Supplementation with 1000 IU vitamin D/d leads to parathyroid hormone suppression, but not increased fractional calcium absorption, in 4-8-y-old children: a double-blind randomized controlled trial.

BACKGROUND The effects of vitamin D supplementation in healthy prepubertal children on physiologic outcomes have not been investigated. OBJECTIVE The objective was to evaluate the effects of supplementation with 1000 IU vitamin D(3)/d on calcium absorption. DESIGN In a double-blind, placebo-controlled trial, we randomly assigned 64 children to 1000 IU vitamin D(3)/d (n = 32) or placebo (n = 32) for 8 wk. Stable isotopes were used to assess calcium absorption. The main outcome measure was calcium absorption before and after supplementation. RESULTS All of the data are shown as means ± SDs. At baseline, vitamin D intake was 221 ± 79 IU/d and calcium intake was 830 ± 197 mg/d. Baseline serum 25-hydroxyvitamin D [25(OH)D] was not significantly correlated with fractional or total calcium absorption. After 8 wk, with baseline values used as a covariate, no differences were seen in fractional or total calcium absorption based on supplementation group (P = 0.75 and 0.36, respectively). Supplemented children had a significant increase in 25(OH)D concentrations (from 27.7 ± 7.4 to 36.0 ± 10.3 ng/mL; P < 0.0001) and a decrease in parathyroid hormone (from 21.4 ± 10.4 to 12.9 ± 7.1 pg/mL; P < 0.001); no significant changes in the placebo group were observed. No adverse side effects were noted in either group. CONCLUSIONS Vitamin D(3) supplementation at 1000 IU/d increases 25(OH)D and decreases parathyroid hormone in children with average vitamin D intakes below the dietary recommendations of the Institute of Medicine. However, no significant effects of this change on calcium absorption occurred. This trial was registered at clinicaltrials.gov as NCT 00868738.

[1]  Christine L. Taylor,et al.  IOM committee members respond to Endocrine Society vitamin D guideline. , 2012, The Journal of clinical endocrinology and metabolism.

[2]  C. Gordon,et al.  Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. , 2011, The Journal of clinical endocrinology and metabolism.

[3]  Christine L. Taylor,et al.  Dietary Reference Intakes for Calcium and Vitamin D , 2016, Pediatric Clinical Practice Guidelines & Policies.

[4]  G. McCabe,et al.  Daily supplementation with 25 μg cholecalciferol does not increase calcium absorption or skeletal retention in adolescent girls with low serum 25-hydroxyvitamin D. , 2010, The Journal of nutrition.

[5]  C. Gordon,et al.  An inflection point of serum 25-hydroxyvitamin D for maximal suppression of parathyroid hormone is not evident from multi-site pooled data in children and adolescents. , 2010, The Journal of nutrition.

[6]  G. McCabe,et al.  Vitamin D status and calcium metabolism in adolescent black and white girls on a range of controlled calcium intakes. , 2008, The Journal of clinical endocrinology and metabolism.

[7]  S. Abrams,et al.  Adolescence: How do we increase intestinal calcium absorption to allow for bone mineral mass accumulation? , 2007 .

[8]  W. Willett,et al.  The urgent need to recommend an intake of vitamin D that is effective. , 2007, The American journal of clinical nutrition.

[9]  M. Holick The vitamin D epidemic and its health consequences. , 2005, The Journal of nutrition.

[10]  S. Abrams,et al.  Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents. , 2005, The Journal of clinical endocrinology and metabolism.

[11]  B. Hollis Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. , 2005, The Journal of nutrition.

[12]  S. Abrams,et al.  Calcium absorption, bone mass accumulation, and kinetics increase during early pubertal development in girls. , 2000, The Journal of clinical endocrinology and metabolism.

[13]  S. Abrams Using stable isotopes to assess mineral absorption and utilization by children. , 1999, The American journal of clinical nutrition.

[14]  S. Abrams,et al.  Vitamin D Receptor Gene Fok1 Polymorphism Predicts Calcium Absorption and Bone Mineral Density in Children , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[15]  S. Abrams,et al.  Calcium absorption and kinetics are similar in 7- and 8-year-old Mexican-American and Caucasian girls despite hormonal differences. , 1999, The Journal of nutrition.