Calcium and Vitamin D Supplementation to Improve Linear Growth in Children

P. Ramachandran, Anshu Sharma, H. Gopalan
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Abstract

In India, the prevalence of vitamin D deficiency as assessed by vitamin D levels below 20 ng/ml is high across the country, in all socio-economic, age and sex groups. Studies from India have documented that prevalence of vitamin D deficiency is high in breast-fed infants. Stunting in young children continues to be a major public health problem in India. It is possible that in addition to low birth weight and chronic energy deficiency, vitamin D deficiency may contribute to the high stunting rates in breast-fed Indian children. If this were so, vitamin D supplementation may reduce the magnitude of linear growth retardation in the first two years of life. A community-based randomised, double-blind supervised daily supplementation of 250 mg of calcium and 250 IU of Vitamin D (Group A) or placebo (Group B) to breast-fed infants from the first month up to 23 months of age was undertaken to assess the impact, if any, of vitamin D supplementation on linear growth in children and height attained at 23 months. At enrolment, there were no significant differences in weight, length and BMI between infants belonging to Group A or Group B. There were no significant differences in infant and young child feeding practices, morbidity due to infection, or linear growth and height attained at 23 months between Group A and Group B. These data suggest that daily supplementation of calcium and vitamin D between 0-23 months did not have any significant impact on linear growth of children from urban low middle income families.
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补充钙和维生素D促进儿童线性生长
在印度,根据维生素D水平低于20纳克/毫升的评估,维生素D缺乏症的流行率在全国各地,在所有社会经济、年龄和性别群体中都很高。来自印度的研究表明,母乳喂养的婴儿维生素D缺乏症的患病率很高。在印度,幼儿发育迟缓仍然是一个主要的公共卫生问题。除了低出生体重和慢性能量缺乏外,维生素D缺乏可能是母乳喂养的印度儿童发育迟缓率高的原因之一。如果是这样的话,补充维生素D可能会减少生命最初两年线性生长迟缓的程度。一项以社区为基础的随机、双盲、监督的研究对母乳喂养的婴儿从第一个月到23个月每天补充250毫克钙和250国际单位维生素D (A组)或安慰剂(B组),以评估维生素D补充对儿童线性生长和23个月时达到的身高的影响。在入组时,A组和b组婴儿的体重、身高和BMI均无显著差异。在婴幼儿喂养方式、感染发病率、这些数据表明,在0-23个月期间每天补充钙和维生素D对城市中低收入家庭儿童的线性生长没有任何显著影响。
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