Stoss therapy using fortified biscuit for vitamin D-deficient children: a novel treatment

Area of Science:

• Pediatric Endocrinology
• Nutritional Science
• Public Health

Background:

• Vitamin D deficiency is a prevalent issue in children.
• Effective treatment strategies are crucial for achieving optimal vitamin D levels.
• Stoss therapy, a high-dose vitamin D regimen, is used for rapid repletion.

Purpose of the Study:

• To evaluate the efficacy of vitamin D stoss therapy administered via fortified biscuits.
• To compare the effectiveness of biscuit, capsule, and ampoule formulations of vitamin D.
• To assess treatment compliance and outcomes in vitamin D-deficient children.

Main Methods:

• A randomized single-blind clinical trial involving 108 children (30-72 months) with vitamin D deficiency.
• Three groups received vitamin D: fortified biscuit (BG), capsule (CG), or intramuscular ampoule (AG).
• All formulations delivered 50,000 IU cholecalciferol twice weekly for 3 weeks, except for a single 300,000 IU ampoule dose.

Main Results:

• All treatment methods increased mean serum 25(OH)D concentrations.
• Significant differences in mean serum 25(OH)D were observed between the ampoule and biscuit groups (P=0.012).
• No significant differences were found between ampoule and capsule (P=0.3) or capsule and biscuit (P=0.62) groups.

Conclusions:

• Vitamin D-fortified biscuits represent a viable and potentially more compliant alternative for stoss therapy in children.
• This method may be particularly beneficial for children who experience adverse effects with capsules.
• Fortified biscuits could be considered for both treatment and prevention of vitamin D deficiency in pediatric populations.