1. A daily 5000IU vs. weekly 50,000IU Vitamin D supplementation to Vitamin D deficient obese children: a head to head comparison Deborah Preston and Yoram Elitsur, MD Department of Pediatrics, Gastroenterology Division, Marshall University Joan C Edwards School of Medicine
Hypothesis
To compare between 2 doses of Vitamin D supplementation in a cohort of obese children from WV.
Background
Vitamin D deficiency is a common finding among American children especially those with obesity. Vitamin D deficiency has been associated with obesity related complications including NAFLD and metabolic syndrome. The dose of Vitamin D supplementation recommended for normal healthy children has been reported but there are no guidelines aimed towards children with high risk conditions to develop Vitamin D deficiency such as: obesity, ethnicity, low sun exposure and others.
Methods
Obese children who attended the pediatric clinic were prospectively recruited.
Exclusion criteria included children who have malabsorption conditions, endocrine pathology involving the parathyroid system or various calcium metabolic problems.
Serum Vitamin D levels were measured in all obese children and those with Vitamin D deficiency (defined as level <20ng/ml) were randomly assigned to one of two supplementation groups: 5000 IU/day (Group A) and 50,000 IU/wk (Group B).
Supplementation was provided to all participants for the duration of the study.
Compliance was assessed by weekly telephone calls and pill counts at 1 month and the completion of the study.
Repeat Vitamin D levels were checked upon completion of the treatment at 2 months.
Results
Vitamin D levels were measured in 50 obese children;4 (8%) had normal levels (>30ng/ml), 13 (26%) were insufficient (20-30ng/ml), and 33 (66%) were deficient (<20ng/ml).
A total of 24 children composed our study (15 - Group A; 9 - Group B).
Seven children declined participation and 2 were non-compliant with protocol and were not included in the study groups.
All children except 2 (group A) achieved adequate serum levels (>30ng/ml).
None had Vitamin D toxicity or abnormal serum calcium levels.
There was a significant difference in Vitamin D levels noted between the groups.
Conclusion
Vitamin D supplementation at a dose of 5000IU/d is not as effective as 50000IU/wk. Both doses are safe and should be recommended to obese children but the higher dose is less likely to result in insufficient levels after treatment.
References
C B Turer, H Lin, and G Flores. Prevalence of Vitamin D Deficiency among overweight and Obese US Children. Pediatrics. 2013; 131;e152
C Braegger, C Campoy, V Colomb, T Decsi, M Domellof, M Fewtrell, I Hojsak, W Mihatsch, C Molgaard, R Shamir, D Turk, and J van Gouldoever on behalf of the ESPHGHAN Committee on Nutrition. Vitamin D in the Healthy European Paediatric Population. JPGN. June :6,
A Kelly, D Prasad, S A Rubin, A R Lauff, B S Zemel, and S N Magge. Vitamin D supplementation with 1000 IU vs 5000 IU in obese, African American, Vitamin D deficient adolescents. Presented at the PAS meeting (Unpublished as of present)
Results
Total Pts. 50
Normal
4 (8%)
Insufficient
13 (26%)
Deficient
33 (66%)
Deficient
33 (66%)
Declined - 7
Failed –2 (NC)
Group A
5,000 IU
Daily 15
Still in Tx 2
Completed Tx 13
≤ 30 ng/mL
≥ 30 ng/mL 11
Group B
50,000 IU
Once Weekly 9
Mean Serum Levels
# Patients
Vitamin D Mean (± SD)
p-value 13
(Group A)
5000 IU
40.19
± 2.999
0.0185 9
(Group B)
50,000 IU
52.09
± 3.506