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24 Vitamin D global guidelines for children, huge diversity – Sept 2022

Evaluation of the clinical practice guidelines and consensuses on calcium and vitamin D supplementation in healthy children using the Appraisal of Guidelines for Research and Evaluation II instrument and Reporting Items for Practice Guidelines in Healthcare statement

Front Nutr. 2022 Sep 27;9:984423.doi: 10.3389/fnut.2022.984423
Lanzhi He 1 2 , Pengxiang Zhou 1 3 , Xin Zhou 4 , Shuxia Tian 1 5 , Jing Han 1 6 , Suodi Zhai 1 3

Background: This study aimed to assess the methodological and reporting quality of the guidelines and consensus on calcium and vitamin D supplementation in healthy children, and the consistency of these recommendations.

Methods: A systematic search of relevant guideline websites and databases, including PubMed, Embase, CNKI, WangFang, and SinoMed, was undertaken from inception to April 7, 2021, by two independent reviewers who assessed the eligible guidelines using the validated Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) tools. Overall, the between-reviewer agreement was evaluated using an intra-class correlation coefficient.

Results: A total of 24 guidelines and consensuses from 2002 to 2022 were identified from China, the United States, Canada, France, Australia, New Zealand, Europe, and other countries and regions. These were of mixed quality, and scored poorly in the rigor of development, editorial independence, and applicability of the domains of AGREE II. Among the seven domains of the RIGHT checklist, domain one (basic information) had the highest reporting rate (69.3%), whereas domain five (review and quality assurance) had the lowest reporting rate (11.5%). The overall quality of the included guidelines and consensuses was low.
Only 12 guidelines were recommended, with modifications. The recommended calcium intake for children of different ages varies greatly (400-1,150 mg/day).
Among the included guidelines and consensuses, a vitamin D (VD) prevention dose of 400 IU/day in infants was generally considered safe, and 25-hydroxyvitamin-D [25(OH)D] levels of <20 ng/mL (50 nmol/L) or 20-30 ng/mL (50-75 nmol/L) indicated VD deficiency or insufficiency.
However, the recommended amount of VD for children of different age groups and risk strata differed considerably (400-4,000 IU/day or 10-100 μg/day). The choice of VD2 or VD3 supplements and sunlight exposure also differed across the guidelines and consensuses.

Conclusion: There is considerable variability in calcium and VD guidelines and consensus development methods in calcium and VD supplementation for healthy children. Therefore, efforts are necessary to strengthen the methodological rigor of guideline development and utilize the best available evidence
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VitaminDWiki - Consensus Vitamin D category contains

68 Vitamin D consensus publications

VitaminDWiki - Optimum category contains

The RDA is barely enough for the bones to survive.
   Need an optimal level for the body to thrive

99 items in Optimum Vitamin D category

Example pages


Dose size needed per individual varies by 4X

  1. Amount needed varies with weight
    perhaps 100 IU per 1 kg infant, 1000 IU per 10kg child
  2. Preemies need much larger doses (45 studies as of Oct 2022
    10% of all births are preemies - yet recommendations rarely consider preemies
  3. Amount needed varies with skin color
  4. Amount needed varies with genes
  5. Amount needed varies with heallth problem to be prevented
  6. Amount needed varies with heallth problem to be treated
  7. Amount needed increases if poor gut if not use a gut-friendly form

11+ CALL FOR ACTION in VitaminDWiki titles

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Items found: 11

Created by admin. Last Modification: Wednesday February 7, 2024 22:22:56 GMT-0000 by admin. (Version 11)

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18650 Child dosing_CompressPdf.pdf admin 17 Oct, 2022 468.27 Kb 196