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Effect of free vitamin D2 drops on serum 25-hydroxyvitamin D in infants with immigrant origin: a cluster randomized controlled trial

Abstract

Background/Objective:

To study whether a free supply of vitamin D2 drops to 6-week-old infants together with tailor-made information handouts improves the vitamin D status after 7 weeks in the intervention group compared to a control group.

Subjects/Methods:

In this cluster randomized controlled trial in eight child health clinics in Oslo, Norway, 66 healthy infants with Pakistani, Turkish or Somali background were included. The intervention group received daily supplementation of vitamin D drops containing 10 μg (400 IU) of ergocalciferol (vitamin D2) with a tailor-made information brochure about vitamin D and its sources, and instruction on how to administer the drops. They were compared to a control group receiving usual care. The principal outcome measure was increase in serum 25-hydroxyvitamin D (S-25OHD) 7 weeks later. S-25OHD was analyzed by high-performance liquid chromatography-ultraviolet-mass spectrometry.

Results:

Total 78% (n=51) of the included infants completed the study. At follow-up, S-25OHD was significantly higher in the intervention group than in the control group (93.5 versus 72.7 nmol l−1, P=0.03). The mean increase in S-25OHD adjusted for baseline was 28 nmol l−1 (95% confidence interval 10.9–45.2, P=0.002) higher in the intervention group than in the control group. Among exclusively breastfed infants at baseline, S-25OHD increased by 32.3 nmol l−1 (P=0.035) in the intervention group compared to control group.

Conclusion:

Free supply of vitamin D drops to 6-week-old infants together with tailor-made information handouts significantly improved the vitamin D status of infants with immigrant background compared to usual care.

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References

  • Andiran N, Yordam N, Ozon A (2002). Risk factors for vitamin D deficiency in breast-fed newborns and their mothers. Nutrition 18, 47–50.

    Article  CAS  Google Scholar 

  • Armas L, Hollis B, Heany R (2004). Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab 89, 5387–5391.

    Article  CAS  Google Scholar 

  • Atiq M, Suria A, Nizami SQ, Ahmed I (1998). Vitamin D status of breastfed Pakistani infants. Acta Paediatr 87, 737–740.

    Article  CAS  Google Scholar 

  • Brunvand L, Brunvatne R (2001). Health problems among immigrant children in Norway. Tidsskr Nor Laegeforen 121, 715–718.

    CAS  PubMed  Google Scholar 

  • Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R (2003). Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr 142, 169–173.

    Article  CAS  Google Scholar 

  • Gartner LM, Greer FR (2003). Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 111, 908–910.

    Article  Google Scholar 

  • Global Strategy for Infant and Young Child Feeding (2003). World Health Organization: Geneva (http://www.who.int/nutrition/topics/global_strategy/en/).

  • Hanley JA, Negassa A, Edwardes MD, Forrester JE (2003). Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol 157, 364–375.

    Article  Google Scholar 

  • Holvik K, Meyer HE, Haug E, Brunvand L (2005). Prevalence and predictors of vitamin D deficiency in five immigrant groups living in Oslo, Norway: the Oslo Immigrant Health Study. Eur J Clin Nutr 59, 57–63.

    Article  CAS  Google Scholar 

  • Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ et al. (2006). Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet 367, 36–43.

    Article  CAS  Google Scholar 

  • Kreiter SR, Schwartz RP, Kirkman Jr HN, Charlton PA, Calikoglu AS, Davenport ML (2000). Nutritional rickets in African American breast-fed infants. J Pediatr 137, 153–157.

    Article  CAS  Google Scholar 

  • Lande B, Andersen LF, Baerug A, Trygg KU, Lund-Larsen K, Veierod MB et al. (2003). Infant feeding practices and associated factors in the first six months of life: the Norwegian Infant Nutrition Survey. Acta Paediatr 92, 152–161.

    Article  CAS  Google Scholar 

  • Lips P (2007). Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103, 620–625.

    Article  CAS  Google Scholar 

  • Meyer HE, Falch JA, Sogaard AJ, Haug E (2004). Vitamin D deficiency and secondary hyperparathyroidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway, The Oslo Health Study. Bone 35, 412–417.

    Article  CAS  Google Scholar 

  • Nordic Nutrition Recommendations (2004). Integrating Nutrition and Physical Activity, 4th edn. Nordic Council of Ministers: Copenhagen, Denmark (http://www.norden.org/pub/velfaerd/livsmedel/sk/N2004013.pdf).

  • The Norwegian Directorate of Health and Social Affairs (2001). Infant Feeding Recommendations 2001 (in Norwegian). The Norwegian Directorate of Health and Social Affairs: Oslo, Norway.

  • Thomson K, Morley R, Grover SR, Zacharin MR (2004). Postnatal evaluation of vitamin D and bone health in women who were vitamin D-deficient in pregnancy, and in their infants. Med J Aust 181, 486–488.

    PubMed  Google Scholar 

  • Vickers AJ, Altman DG (2001). Statistics notes: analysing controlled trials with baseline and follow up measurements. BMJ 323, 1123–1124.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank all mothers, health visitors and members of the study advisory group Leif Brunvand, Aud Haugen, Else-Karin Grøholt and Kirsten Berge, our child health clinics coordinator, for their help with the study. We also thank Magne Thoresen, University of Oslo for conducting the independent statistical analysis of the primary outcomes. This study was funded by the Directorate for Health and Social Affairs. The views and opinions expressed do not necessarily reflect those of the Directorate for Health and Social Affairs.

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Correspondence to H E Meyer.

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Guarantor: HE Meyer.

Contributors: AAM carried out the data collection, performed data analysis and prepared the manuscript. HEM developed the study protocol, secured initial funding and assisted in the analysis of the data. K-IK and HEM supervised the study. All authors commented on the draft, contributed to the interpretation of the findings and approved the final version of the manuscript.

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Madar, A., Klepp, KI. & Meyer, H. Effect of free vitamin D2 drops on serum 25-hydroxyvitamin D in infants with immigrant origin: a cluster randomized controlled trial. Eur J Clin Nutr 63, 478–484 (2009). https://doi.org/10.1038/sj.ejcn.1602982

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