The Journal for Nurse Practitioners. online 17 June 2017, https://doi.org/10.1016/j.nurpra.2017.05.012
Renée L. Davis, DNP, CPNP-PC, Deborah G. Loman, PhD, CPNP-PC, Rebecca A. Lorenz, PhD, RN
• Guidelines lack consensus for vitamin D screening for at-risk adolescents.
• In this study, 91% had low vitamin D according to the definition of the Endocrine Society.
• Using the recommendations of the American Academy of Pediatrics, no adolescent in this study would have been screened.
• Assessing of vitamin D intake and sun exposure is recommended to identify those at risk.
• The highest vitamin D level was found in white non-Hispanics and lowest in black non-Hispanics.
There continues to be no consensus as to
The Vitamin D levels needed (12 ng to 40 ng - or more)
How much should be given (600 to1600 IU for children)
Who needs even more
Which associated nutrients are also needed (Mg, Omega-3, Vitamin K2, etc)
Clinical practice guidelines differ on screening recommendations and definitions for adequate vitamin D levels. A chart review of 32 overweight/obese adolescents showed that 91% had low vitamin D levels based on the Endocrine Society definition of sufficient levels (≥ 30 ng/mL), whereas only 56% were low based on the American Academy of Pediatrics definition of sufficient levels (>20 ng/mL). Nurse practitioners should routinely inquire about exercise, healthy diet, and outdoor activities to identify those at risk for low vitamin D. A consensus in recommendations for vitamin D screening and sufficient serum levels would be beneficial for nurse practitioners for early recognition and consistency in care.