Vitamin D dose size should increase with body weight (Cystic Fibrosis in this case) – Nov 2018

Vitamin D intake, serum 25-hydroxy vitamin D and pulmonary function in paediatric patients with cystic fibrosis: a longitudinal approach.

Br J Nutr. 2018 Nov 16:1-7. doi: 10.1017/S0007114518003021. [Epub ahead of print]

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Overview Obesity and Vitamin D contains the following summary

Obese need more Vitamin D
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  • Normal weight     Obese     (50 ng = 125 nanomole)

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  • Normal weight     Obese     (50 ng = 125 nanomole)

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Timmers NKLM1, Stellato RK2, van der Ent CK3, Houwen RHJ1, Woestenenk JW1.
1 1Department of Paediatric Gastroenterology,University Medical Centre Utrecht,KE.04.133.1,P.O. Box 85500,3508 GA Utrecht,The Netherlands.
2 Department of Biostatistics, Julius Centre,University Medical Centre Utrecht,STR.6.131,P.O. Box 85500,3508 GA Utrecht,The Netherlands.
3 Cystic Fibrosis Centre,University Medical Centre Utrecht,KH.01.419.0,P.O. Box 85500,3508 GA Utrecht,The Netherlands.

Pancreatic-insufficient children with cystic fibrosis (CF) receive age-group-specific vitamin D supplementation according to international CF nutritional guidelines.

The potential advantageous immunomodulatory effect of serum 25-hydroxy vitamin D (25(OH)D) on pulmonary function (PF) is yet to be established and is complicated by CF-related vitamin D malabsorption. We aimed to assess whether current recommendations are optimal for preventing deficiencies and whether higher serum 25(OH)D levels have long-term beneficial effects on PF. We examined the longitudinal relationship between vitamin D intake, serum 25(OH)D and PF in 190 CF children during a 4-year follow-up period. We found a significant relationship between total vitamin D intake and serum 25(OH)D (β = 0·02; 95 % CI 0·01, 0·03; P = 0·000). However, serum 25(OH)D decreased with increasing body weight (β = -0·79; 95 % CI -1·28, -0·29; P = 0·002). Furthermore, we observed a significant relationship between serum 25(OH)D and forced expiratory volume in 1 s (β = 0·056; 95 % CI 0·01, 0·102; P = 0·018) and forced vital capacity (β = 0·045; 95 % CI 0·008, 0·082; P = 0·017). In the present large study sample, vitamin D intake is associated with serum 25(OH)D levels, and adequate serum 25(OH)D levels may contribute to the preservation of PF in children with CF.

Furthermore, to maintain adequate levels of serum 25(OH)D, vitamin D supplementation should increase with increasing body weight. Adjustments of the international CF nutritional guidelines, in which vitamin D supplementation increases with increasing weight, should be considered.

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