Is daily 400 IU of vitamin D supplementation appropriate for every country: a cross-sectional study.

backgroundVitamin D deficiency in childhood is a significant problem worldwide. Religious, social customs, and lack of food fortification were significant hurdles in the way of the rickets scourge. Recent data support a serum level of 25(OH)D level > 40 ng/mL as the appropriate standard to achieve to prevent rickets. Herein, the current approaches of preventing rickets and optimal level of different vitamin D intakes were evaluated.

methodsA total of 148 fully breastfed, healthy children between age of 2-24 months were investigated by screening serum 25(OH)D from April 1 to May 31, 2006. Three groups were composed according to ages (2-6, 6-12, 12-24 months), and those groups were paired with three subgroups established according to vitamin D intake of ≤300, 400, and 600 IU/day. Vitamin D status was evaluated with regard to cut-off value of 15 ng/mL and 40 mg/dL. The clothing types and vitamin D supplementation of mothers were recorded.

resultsWe found that 27.3% of cases in 2-6 months, 8.3% in 6-12 months and 30% in 12-24 months had 25(OH)D <15 ng/mL and 54.5, 33.3, and 50% of cases were <40 ng/dL with 400 IU/day vitamin D intake. With 600 IU/day supplementation, 14.3, 10.3, and 4.8% of cases had 25(OH)D <15 ng/mL, respectively.

conclusionVitamin D intake of 400 IU/day seems to be favorable at the first year in breastfed children but vitamin D deficiency was still evident after prophylaxis. Vitamin D supplementation should be at least 600 IU/day in Turkey, and nutrition policy should focus on the food fortification with vitamin D.