Cochrane review of Vitamin D and stunting will be ignoring 9 important concerns

The effects of oral vitamin D supplementation on linear growth and non-communicable diseases among infants and children younger than five years of age

Extensive description of how the review of Randomized controlled trials will be conducted

Important concerns that they appear to be ignoring

1. Vitamin D taken during pregnancy

2. Type of vitamin D given

   • Infants will reject Vitamin D oils which they cannot digest
   • There are many other forms of vitamin, such as gut friendly and topical

3. Cofactors which are known to improve growth – such as Magnesium and Omega-3

4. How soon after birth were supplements started

   • Day zero, day 10, month 1, month 12 . . .

5. Extra vitamin D needed if infant is a preemie, unhealthy, etc,

6. Does the dose size vary with infant weight

7. Was the mother breastfeeding, and if so, was she supplementing

8. If using formula, was the formula fortified - was the formula low fat (2.5 X less vitamin D gets into the infant)

9. The vitamin D level achieved by the infant

   • They appear to be only looking at dosing, and ignoring response to the dose

10. Skin color of the infant - dark skin infants often need much larger doses

11. Was the infant given enough time in the noon-day sun to generate Vitamin D (> 30 minutes a week)

12. Was Calcium also given

13. Will they be accounting for deaths in the non-supplemented infants?

14. Will they include RCTs with loading doses, injections, monthly doses, etc?

See also VitaminDWiki

• Obese children and youths need more vitamin D – Review Feb 2015

• Preemies, Vitamin D, Omega-3, etc. - several studies

• Low Vitamin D in infants - video interview of Dr. Holick - May 2017

• Rickets needs Vitamin D and Calcium - Global Consensus Jan 2016

• Vitamin D deficiency diseases in dark skinned people living far from equator – Meta-analysis Oct 2013

• Rickets in Norway – 93 percent had darker skin (lower vitamin D) – May 2017

• Post-mortem analysis of children in London Hospital – only 1 child had adequate level of vitamin D – July 2014

• Critically ill children with low vitamin D: 2.5 X more likely to die or stay 2 days longer - meta-analysis Nov 2017

• Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017

• NAFLD in children nicely treated by combination of Vitamin D and Omega-3 – RCT Dec 2016

• Cochrane Reviews might be influenced by big Pharma – 5 board members leave in 1 day – Sept 2018