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Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial.
Am J Clin Nutr 2017; 106(1):105-112AJ

Abstract

Background:

Dark skin and low exposure to sunlight increase the risk of vitamin D insufficiency in children.

Objective:

The aim of the study was to evaluate the amount of vitamin D needed to ascertain that most children >4 y of age attain sufficient serum 25-hydroxyvitamin D [S-25(OH)D; i.e., ≥50 nmol/L] during winter regardless of latitude and skin color.

Design:

In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (63°N) and southern (55°N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based vitamin D3 supplements that provided 2 (placebo), 10, or 25 μg/d during 3 winter months.

Results:

Mean daily vitamin D intake increased from 6 to 17 μg and 26 μg in the intervention groups supplemented with 10 and 25 μg, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 μg/d attained sufficient concentrations, whereas 25 μg/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair- and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 μg/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH)D/L, intakes of 6 and 20 μg/d are required in fair-skinned children, whereas 14 and 28 μg/d are required in children with dark skin.

Conclusion:

Children with fair and dark skin require vitamin D intakes of 20 and 28 μg/d, respectively, to maintain S-25(OH)D ≥50 nmol/L, whereas intakes of 6 and 14 μg/d, respectively, are required to maintain concentrations ≥30 nmol/L during winter. This trial was registered at clinicaltrials.gov as NCT01741324.

Authors+Show Affiliations

Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden; and inger.ohlund@umu.se.Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden; and.Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden; and.Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden; and.Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28615261

Citation

Öhlund, Inger, et al. "Increased Vitamin D Intake Differentiated According to Skin Color Is Needed to Meet Requirements in Young Swedish Children During Winter: a Double-blind Randomized Clinical Trial." The American Journal of Clinical Nutrition, vol. 106, no. 1, 2017, pp. 105-112.
Öhlund I, Lind T, Hernell O, et al. Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial. Am J Clin Nutr. 2017;106(1):105-112.
Öhlund, I., Lind, T., Hernell, O., Silfverdal, S. A., & Karlsland Åkeson, P. (2017). Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial. The American Journal of Clinical Nutrition, 106(1), pp. 105-112. doi:10.3945/ajcn.116.147108.
Öhlund I, et al. Increased Vitamin D Intake Differentiated According to Skin Color Is Needed to Meet Requirements in Young Swedish Children During Winter: a Double-blind Randomized Clinical Trial. Am J Clin Nutr. 2017;106(1):105-112. PubMed PMID: 28615261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial. AU - Öhlund,Inger, AU - Lind,Torbjörn, AU - Hernell,Olle, AU - Silfverdal,Sven-Arne, AU - Karlsland Åkeson,Pia, Y1 - 2017/06/14/ PY - 2016/10/10/received PY - 2017/05/09/accepted PY - 2017/6/16/pubmed PY - 2017/8/2/medline PY - 2017/6/16/entrez KW - child KW - intervention KW - latitude KW - season KW - serum 25-hydroxyvitamin D KW - vitamin D SP - 105 EP - 112 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 106 IS - 1 N2 - Background: Dark skin and low exposure to sunlight increase the risk of vitamin D insufficiency in children.Objective: The aim of the study was to evaluate the amount of vitamin D needed to ascertain that most children >4 y of age attain sufficient serum 25-hydroxyvitamin D [S-25(OH)D; i.e., ≥50 nmol/L] during winter regardless of latitude and skin color.Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (63°N) and southern (55°N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based vitamin D3 supplements that provided 2 (placebo), 10, or 25 μg/d during 3 winter months.Results: Mean daily vitamin D intake increased from 6 to 17 μg and 26 μg in the intervention groups supplemented with 10 and 25 μg, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 μg/d attained sufficient concentrations, whereas 25 μg/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair- and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 μg/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH)D/L, intakes of 6 and 20 μg/d are required in fair-skinned children, whereas 14 and 28 μg/d are required in children with dark skin.Conclusion: Children with fair and dark skin require vitamin D intakes of 20 and 28 μg/d, respectively, to maintain S-25(OH)D ≥50 nmol/L, whereas intakes of 6 and 14 μg/d, respectively, are required to maintain concentrations ≥30 nmol/L during winter. This trial was registered at clinicaltrials.gov as NCT01741324. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/28615261/Increased_vitamin_D_intake_differentiated_according_to_skin_color_is_needed_to_meet_requirements_in_young_Swedish_children_during_winter:_a_double_blind_randomized_clinical_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.116.147108 DB - PRIME DP - Unbound Medicine ER -