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Infants getting up to 1600 IU did not increase blood level of vitamin D – RCT March 2016

Vitamin D supplementation in breastfed infants from Montréal, Canada: 25-hydroxyvitamin D and bone health effects from a follow-up study at 3 years of age.

Osteoporos Int. 2016 Mar 11. [Epub ahead of print]
Gallo S1, Hazell T2, Vanstone CA3, Agellon S3, Jones G4, L'Abbé M5, Rodd C6, Weiler HA7.
Author information
1Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, 22030, USA.
2Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
3School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada.
4Department of Biomedical and Molecular Sciences in the School of Medicine, Queen's University, Kingston, ON, Canada.
5Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
6Winnipeg Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.
7School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, Québec, H9X 3V9, Canada. hope.weiler at mcgill.ca.


Whether infant vitamin D supplementation may have long-term bone benefits is unclear. In this study, breastfed infants who received vitamin dosages greater than 400 IU/day did not have higher bone mineralization at 3 years. This study provides important data to inform pediatric public health recommendations for vitamin D.

INTRODUCTION:
North American health agencies recommend breastfed infants should be supplemented with 400 IU of vitamin D/day to support bone health. Few studies examined the long-term benefits of early life vitamin D supplementation on bone mineralization. The objective of this study was to determine if a dose-response relationship exists between infant vitamin D supplementation, vitamin D status, and bone outcomes at 3 years of age.

METHODS:
This was a double-blind randomized trial of 132, 1-month-old healthy, breastfed infants from Montréal, Canada, between 2007 and 2010. In this longitudinal analysis, 87 infants (66 %) returned for follow-up at 3 years of age, between 2010 and 2013. At 1 month of age, participants were randomly assigned to receive oral cholecalciferol (vitamin D3) supplements of 400, 800, 1200, or 1600 IU/day until 12 months of age. Lumbar spine vertebrae 1-4 (LS) bone mineral density (BMD), LS and whole body bone mineral content (BMC), and mineral accretion were measured by dual-energy x-ray absorptiometry at 3 years.
RESULTS:
At follow-up, the treatment groups were similar in terms of diet, sun exposure, and demographics. There were no significant differences among the groups in LS or whole body BMC, BMD, or accretion. Although, 25(OH)D concentrations were not different among the groups, higher doses (1200 and 1600 IU/day) achieved higher 25(OH)D area under the curve from 1 to 36 months vs. 400 IU/day.
CONCLUSIONS:
This is the first longitudinal follow-up of an infant vitamin D dose-response study which examines bone mineralization at 3 years of age. Dosages higher than 400 IU/day do not appear to provide additional benefits to the bone at follow-up. Larger studies with more ethnically diverse groups are needed to confirm these results.

PMID: 26968165

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