Journal of Pediatric Nursing, Vol 38, Jan–Feb 2018, Pages 20–26, https://doi.org/10.1016/j.pedn.2017.10.005
Linda Cheng,
Highlights
• Obesity is a strong risk factor for vitamin D deficiency.
• Vitamin D deficiency in obese children is predictive of metabolic syndrome.
• The pediatric nurse should prevent, screen for, assess for, treat, and counsel on VDD.
Unfortunately, the publication is not very up-to-date
- No recommendation for time in the sun
- No mention that other forms of Vitamin D bioavailable Vitamin D
- No mention that most countries still do not fortify milk or other foods
- No mention that low-fat milk has 2.5X less bio-available Vitamin D
- No mention of increased needs for high risk categories such as dark skin
- No change of Vitamin D dose with age (age 1-18)
600 IU up to age 18 for any normal weight
1200-1800 IU for age 18 - if obese - independent of actual weight - Recommends Vitamin D2 and well as D3
- Considers sufficient vitamin D level to be just 20 ng/mL
Items in both categories Obesity and Infant-Child are listed here:
- Childhood BMI decreased when add Vitamin D (Note: less than half of the studies used more than 600 IU) – meta-analysis March 2023
- Child Obesity and Vitamin D - many studies
- Recent increases in pediatric endocrine problems may be decreased by Vitamin D – Aug 2022
- Obese during childhood usually results in obese adult (M.R., not a surprise) - Aug 2022
- Less obese child if supplemented with Vitamin D as an infant– meta-analysis Feb 2021
- Obese children had 2.2 X less response to a single dose of Vitamin D – Oct 2020
- Little weight loss in obese children from very small amount of vitamin D (1200 IU) – RCT April 2020
- Increased weight in children 8X more likely for each unit increase in adenovirus (if ignore Vitamin D) – Nov 2019
- Obesity 3X more likely in US children having low vitamin D – July 2019
- Overweight children are 3.4 X more likely to have low Vitamin D – March 2019
- Indoor pollution is a problem with obese black asthmatic children – May 2018
- Severe Non-Alcoholic fatty liver disease treated by Omega-3 – RCT April 2018
- The Convergence of Two Epidemics: Vitamin D Deficiency in Obese School-aged Children – Jan 2018
- Fatty liver disease in children nicely treated by combination of Vitamin D and Omega-3 – RCT Dec 2016
- Omega-3 in infancy reduces Obesity following antibiotic (confirmed in rats, suspected in humans) – Feb 2016
- Vitamin D deficiency and childhood obesity: interactions, implications, and recommendations (5,000 IU) – Feb 2016
- Obese children – 71 percent had low vitamin D– Jan 2016
- Infant risk of obesity increased by 50 percent if low vitamin D during pregnancy – Sept 2015
- Obese children and youths need more vitamin D – Review Feb 2015
- Overweight children associated with low vitamin D during pregnancy – 2015, 2018
- Higher vitamin D at birth associated with less diabetes and obesity 35 years later – Jan 2014
- More Hypertension in obese children with low vitamin D, especially at night – Dec 2013
- Very poor follow-thu with vitamin D testing and supplementation of obese children – June 2013
- Obese children gain weight more quickly when have low vitamin D – Oct 2013
- Obese mothers with adequate vitamin D gave birth to low D and fat infants – Jan 2013
- Heavier kids more vitamin D deficient, especially if dark skinned – Pediatrics Dec 2012
- Obese children with celiac disease had lower levels of vitamin D – April 2012
- The more vitamin D the lower the infant BMI – March 2011
- Obama task force told that childhood Obesity linked to Vitamin D Deficiency – Aug 2010
Items in both categories Obesity and Youth are listed here:
- Child Obesity and Vitamin D - many studies
- Based on PTH response, obese adolescents may not need and much vitamin D as non-obese (12 ng vs 16.5 ng) – June 2021
- Overweight children are 3.4 X more likely to have low Vitamin D – March 2019
- Half of obese black teens achieved at least 30 ng of Vitamin D with 5,000 IU daily – June 2018
- The Convergence of Two Epidemics: Vitamin D Deficiency in Obese School-aged Children – Jan 2018
- Obese children – 71 percent had low vitamin D– Jan 2016
- 5,000 IU daily or 50,000 IU Vitamin D weekly repleted many dark skinned adolescents – RCT Dec 2015
- Obese children and youths need more vitamin D – Review Feb 2015
- Obese teens need more than 2,000 IU of vitamin D for 3 months– RCT Feb 2015
- Vitamin D deficiency 4X more likely in Italian teens if: dark skin, winter, obese, little sun, or use sunscreen – June 2014
- Increasing time with indoor media, prescribe time outdoors - Sept 2013
- Italian youth vitamin D deficiency increased likelihood: 27X if winter, 5X if obese, etc. – Aug 2013
- 3X more abdominal obesity among Korean children having low vitamin D – July 2012
- Korean teens more likely to be obese if have less than 18 ng of vitamin D – June 2012
- Bariatric surgery less than 30 ng of vitamin D – 82 pcnt teens, 100 pcnt of black teens – June 2012
- Teen obesity strongly associated with vitamin D deficiency – April 2012
- Obesity lowers vitamin D which increases probability of diabetes in children – Nov 2011
- Obese teens needed 4000 IU of vitamin D - Nov 2011
- Black obese children had low vitamin D and more fat under skin than whites – Mar 2011
- Increased forearm fractures in obese children - Nov 2010
- Perhaps low vitamin D increases child obesity - Sept 2010
- Obesity in American-Indians and African-American teens
- Low vitamin D in teens: especially black or overweight – June 2010
- Calcium deficiency is a risk factor for overweight female teenagers April 2010
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Problem: Vitamin D deficiency (VDD) and obesity are two interrelated global epidemics that affect school-aged children. This article will review the relationship between VDD and obesity in school-aged children and implications it has for the pediatric nurse (PN).
Eligibility criteria: Original articles of studies, review articles and meta-analyses were selected from the past 5 years and pooled for review. These included obese school-aged children who had vitamin D insufficiency. The latest guidelines concerning the issue were also included.
Sample: Children 6–12 years of age with obesity and vitamin D insufficiency.
Results: This review strongly implies obesity in children being a strong risk factor for VDD. Prevention of VDD starts with lifestyle changes and adequate dietary intake of fortified foods and current screening recommendations for VDD are inconsistent. Vitamin D supplementation is recommended with inadequate intake or deficient serum 25-hydroxyvitamin D levels or signs of hypocalcemia. Supplementation doses differ based on whether VDD is being prevented or being treated and in obese children, the Endocrine Society recommends a dose that is two to three times higher than for normal weight children. Subclinical signs and symptoms of VDD include musculoskeletal pain, fractures, reduced bone density and reduced immunity.
Conclusions: Whereas obesity is a strong risk factor for VDD, more research is needed to clarify the role of VDD as a risk factor for obesity.
Implications: The PN plays an essential role in preventing, screening for, assessing for, treating and counseling on VDD in obese school-aged children.