Vitamin D supplementation for children with cancer: A systematic review and consensus recommendations
Cancer Med. 2021 Jun 8. doi: 10.1002/cam4.4013
Jenneke E van Atteveld 1, Iris E Verhagen 1, Marry M van den Heuvel-Eibrink 1, Hanneke M van Santen 1 2, Inge M van der Sluis 1, Natascia Di Iorgi 3, Jill H Simmons 4, Leanne M Ward 5, Sebastian J C M M Neggers 1 6
Background: Prevalent vitamin D deficiency (VDD) and low bone mineral density (BMD) have led to vitamin D supplementation for children with cancer, regardless vitamin D status. However, it remains unsettled whether this enhances bone strength. We sought to address this issue by carrying out a systematic review of the literature.
Methods: We conducted a literature search using PubMed, Embase, and Cochrane databases. Studies including children up to 5 years after cancer therapy were assessed for the association between 25-hydroxyvitamin D (25OHD) levels and BMD Z-scores or fractures, and the effect of vitamin D supplementation on BMD or fractures. Evidence quality was assessed using the GRADE methodology.
Results: Nineteen studies (16 observational and 3 interventional, mainly involving children with hematologic malignancies) were included. One study which analyzed 25OHD as a threshold variable (≤10 ng/ml) found a significant association between 25OHD levels and BMD Z-scores, while 25OHD as a continuous variable was not significantly associated with BMD Z-scores in 14 observational studies. We found neither a significant association between lower 25OHD levels and fractures (2 studies), nor between vitamin D (and calcium) supplementation and BMD or fracture frequency (3 studies) (very low quality evidence).
Conclusion: There is a lack of evidence for an effect of vitamin D (and calcium) supplementation on BMD or fractures in children with cancer. Further research is needed; until then, we recommend dietary vitamin D/calcium intake in keeping with standard national guidelines, and periodic 25OHD monitoring to detect levels <20 ng/ml. Vitamin D/calcium supplementation is recommended in children with low levels, to maintain levels ≥20 ng/ml year-long.
Cancer during childhood - many studies
Optimum category starts with
The RDA is barely enough for the bones to survive.
Need an optimal level for the body to thrive
Example pages
- Is 50 ng of vitamin D too high, just right, or not enough
- Revisiting Vitamin D Guidelines – Holick Oct 2024 has
- Saudi study defines normal Vitamin D level to be 50 to 70 ng (diabetes, etc.) - June 2020
- Need 40 to 60 ng of Vitamin D – 48 scientists call for action – 2015
- Vitamin D RDA of 600 IU is not enough - global RCT meta-analysis March 2019
- Vitamin D sufficiency 10 to 30 ng, optimal 40 to 80 ng (no consensus)– May 2018
- 4 X fewer visits to Dr. after getting high level of vitamin D (Interview with transcript) - Jan 3, 2022
- Vitamin D sufficiency 10 to 30 ng, optimal 40 to 80 ng (no consensus)– May 2018
- Sports benefits from up to 50 ng of Vitamin – meta-analysis - Nov 2012
- Vitamin D of 32 to 60 ng is needed before, during, and after pregnancy – Dec 2012
- Hypothesis by VitaminDWiki – Vitamin D levels are no longer limited by evolution
- VitaminDWiki pages with HIGH-DOSE in title 878 as of Nov 2024
| 3990 visitors, last modified 11 Jun, 2021, |