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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(8):2459-66OI

Abstract

Whether infant vitamin D supplementation may have long-term bone benefits is unclear. In this study, breastfed infants who received vitamin dosages greater than 400 IU/day did not have higher bone mineralization at 3 years. This study provides important data to inform pediatric public health recommendations for vitamin D.

INTRODUCTION

North American health agencies recommend breastfed infants should be supplemented with 400 IU of vitamin D/day to support bone health. Few studies examined the long-term benefits of early life vitamin D supplementation on bone mineralization. The objective of this study was to determine if a dose-response relationship exists between infant vitamin D supplementation, vitamin D status, and bone outcomes at 3 years of age.

METHODS

This was a double-blind randomized trial of 132, 1-month-old healthy, breastfed infants from Montréal, Canada, between 2007 and 2010. In this longitudinal analysis, 87 infants (66 %) returned for follow-up at 3 years of age, between 2010 and 2013. At 1 month of age, participants were randomly assigned to receive oral cholecalciferol (vitamin D3) supplements of 400, 800, 1200, or 1600 IU/day until 12 months of age. Lumbar spine vertebrae 1-4 (LS) bone mineral density (BMD), LS and whole body bone mineral content (BMC), and mineral accretion were measured by dual-energy x-ray absorptiometry at 3 years.

RESULTS

At follow-up, the treatment groups were similar in terms of diet, sun exposure, and demographics. There were no significant differences among the groups in LS or whole body BMC, BMD, or accretion. Although, 25(OH)D concentrations were not different among the groups, higher doses (1200 and 1600 IU/day) achieved higher 25(OH)D area under the curve from 1 to 36 months vs. 400 IU/day.

CONCLUSIONS

This is the first longitudinal follow-up of an infant vitamin D dose-response study which examines bone mineralization at 3 years of age. Dosages higher than 400 IU/day do not appear to provide additional benefits to the bone at follow-up. Larger studies with more ethnically diverse groups are needed to confirm these results.

Authors+Show Affiliations

Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, 22030, USA.Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada.School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada.Department of Biomedical and Molecular Sciences in the School of Medicine, Queen's University, Kingston, ON, Canada.Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.Winnipeg Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada. hope.weiler@mcgill.ca.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26968165

Citation

Gallo, S, 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." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 27, no. 8, 2016, pp. 2459-66.
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(8):2459-66.
Gallo, S., Hazell, T., Vanstone, C. A., Agellon, S., Jones, G., L'Abbé, M., ... Weiler, H. A. (2016). 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. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(8), pp. 2459-66. doi:10.1007/s00198-016-3549-z.
Gallo S, 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(8):2459-66. PubMed PMID: 26968165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Gallo,S, AU - Hazell,T, AU - Vanstone,C A, AU - Agellon,S, AU - Jones,G, AU - L'Abbé,M, AU - Rodd,C, AU - Weiler,H A, Y1 - 2016/03/11/ PY - 2015/10/30/received PY - 2016/02/22/accepted PY - 2016/3/13/entrez PY - 2016/3/13/pubmed PY - 2018/3/23/medline KW - 25-hydroxyvitamin D KW - Bone mineral KW - Bone mineral accretion KW - Dual-energy x-ray absorptiometry KW - Infants KW - Pediatrics KW - Supplementation KW - Vitamin D SP - 2459 EP - 66 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 27 IS - 8 N2 - UNLABELLED: Whether infant vitamin D supplementation may have long-term bone benefits is unclear. In this study, breastfed infants who received vitamin dosages greater than 400 IU/day did not have higher bone mineralization at 3 years. This study provides important data to inform pediatric public health recommendations for vitamin D. INTRODUCTION: North American health agencies recommend breastfed infants should be supplemented with 400 IU of vitamin D/day to support bone health. Few studies examined the long-term benefits of early life vitamin D supplementation on bone mineralization. The objective of this study was to determine if a dose-response relationship exists between infant vitamin D supplementation, vitamin D status, and bone outcomes at 3 years of age. METHODS: This was a double-blind randomized trial of 132, 1-month-old healthy, breastfed infants from Montréal, Canada, between 2007 and 2010. In this longitudinal analysis, 87 infants (66 %) returned for follow-up at 3 years of age, between 2010 and 2013. At 1 month of age, participants were randomly assigned to receive oral cholecalciferol (vitamin D3) supplements of 400, 800, 1200, or 1600 IU/day until 12 months of age. Lumbar spine vertebrae 1-4 (LS) bone mineral density (BMD), LS and whole body bone mineral content (BMC), and mineral accretion were measured by dual-energy x-ray absorptiometry at 3 years. RESULTS: At follow-up, the treatment groups were similar in terms of diet, sun exposure, and demographics. There were no significant differences among the groups in LS or whole body BMC, BMD, or accretion. Although, 25(OH)D concentrations were not different among the groups, higher doses (1200 and 1600 IU/day) achieved higher 25(OH)D area under the curve from 1 to 36 months vs. 400 IU/day. CONCLUSIONS: This is the first longitudinal follow-up of an infant vitamin D dose-response study which examines bone mineralization at 3 years of age. Dosages higher than 400 IU/day do not appear to provide additional benefits to the bone at follow-up. Larger studies with more ethnically diverse groups are needed to confirm these results. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26968165/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_ L2 - https://dx.doi.org/10.1007/s00198-016-3549-z DB - PRIME DP - Unbound Medicine ER -