Med Prim Care. 2018;7:324–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kamboj P, Dwivedi S, Toteja GS. Prevalence of hypovitaminosis D in India and way forward. Indian J Med Res.2018; 548–56.

  34. Selvarajan S, Gunaseelan V, Ananda baskar N, et al. Systematic review on vitamin D level in healthy Indian population and analysis of its associated factors. Indian J Endocrinol Metab. 2017;21:765–775.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Jeyakumar A, Shinde V. A systematic review and mete-analysis of prevalence of vitamin D deficiency among adolescent girls in selected Indian states. Nutr Health. 2019; 25:61–70.

    Article  PubMed  Google Scholar 

  36. Willet AM. Vitamin D status and its relationship with parathyroid hormone and bone mineral status in older adolescents. Proc Nutr Soc. 2005;64:193–203.

    Article  CAS  Google Scholar 

  37. Garg U. 25-Hydroxyvitamin D Testing: Immunoassays Versus Tandem Mass Spectrometry. Clin Lab Med. 2018;38:439–453.

    Article  PubMed  Google Scholar 

  38. Carter GD, Berry J, Durazo-Arvizu R, et al. Hydroxyvitamin D assays: an historical perspective from DEQAS. J Steroid Biochem Mol Biol. 2018; 177:30–5.

    Article  CAS  PubMed  Google Scholar 

  39. Gallo S, Comeau K, Agellon S, et al. Methodological issues in assessing plasma 25-hydroxyvitamin D concentration in newborn infants. Bone.2014;186–90.

  40. Lai JKC, Lucas RM, Banks E, Ponsomby AL, Ausimmune Investigator Group. Int Med J. 2011; 43–49.

  41. Tai SS, Bedner M, Phinney KW. Development of a candidate reference measurement procedure for the determination of 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 in human serum using isotope-dilution liquid chromatography-tandem mass spectrometry. Anal Chem. 2010;82:1942–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–30.

    Article  CAS  PubMed  Google Scholar 

  43. Jeyakumar A, Shinde V, Ravindran R. Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis. J Health Popubl Nutr. 2021;40:28.

    Article  Google Scholar 

  44. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Accessed July 12, 2021. Available at URL: https://www.who.int/publications/i/item/9789241549912

  45. WHO antenatal care recommendations for a positive pregnancy experience. Nutritional interventions update: Vitamin D supplements during pregnancy. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.

  46. Dietary guidelines for Indians — A manual. National Institute of Nutrition. Indian Council of Medical Research. Accessed October 3, 2021. Available at: http://ninindia.org/DietaryGuidelinesforNINwebsite.pdf

  47. WHO. Guideline: Calcium supplementation in pregnant women. Geneva, World Health Organization, 2013. Accessed on 03 Nov 2021._Available at URL: https://www.nhp.gov.in/sites/default/files/pdf/9789241505376_eng.pdf

  48. van der Pligt P, Willcox J, et al, van Daly RM. Associations of maternal vitamin D deficiency with pregnancy and neonatal complications in developing countries: A systematic review. Nutrients. 2018;10:640.

    Article  PubMed Central  CAS  Google Scholar 

  49. Aghajafari F, Nagulesapillai T, Ronksley PE, et al. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: Systematic review and meta-analysis of observational studies. BMJ. 2013;346:f1169.

    Article  PubMed  Google Scholar 

  50. Harvey NC, Holroyd C, Ntani G, et al. Vitamin D supplementation in pregnancy: a systematic review. Health Technol Assess. 2014;18:1–190.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019;7:CD008873.

    PubMed  Google Scholar 

  52. Pérez-López FR, Pasupuleti V, Mezones-Holguin E, et al. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: A systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2015;103:1278–88.e4.

    Article  PubMed  CAS  Google Scholar 

  53. Ogbo FA, Dhami MV, Awosemo AO, et al. Regional prevalence and determinants of exclusive breastfeeding in India. Int Breastfeed J. 2019;14:20

    Article  PubMed  PubMed Central  Google Scholar 

  54. Ozkan B, Doneray H, Karacan M, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey [published correction appears in Eur J Pediatr. 2009 Jan;168(1):101]. Eur J Pediatr. 2009;168:95–100

    Article  PubMed  Google Scholar 

  55. Mutlu GY, Kusdal Y, Ozsu E, Cizmecioglu FM, Hatun S. Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;2011:4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  56. Gallo S, Comeau K, Vanstone C, et al. Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: A randomized trial. JAMA. 2013;309:1785–92.

    Article  CAS  PubMed  Google Scholar 

  57. Gallo S, Hazell T, Vanstone CA, et al. Vitamin D supplementation in breastfed infants from Montréal, Canada: 25-hydroxyvitamin D and bone health effects from a follow-up study at 3 years of age. Osteoporos Int. 2016;27:2459–66.

    Article  CAS  PubMed  Google Scholar 

  58. Holmlund-Suila E, Viljakainen H, Hytinantti T, et al. High-dose vitamin d intervention in infants—effects on vitamin d status, calcium homeostasis, and bone strength. J Clin Endocrinol Metab. 2012;97:4139–47.

    Article  CAS  PubMed  Google Scholar 

  59. Natarajan CK, Sankar MJ, Agarwal R, et al. Trial of daily vitamin D supplementation in preterm infants. Pediatrics. 2014;133: e628–34.

    Article  PubMed  Google Scholar 

  60. Cho SY, Park HK, Lee HJ. Efficacy and safety of early supplementation with 800 IU of vitamin D in very preterm infants followed by underlying levels of vitamin D at birth. Ital J Pediatr. 2017;43:45

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  61. Fort P, Salas AA, Nicola T, et al. A Comparison of 3 vitamin D dosing regimens in extremely preterm infants: A randomized controlled trial. J Pediatr. 2016;174:132–138.e1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Munshi UK, Graziano PD, Meunier K, et al. Serum 25 hydroxy vitamin D levels in very low birth weight infants receiving oral vitamin D supplementation. J Pediatr Gastroenterol Nutr. 2018;66(4):676–9.

    Article  CAS  PubMed  Google Scholar 

  63. Bronsky J, Campoy C, Braegger C; ESPGHAN/ESPEN/ESPR/CSPEN working group on pediatric parenteral nutrition. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Vitamins. Clin Nutr. 2018;37:2366–78.

    Article  CAS  PubMed  Google Scholar 

  64. Huey SL, Acharya N, Silver A, et al. Effects of oral vitamin D supplementation on linear growth and other health outcomes among children under five years of age. Cochrane Database Sys Rev. 2020;12:CD012875.

    Google Scholar 

  65. Holick F. Environmental factors that influence the cutaneous production of vitamin D3. Am J Clin Nutr. 1995;61:638S–45S.

    Article  CAS  PubMed  Google Scholar 

  66. Webb AR, Alghamdi R, Kift R, Rhodes LE. 100 years of vitamin D: Dose-response for change in 25-hydroxyvitamin D after UV exposure: Outcome of a systematic review. Endocr Connect. 2021;10:R248–R266.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Grigalavicius M, Moan J, Dahlback A, Juzeniene A. Vitamin D and ultraviolet phototherapy in Caucasians. J Photochem Photobiol B: Biol. 2015;147:69–74.

    Article  CAS  Google Scholar 

  68. WHO. Global Solar UV Index: A practical Guide. https://www.who.int/uv/publications/en/UVIGuide.pdf?ua=l#:∼:text=The%20Global%20Solar%20UV%20Index%20(UVI)%20describes%20the%20level%20of,takes%20for%20harm%20to%20occur

  69. Jager N, Schöpe J, Wagenpfeil S, et al. The Impact of UV-dose, body surface area exposed and other factors on cutaneous vitamin D synthesis measured as serum 25(OH)D concentration: Systematic review and meta-analysis. Anticancer Res. 2018;38: 1165–71.

    CAS  PubMed  Google Scholar 

  70. Khan SR, Whiteman D, Kimlim MG, et al. Effect of solar ultraviolet radiation exposure on serum 25(OH)D concentration: a pilot randomised controlled trial. Photochem Photobiol Sci. 2018;17:570–7.

    Article  CAS  PubMed  Google Scholar 

  71. Datta P, Philipsen PA, Olsen P, et al. Pigment genes not skin pigmentation affect UV-B-induced vitamin D. Photochem Photobiol Sci. 2019;18:448–58.

    Article  CAS  PubMed  Google Scholar 

  72. Sachdeva S. Fitzpatrick skin typing: Applications in dermatology. Indian J Dermatol Venereol Leprol. 2009;75:93–6.

    Article  PubMed  Google Scholar 

  73. Cashman KD, Sheehy T, O’Neill CM. Is vitamin D deficiency a public health concern for low middle -income countries? A systematic literature reviews. Eur J Nutr.2019; 1–21.

  74. Millen AE, Bodnar LM. Vitamin D assessment in population-based studies: A review of the. Am J Clin Nut. 2008;87:1102S–5S.

    Article  CAS  Google Scholar 

  75. Mac Laughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985;76: 1536–8.

    Article  CAS  Google Scholar 

  76. Harinarayan CV, Holick MF, Prasad UV, Vani PS, Himabindu G. Vitamin D status and sun exposure in India. Dermato endocrinol. 2013;5:130–41.

    Article  CAS  Google Scholar 

  77. Hettiaratchy S, Papini R. Initial management of a major burn: II-assessment and resuscitation. BMJ. 2004;329:101–3.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Specker BL, Ho ML, Oestreich A, et al. Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. J Pediatr. 1985;107:372–6.

    Article  CAS  PubMed  Google Scholar 

  79. Rockell JE, Green TJ, Murray C, Susan J. Season and ethnicity are determinants of serum of serum 25(OH)D concentration in New Zealand children aged 5–14 yr. J Nutr. 2005;135:2602–8.

    Article  CAS  PubMed  Google Scholar 

  80. Rajakumar K, Holick MF, Jeong K, et al. Impact of season and diet on vitamin D status of African American and Caucasian children. Clin Pediatr (Phila). 2011;50:493–502.

    Article  Google Scholar 

  81. Raizada N, Goyal A, Singla R, Sreenivas V, Gupta N, Khadgawat R. Changing trend in vitamin D status from 2008 to 2016: An experience from a tertiary care institute in North India. Indian J Endocrinol Metab. 2020;24:150–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Nurbazlin M, Chee WS, Rokiah P, et al. Effects of sun exposure on 25(OH) vitamin D concentration in urban and rural women in Malaysia. Asia Pac J Clin Nutr. 2013;22:391–9.

    CAS  PubMed  Google Scholar 

  83. Harinarayan CV. How to treat Vitamin D deficiency in sundrenched India — guidelines. J Clin Sci Res. 2018; 7:131–40.

    Article  Google Scholar 

  84. Ekbote VH, Khadilkar AV, Mughal MZ, et al. Sunlight exposure and development of rickets in Indian toddlers. Indian J Pediatr. 2010;77:61–5.

    Article  CAS  PubMed  Google Scholar 

  85. Marwaha RK, Sreenivas V, Talwar D, et al. Impact of solar ultraviolet B radiation (290–320 nm) on vitamin D synthesis in children with type IV and V skin. Br J Dermatol. 2015;173: 604–6.

    Article  CAS  PubMed  Google Scholar 

  86. Patwardhan VG, Mughal ZM, Padidela R, et al. Randomized control trial assessing impact of increased sunlight exposure versus vitamin D supplementation on lipid profile in Indian Vitamin D deficient men. Indian J Endocrinol Metab. 2017; 21: 393–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Singh S, Jha B, Tiwary NK, Agrawal NK. Does using a high sun protection factor sunscreen on face, along with physical photoprotection advice, in patients with melasma, change serum vitamin D concentration in Indian conditions? A pragmatic pretest-posttest study. Indian J Dermatol Venereol Leprol. 2019; 85:282–6.

    Article  PubMed  Google Scholar 

  88. Paul SP. Ensuring the safety of sunscreens, and their efficacy in preventing skin cancers: challenges and controversies for clinicians, formulators, and regulators. Front Med (Lausanne). 2019;6:195.

    Article  Google Scholar 

  89. Moradi S, Shahdadian H, Rouhani MH. A comparison of the effect of supplementation and sunlight exposure on serum vitamin D and parathyroid hormone: A systematic review and meta-analysis. Critical Rev Food Sci Nutr. 2020;60:1881–1889.

    Article  CAS  Google Scholar 

  90. Veleva BI, Caljouw MAA, van der Steen JT, et al. The effect of ultraviolet B irradiation compared with oral vitamin D supplementation on the well-being of nursing home residents with dementia: a randomized controlled trial. Int J Environ Res Public Health. 2020;17:1684.

    Article  CAS  PubMed Central  Google Scholar 

  91. Datta P, Philipsen PA, Olsen P, et al. Serum 25(OH)D levels after oral vitamin D3 supplementation and UV-B exposure correlate. Photodermatol Photoimmunol Photomed. 2019;35: 344–53.

    Article  CAS  PubMed  Google Scholar 

  92. Wu T, Luo H, Wang R, et al. Effect of vitamin D supplementation and outdoor time on the 25(OH)D level in adolescents. Wei Sheng Yan Jiu. 2017;46:207–12 [article in Chinese].

    PubMed  Google Scholar 

  93. Cashman KD, Kiely M, Seamans KM, Urbain P. Effect of Ultraviolet light-exposed mushrooms on vitamin D status: liquid chromatography-tandem mass spectrometry reanalysis of bio-banked sera from a randomized controlled trial and a systematic review plus meta-analysis. J Nutr. 2016;146:565–75.

    Article  CAS  PubMed  Google Scholar 

  94. National Institute of Nutrition, Indian Council of Medical Research, Ministry of Health and Family Welfare. Indian Food composition tables. 2017. Accessed July 9,2021. Available from: http://www.indiaenvironmentportal.org.in/files/file/IFCT%202017%20Book.pdf

  95. Saggese G, Vierucci F, Prodam F, et al. Vitamin D in pediatric age: Consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018;44:51.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  96. Schmid A, Walther B. Natural vitamin D content in animal products. Adv Nutr. 2013;4:453:62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Bailey RL, Dodd KW, Goldman JA, et al. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr. 2010;140:817–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Hill TR, O’Brien MM, Cashman KD, et al. Vitamin D intakes in 18–64-y-old Irish adults. Eur J Clin Nutr. 2004;58:1509–17.

    Article  CAS  PubMed  Google Scholar 

  99. Freisling H, Fahey MT, Moskal A, et al. Region-specific nutrient intake patterns exhibit a geographical gradient within and between European countries. J Nutr. 2010;140:1280–6.

    Article  CAS  PubMed  Google Scholar 

  100. Munasinghe LL, Yuan Y, Willows ND, et al. Vitamin D deficiency and sufficiency among Canadian children residing at high latitude following the revision of the RDA of vitamin D intake in 2010. Br J Nutr. 2017;117:1052–4.

    Article  CAS  PubMed  Google Scholar 

  101. Petersen RA, Damsgaard CT, Dalskov SM, et al. Vitamin D status and its determinants during autumn in children at northern latitudes: A cross-sectional analysis from the optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study. Br J Nutr. 2016; 115:23–50.

    Article  CAS  Google Scholar 

  102. Ekbote VH, Khadilkar AV, Khadilkar VV, et al. Dietary patterns with special reference to calcium intake in 2–16-year-old urban western Indian children. Indian J Public Health. 2017;61: 188–93.

    Article  PubMed  Google Scholar 

  103. Harinarayan CV, Akhila H. Modern India and the tale of twin nutrient deficiency-calcium and vitamin D-nutrition trend data 50 years-retrospect, introspect, and prospect. Front Endocrinol (Lausanne). 2019;10:493.

    Article  Google Scholar 

  104. ICMR-NIN Expert Group on Nutrient Requirement for Indians, Recommended Dietary Allowances (RDA) and Estimated Average Requirements (EAR). ICMR-National Institute of Nutrition, Hyderabad, 2020. Accessed November 18, 2021. Available from: https://www.nin.res.in/RDA_Full_Report_2020.html

  105. Bloom E, Klein EJ, Shushan D, Feldman KW. Variable presentations of rickets in children in the emergency department. Pediatr Emerg Care 2004;20:126–130.

    Article  PubMed  Google Scholar 

  106. Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142–1152.

    Article  PubMed  Google Scholar 

  107. Gordon CM, Williams AL, Feldman HA, et al. Treatment of hypovitaminosis D in infants and toddlers. J Clin Endocrinol Metab. 2008;93:2716–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Markestad T, Halvorsen S, Halvorsen KS, et al. Plasma concentrations of vitamin D metabolites before and during treatment of vitamin D deficiency rickets in children. Acta Padiatr Scand 1984;73:225–231.

    Article  CAS  Google Scholar 

  109. Kruse K. Pathophysiology of calcium metabolism in children with vitamin D-deficiency rickets. J Pediatr 1995;126:736–741.

    Article  CAS  PubMed  Google Scholar 

  110. Cesur Y, Caksen H, Gundem A, et al. Comparison of low and high dose of vitamin D treatment in nutritional vitamin D deficiency rickets. J Pediatr Endocrinol Metab 2003;16:1105–09.

    Article  CAS  PubMed  Google Scholar 

  111. Mittal H, Rai S, Shah D, et al. 300,000 IU or 600,000 IU of oral vitamin D 3 for treatment of nutritional rickets: a randomized controlled trial. Indian Pediatr 2014;51:265–72.

    Article  PubMed  Google Scholar 

  112. Tannous P, Fiscaletti M, Wood N, et al. Safety and effectiveness of Stoss therapy in children with vitamin D deficiency. J Paediatr Child Health. 2020;56:81–89.

    Article  PubMed  Google Scholar 

  113. Tan JK, Kearns P, Martin AC, Siafarikas A. Randomised controlled trial of daily versus stoss vitamin D therapy in Aboriginal children. J Paediatr Child Health. 2015;51:626–31.

    Article  PubMed  Google Scholar 

  114. Mondal K, Seth A, Marwaha R, et al. A randomized controlled trial on safety and efficacy of single intramuscular versus staggered oral dose of 600,000 IU vitamin D in treatment of nutritional rickets. J Trop Pediatr 2014;60:203–10.

    Article  PubMed  Google Scholar 

  115. Shah BR, Finberg L. Single-dose therapy for nutritional vitamin D-deficiency rickets: a preferred method. J Pediatr. 1994;125:487–90.

    Article  CAS  PubMed  Google Scholar 

  116. Shakiba M, Sadr S, Nefei Z, et al. Combination of bolus dose vitamin D with routine vaccination in infants: A randomised trial. Singapore Med J. 2010;51:440–5.

    CAS  PubMed  Google Scholar 

  117. Cipriani C, Romagnoli E, Pepe J, et al. Long-term bioavailability after a single oral or intramuscular administration of 600,000 IU of ergocalciferol or cholecalciferol: implications for treatment and prophylaxis. J Clin Endocrinol Metab. 2013;98:2709–15.

    Article  CAS  PubMed  Google Scholar 

  118. Zabihiyeganeh M, Jahed A, Nojomi M. Treatment of hypo-vitaminosis D with pharmacologic doses of cholecalciferol, oral vs intramuscular; an open labeled RCT. Clin Endocrinol (Oxf). 2013;78:210–16.

    Article  CAS  Google Scholar 

  119. Dunlop E, Kiely ME, James AP, et al. Vitamin D food fortification and biofortification increases serum 25-hydroxy-vitamin D concentrations in adults and children: An updated and extended systematic review and meta-analysis of randomized controlled trials. J Nutr. 2021;151:2622–35.

    Article  PubMed  Google Scholar 

  120. Balachandar R, Pullakhandam R, Kulkarni B, Sachdev HS. Relative efficacy of Vitamin D2 and Vitamin D3 in improving Vitamin D status: Systematic review and meta analysis. Nutrients 2021;13:3328.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  121. Aggarwal V, Seth A, Marwaha RK, et al. Management of nutritional rickets in Indian children: A randomized controlled trial. J Trop Pediatr. 2013;59:127–33.

    Article  PubMed  Google Scholar 

  122. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M, Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.

    Article  PubMed  Google Scholar 

  123. Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ 2010;340:b5664.

    Article  PubMed  CAS  Google Scholar 

  124. Shaw NJ, Mughal MZ. Vitamin D and child health. 2. Extra skeletal and other aspects. Arch Dis Child 2013;98:368–72.

    Article  PubMed  Google Scholar 

  125. Munns C, Zacharin MR, Rodda CP, et al; Paediatric Endocrine Group; Pediatric Bone Australasia. Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement. Med J Aust 2006; 185: 268–272.

    Article  PubMed  Google Scholar 

  126. Lhamo Y, Chugh PK, Tripathi CD. Vitamin D Supplements in the Indian Market. Indian J Pharm Sci. 2016;78:41–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Thacher TD, Fischer PR, Pettifor JM, et al. A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children. N Engl J Med. 1999;341:563–68.

    Article  CAS  PubMed  Google Scholar 

  128. Balasubramanian K, Rajeswari J, Gulab, et al. Varying role of vitamin D deficiency in the etiology of rickets in young children vs adolescents in northern India. J Trop Pediatr. 2003;49: 201–6.

    Article  CAS  PubMed  Google Scholar 

  129. Kutluk G, Cetinkaya F, Ba°ak M. Comparisons of oral calcium, high dose vitamin D and a combination of these in the treatment of nutritional rickets in children. J Trop Pediatr. 2002;48: 351–53.

    Article  PubMed  Google Scholar 

  130. White HJ. Vitamin D signaling, infectious diseases, and regulation of innate immunity. Infect Immun. 2008;76:3837–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  131. Choudhary N, Gupta P. Vitamin D supplementation for severe pneumonia — a randomized controlled trial. Indian Pediatr, 2012; 49:449–54.

    Article  PubMed  Google Scholar 

  132. Gupta P, Dewan P, Shah D, et al. Vitamin D supplementation for treatment and prevention of pneumonia in under-five children: A randomized double-blind placebo controlled trial. Indian Pediatr. 2016;53:967–76.

    Article  PubMed  Google Scholar 

  133. Somnath SH, Biswal N, Chandrasekaran V, et al. Therapeutic effect of vitamin D in acute lower respiratory infection: a randomized controlled trial. Clin Nutr ESPEN. 2017;20:24–28.

    Article  PubMed  Google Scholar 

  134. Singh N, Kamble D, Mahantshetti NS. Effect of vitamin D supplementation in the prevention of recurrent pneumonia in under-five children. Indian J Pediatr. 2019; 86:1105–11.

    Article  PubMed  Google Scholar 

  135. Yakoob MY, Salam RA, Khan FR, Bhutta ZA. Vitamin D supplementation for preventing infections in children under five years of age. Cochrane Database Syst Rev. 2016;11:CD008824.

    PubMed  Google Scholar 

  136. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia. Cochrane Database Syst Rev 2018;7:CD011597.

    PubMed  Google Scholar 

  137. Jolliffe DA, Camargo CA Jr, Sluyter JD, et al. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. Lancet Diabetes Endocrinol. 2021; 9:276–292.

    Article  CAS  PubMed  Google Scholar 

  138. Coussens AK, Martineau AR, Wilkinson RJ. Anti-Inflammatory and Antimicrobial Actions of Vitamin D in Combating TB/HIV. Scientifica (Cairo). 2014;2014:903680.

    Google Scholar 

  139. Xia J, Shi L, Zhao L, Xu F. Impact of vitamin D supplementation on the outcome of tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials. Chin Med J. 2014;127:3127–3134.

    PubMed  Google Scholar 

  140. Wu HX, Xiong XF, Zhu M, et al, Cheng DY. Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis. BMC Pulm Med. 2018;18:108.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  141. Jiménez-Sousa MÁ, Martínez I, Medrano LM, Fernández-Rodríguez A, Resino S. Vitamin D in Human Immunodeficiency Virus Infection: Influence on Immunity and Disease. Front Immunol. 2018;9:458.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  142. Mirza A, Wells S, Gayton T, et al. Vitamin D deficiency in HIV-infected children. South Med J. 2016; 109:683–687.

    CAS  PubMed  Google Scholar 

  143. Chokephaibulkit K, Saksawad R, Bunupuradah T, et al. Prevalence of vitamin D deficiency among perinatally HIV-infected Thai adolescents receiving antiretroviral therapy. Pediatr Infect Dis J. 2013;32:1237–9.

    Article  PubMed  Google Scholar 

  144. Rutstein R Downes A, Zemel B, Schall J, Stallings V. Vitamin D status in children and young adults with perinatally acquired HIV infection. Clin Nutr. 2011;30:624–628.

    Article  CAS  PubMed  Google Scholar 

  145. Giusti A, Penco GP. Vitamin D deficiency in HIV-infected patients: A systematic review. Nutr Diet Suppl 2011;3:101–111.

    Article  CAS  Google Scholar 

  146. Arpadi SM, McMahon D, Abrams EJ, et al. Effect of bimonthly supplementation with oral cholecalciferol on serum 25-hydroxyvitamin D concentrations in HIV-infected children and adolescents. Pediatrics. 2009;123:e121–6.

    Article  PubMed  Google Scholar 

  147. Eckard AR, O’Riordan MA, Rosebush JC, et al. Vitamin D supplementation decreases immune activation and exhaustion in HIV-1-infected youth. Antivir Ther. 2018;23:315–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  148. Ahmed AM, Soares Magalhaes RJ, Long KZ, et al. Association of vitamin D status with incidence of enterotoxigenic, enteropathogenic and enteroaggregative Escherichia coli diarrhoea in children of urban Bangladesh. Trop Med Int Health. 2016;21: 973–984.

    Article  CAS  PubMed  Google Scholar 

  149. Aluisio AR, Maroof Z, Chandramohan D, et al. Vitamin D supplementation and childhood diarrhea: a randomized controlled trial. Pediatrics. 2013;132:e832–40.

    Article  PubMed  PubMed Central  Google Scholar 

  150. Hassam I, Kisenge R, Aboud S, Manji K. Association of vitamin D and diarrhoea in children aged less than five years at Muhimbili national hospital, Dar es Salaam: an unmatched case control study. BMC Pediatr. 2019;19:237.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  151. Sudfeld CR, Manji KP, Smith ER, et al. Vitamin D deficiency is not associated with growth or the incidence of common morbidities among Tanzanian infants. J Pediatr Gastroenterol Nutr. 2017;65:467–474.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  152. van Oeffelen AAM, Bekkers MBM, Smit HA, et al. Serum micronutrient concentrations and childhood asthma: the PIAMA birth cohort study: Serum nutrients and childhood asthma. Pediatr Allergy Immunol. 2011;22:784–93.

    Article  CAS  PubMed  Google Scholar 

  153. Brehm JM, Celedón JC, Soto-Quiros ME, et al. Serum Vitamin D Levels and Markers of Severity of Childhood Asthma in Costa Rica. Am J Respi Crit Care Med. 2009;179:765–71.

    Article  CAS  Google Scholar 

  154. Litonjua AA. Vitamin D deficiency as a risk factor for childhood allergic disease and asthma: Curr Opin Allergy Clin Immunol. 2012;12:179–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  155. Liu J, Dong Y, Yin J, et al. Meta-analysis of vitamin D and lung function in patients with asthma. Respir Res 2019;20:161.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  156. Fares MM, Alkhaled LH, Mroueh SM, Akl EA. Vitamin D supplementation in children with asthma: a systematic review and meta-analysis. BMC Res Notes. 2015;8:23.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  157. Riverin BD, Maguire JL, Li P. Vitamin D supplementation for childhood asthma: A systematic review and meta-analysis. PLoS One. 2015;10:e0136841.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  158. Martineau AR, Cates CJ, Urashima M, et al. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2016; 356:CD011511.

    Google Scholar 

  159. Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data [published correction appears in Lancet Respir Med. 2018 Jun;6(6):e27]. Lancet Respir Med. 2017;5(11):881–890.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  160. De Souza Silva J, Pereira SE, Saboya Sobrinho CJ, Ramalho A. Obesity, related diseases and their relationship with vitamin D deûciency in adolescents. Nutr Hosp. 2016;33:381.

    Article  PubMed  CAS  Google Scholar 

  161. Bhatt SP, Misra A, Sharma M, et al. Vitamin D insufficiency is associated with abdominal obesity in urban Asian Indians without diabetes in North India. Diabetes Technol Ther. 2014;16: 392–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  162. Jamka M, WoŸniewicz M, Jeszka J, et al. The effect of vitamin D supplementation on insulin and glucose metabolism in overweight and obese individuals: systematic review with meta-analysis. Sci Rep. 2015;5:16142.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  163. Perna S. Is vitamin D supplementation useful for weight loss programs? A systematic review and meta-analysis of randomized controlled trials. Medicina (Kaunas). 2019;55: E368.

    Article  Google Scholar 

  164. Raed A, Bhagatwala J, Zhu H, et al. Dose responses of vitamin D3 supplementation on arterial stiffness in overweight African Americans with vitamin D deficiency: A placebo controlled randomized trial. PLoS One. 2017;12:e0188424.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  165. Duan L, Han L, Liu Q, Zhao Y, Wang L, Wang Y. Effects of vitamin D supplementation on general and central obesity: Results from 20 randomized controlled trials involving apparently healthy populations. Ann Nutr Metab. 2020; 76:153–164.

    Article  CAS  PubMed  Google Scholar 

  166. Jamka M, WoŸniewicz M, Walkowiak J, Bogdañski P, Jeszka J, Stelmach-Mardas M. The effect of vitamin D supplementation on selected inflammatory biomarkers in obese and overweight subjects: a systematic review with meta-analysis. Eur J Nutr. 2016;55:2163–76.

    Article  CAS  PubMed  Google Scholar 

  167. Rafiq S, Jeppesen PB. Body mass index, vitamin D, and Type 2 Diabetes: A systematic review and meta-analysis. Nutrients. 2018;10:1182.

    Article  PubMed Central  CAS  Google Scholar 

  168. Wadhwa B, Relhan V, Goel K, Kochhar AM, Garg VK. Vitamin D and skin diseases: A review. Indian J Dermatol Venereol Leprol. 2015;81:344–55.

    Article  PubMed  Google Scholar 

  169. Kýlýç S, Sýlan F, Hýz MM, Iþýk S, Ögretmen Z, Özdemir Ö. Vitamin D Receptor Gene BSMI, FOKI, APAI, and TAQI polymorphisms and the risk of atopic dermatitis. J Investig Allerg Clin Immunol. 2016;26:106–10.

    Article  CAS  Google Scholar 

  170. Byun EJ, Heo J, Cho SH, Lee JD, Kim HS. Suboptimal vitamin D status in Korean adolescents: a nationwide study on its prevalence, risk factors including in cotinine-verified smoking status and association with atopic dermatitis and asthma. BMJ Open. 2017;7:e016409.

    Article  PubMed  PubMed Central  Google Scholar 

  171. Robl R, Uber M, Abagge KT, Lima MN, Carvalho VO. Serum vitamin D levels not associated with atopic dermatitis severity. Pediatr Dermatol. 2016;33:283–8.

    Article  PubMed  Google Scholar 

  172. Manousaki D, Paternoster L, Stand IM, et al. Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and at opicdermatitis: A Mendelian randomization study. PLoS Med. 2017;14:e1002294.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  173. Kim MJ, Kim SN, Lee YW, Choe YB, Ahn KJ. Vitamin D status and efficacy of vitamin D supplementation in atopic dermatitis: A systematic review and meta-analysis. Nutrients. 2016;8: E789.

    Article  PubMed  CAS  Google Scholar 

  174. Selewski DT, Chen A, Shatat IF, et al. Vitamin D in incident nephrotic syndrome: a Midwest Pediatric Nephrology Consortium study. Pediatr Nephrol. 2016;31:465–72.

    Article  PubMed  Google Scholar 

  175. Cetin N, Gencler A, Sivrikoz IA. Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome. Saudi J Kidney Dis Transpl. 2019; 30:853–862.

    Article  PubMed  Google Scholar 

  176. Singh DN, Krishnamurthy S, Kamalanathan SK, Hari Chandra kumar KT, Sivamurukan P. Three-monthly bolus vitamin D supplements (1000 vs 400 IU/day) for prevention of bone loss in children with difficult-to-treat nephrotic syndrome: A randomised clinical trial. Paediatr Int Child Health. 2018;38: 251–260.

    Article  PubMed  Google Scholar 

  177. Muske S, Krishnamurthy S, Kamalanathan SK, Rajappa M, Hari Chandra kumar KT, Sivamurukan P. Effect of two prophylactic bolus vitamin D dosing regimens (1000 IU/day vs. 400 IU/day) on bone mineral content in new-onset and infrequently-relapsing nephrotic syndrome: a randomised clinical trial. Paediatr Int Child Health. 2018;38:23–33.

    Article  PubMed  Google Scholar 

  178. Trautmann A, Vivarelli M, Samuel S, et al. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol. 2020;35: 1529–1561.

    Article  PubMed  PubMed Central  Google Scholar 

  179. Vasudevan A, Thergaonkar R, Mantan M, et al; Expert group of the Indian Society of Pediatric Nephrology. Consensus guidelines on management of steroid-resistant nephrotic syndrome. Indian Pediatr. 2021;58:650–666.

    Article  PubMed  Google Scholar 

  180. Wrzosek M, £ukaszkiewicz J, Wrzosek M, et al. Vitamin D and the central nervous system. Pharmacol Rep. 2013;65:271–8.

    Article  CAS  PubMed  Google Scholar 

  181. Alhraiwil NJ, Ali A, Househ MS, Al-Shehri AM, El-Metwally AA. Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries. Neurosciences (Riyadh). 2015;20:137–44.

    Article  Google Scholar 

  182. Koèovská E, Andorsdóttir G, Weihe P, et al. Vitamin din the general population of young adults with autism in the Faroe islands. J Autism Dev Disord. 2014;44:2996–3005.

    Article  Google Scholar 

  183. Grant WB, Wimalawansa SJ, Holick MF, et al. Emphasizing the health benefits of vitamin D for those with neurodevelopmental disorders and intellectual disabilities. Nutrients. 2015;7: 1538–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  184. Cannell JJ. Vitamin D and autism, what’s new? Rev Endocrinol Metab Disord. 2017;18:183–193.

    Article  CAS  Google Scholar 

  185. Jia F, Shan L, Wang B, et al. Bench to bedside review: Possible role of vitamin D in autism spectrum disorder. Psychiatry Res. 2018;260:360–365.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

Funding: None

Author information

Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences, and Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, 110095, India

    Piyush Gupta & Dheeraj Shah

  2. Department of Pediatrics, Maulana Azad Medical College, New Delhi, India

    Aashima Dabas

  3. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India

    Anju Seth & Praveen Kumar

  4. Departments of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

    Vijay Lakshmi Bhatia

  5. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India

    Rajesh Khadgawat

  6. Kanchi Kamakoti CHILDS Trust, Chennai, India

    S. Balasubramanian

  7. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India

    Vaman Khadilkar

  8. Bangluru, India

    H. B. Mallikarjuna

  9. Dr Vasantarao Pawar Medical College, Nashik, Mumbai, India

    Tushar Godbole

  10. JIPMER, Puducherry, India

    Sriram Krishnamurthy

  11. All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

    Jagdish Prasad Goyal

  12. Super Speciality Pediatric Hospital and Post Graduate Teaching Institute, NOIDA, India

    Bhanu Kiran Bhakhri

  13. Aligarh Muslim University, Aligarh, Uttar Pradesh, India

    Ayesha Ahmad

  14. MR Medical College, Gulbarga, India

    Kumar Angadi

  15. Indira Gandhi Institute of Child Health, Bengluru, Karnataka, India

    G. V. Basavaraja

  16. Bakul Parekh Children’s Hospital, Mumbai, India

    Bakul J. Parekh

  17. Indian Council of Medical Research Expert Committee on Nutrient Requirements of Indians and Scientific Committee, Food Safety and Standards Authority of India, New Delhi, India

    Anura Kurpad

  18. Society of Endocrine Health Care for Elderly Adolescents and Children (SEHEAC), New Delhi, India

    R. K. Marwaha

  19. Department of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, Australia

    Craig Munns

  20. Pediatric Bone and Mineral Medicine, Sydney Medical School, University of Sydney, Sydney, Australia

    Craig Munns

  21. Departments of Pediatric and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India

    H. P. S. Sachdev

Authors
  1. Piyush Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aashima Dabas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anju Seth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vijay Lakshmi Bhatia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rajesh Khadgawat
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Praveen Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Balasubramanian
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vaman Khadilkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H. B. Mallikarjuna
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tushar Godbole
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Sriram Krishnamurthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jagdish Prasad Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Bhanu Kiran Bhakhri
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ayesha Ahmad
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Kumar Angadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. G. V. Basavaraja
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Bakul J. Parekh
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Anura Kurpad
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. R. K. Marwaha
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Dheeraj Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Craig Munns
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. H. P. S. Sachdev
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Contributors: All authors were part of the National Consultative Committee that formulated these guidelines. PG, BJP, GVB: conceived the design and prepared the agenda. AA, TG,AD,SK,JPG,KA,BKB: reviewed the literature for each section in detail and wrote the first draft of the respective sections. VK,VLB,RK,AS,HPS,PK,SB,HBM: moderated the draft recommendations of each respective section and provided critical inputs. DS, AK, RKM were invited experts who provided critical inputs for revision and participated in discussions and manuscript editing. CM: provided external review and critical inputs of the draft recommendations which were incorporated in the successive revisions. HPS, AK, DS, PK,PG provided their inputs in the guidelines. All authors approved the final version.

Corresponding author

Correspondence to Piyush Gupta.

Ethics declarations

Competing interests: None stated.

Additional information

Declaration: The present Committee does not plan to review these guidelines or suggest an expiration date for this version of the guideline.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, P., Dabas, A., Seth, A. et al. Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets. Indian Pediatr 59, 142–158 (2022). https://doi.org/10.1007/s13312-022-2448-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-022-2448-y

Keywords

Search

Navigation