Lower Respiratory Tract Infection in Infants reduced 5.9 X by daily 600 IU of vitamin D (China)
Association of Vitamin D Supplementation With Respiratory Tract Infection in Infants
Matern Child Nutr, e12987 2020 Mar 5, DOI: 10.1111/mcn.12987
Miao Hong 1, Ting Xiong 1, Junmei Huang 1 2, Yuanjue Wu 1, Lixia Lin 1, Zhen Zhang 1, Li Huang 1, Duan Gao 1, Huanzhuo Wang 1, Chun Kang 1, Qin Gao 1, Xuefeng Yang 1, Nianhong Yang 1, Liping Hao 1
vs no Vitamin D | 0.46 | 0.17 | 0.18 | | 1/Reduced Risk | 2.2 | 5.9 | 5.5 | --- * Respiratory tract infections in childhood – vitamin D is needed, no consensus of how much – Oct 2015 * Respiratory infections reduced by 63 percent with 4000 IU vitamin D daily - RCT Dec 2012 ADULTS * Vitamin D and Respiratory Tract Infections – meta-analysis with charts June 2013 * Vitamin D in respiratory diseases – Spring 2017 * Largest cause of infant deaths is respiratory infections, which is associated with low vitamin D – April 2011 * Respiratory Tract Infection visits 2.5 less likely with vitamin D: Pregnancy 2000 IU, Infant 800 IU – RCT Oct 2014 * Acute lower respiratory infection 5X more frequent with low vitamin D intake – June 2012 * Vitamin D reduces respiratory tract infections by 40 percent– meta-analysis Dec 2012 * Respiratory Virus risk reduced 35 percent by Vitamin D (14,000 IU weekly) – RCT Oct 2018 * Respiratory diseases helped by vitamin D if initially have low level – RCT review Jan 2015 Chinese take few supplements and have low levels of vitamin D * Vitamin D levels from lowest to highest: Middle East, China. India, S EU. N EU – Dec 2019 * Supplement usage - US 50 percent, China 0.7 percent - 2018 * Vitamin D deficiency in China – only 1 in 18 have even 30 ng, fewer if young or female – Feb 2015 Infants also get vitamin D weekly, monthly, or via breastmilk if mother is fortifying * Monthly vitamin D dosing is better than daily dosing for children and elderly (more likely to be taken) – June 2017 * Vitamin D required for breastfed infants – daily or monthly, infant or mother – Jan 2017 * Can start with a loading dose - no need to wait weeks for the benefit
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Vitamin D deficiency has been reported to be associated with respiratory tract infection (RTI). However, evidence regarding the effects of vitamin D supplementation on susceptibility of infants to RTI is limited. In this prospective birth cohort study, we examined whether vitamin D supplementation reduced RTI risk in 2,244 infants completing the follow-up from birth to 6 months of age. The outcome endpoint was the first episode of paediatrician-diagnosed RTI or 6 months of age when no RTI event occurred. Infants receiving vitamin D supplements at a daily dose of 400-600 IU from birth to the outcome endpoint were defined as vitamin D supplementation and divided into four groups according to the average frequency of supplementation: 0, 1-2, 3-4, and 5-7 days/week. We evaluated the relationship between vitamin D supplementation and time to the first episode of RTI with Kaplan-Meier plots. The associations of vitamin D supplementation with infant RTI, Lower RTI (LRTI) , and RTI-related hospitalization were assessed using modified Poisson regression. The median time to first RTI episode was 60 days after birth (95% CI [60, 90]) for infants without supplementation and longer than 6 months of age for infants with supplementation (p < .001).
We observed inverse trends between supplementation frequency and risk of RTI, LRTI, and RTI-related hospitalization (p for trend < .001), with the risk ratios in the 5-7 days/week supplementation group of 0.46 (95% CI [0.41, 0.50]), 0.17 (95% CI [0.13, 0.24]), and 0.18 (95% CI [0.12, 0.27]), respectively. These associations were significant and consistent in a subgroup analysis stratified by infant feeding.