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Weekly Vitamin D Supplementation to Prevent Acute Respiratory Infections in Young Children at Different Latitudes: A
María Loreto Reyes1, Cecilia Vizcaya2, Catalina Le Roy3
1Endocrinology Section, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Weekly vitamin D3 supplementation improved vitamin D levels in preschoolers but did not reduce the number of acute respiratory infections (ARI). Further research is needed to understand vitamin D
Area of Science:
- Pediatrics
- Nutritional Immunology
- Public Health
Background:
- Vitamin D plays a crucial role in immune function.
- Acute Respiratory Infections (ARI) are a leading cause of morbidity in preschool children.
- The efficacy of vitamin D supplementation in preventing ARI in this age group remains under investigation.
Purpose of the Study:
- To evaluate the effectiveness of weekly vitamin D supplementation in reducing the incidence of acute respiratory infections (ARI) in preschool children.
- To assess the impact of different weekly doses of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D) levels and immune markers.
- To determine the safety profile of weekly vitamin D3 supplementation in young children.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted with 303 preschool children aged 1.5-3.5 years across three Chilean cities.
- Participants received either placebo, low-dose (5600 IU/week), or high-dose (11,200 IU/week) vitamin D3 (cholecalciferol) for six months.
- Primary outcome was parent-reported number of ARI; secondary outcomes included hospitalizations, serum 25(OH)D levels, LL-37/cathelicidin levels, and adverse events.
Main Results:
- Weekly vitamin D3 supplementation led to a dose-dependent increase in serum 25(OH)D levels (P < .001).
- A significantly higher proportion of children in the vitamin D3 groups achieved adequate 25(OH)D levels compared to the placebo group.
- No significant differences were observed in the number of ARI, ARI hospitalizations, LL-37/cathelicidin levels, or adverse events between the groups.
Conclusions:
- Weekly vitamin D3 supplementation effectively improved vitamin D status in preschool children.
- The study did not find evidence that vitamin D3 supplementation reduces the number of acute respiratory infections in this population.
- Further research may be warranted to explore optimal dosing or specific subgroups that might benefit from vitamin D supplementation for ARI prevention.
Objective:
To evaluate the effectiveness of weekly vitamin D supplementation in reducing the number of acute respiratory infections (ARI) in preschool children.
Study Design:
Randomized, double-blind, placebo-controlled trial in 303 children aged 1.5-3.5 years from 2014 to 2105 in 3 Chilean cities at different latitudes: Santiago (33°S, n = 101), Talcahuano (37°S, n = 103), and Punta Arenas (53°S, n = 99). Participants were allocated (1:1:1) to receive placebo, cholecalciferol (vitamin D3 (VD3)) 5600 IU/week (low-dose), or 11 200 IU/week (high-dose) for 6 months. Primary outcome was parent-reported number of ARI; secondary outcomes included number of ARI hospitalizations, change of serum 25-hydroxyvitamin D (25(OH)D) and LL-37/cathelicidin levels, and adverse events.
Results:
The mean age of participants was 26 ± 6 months; 45% were female. Baseline 25(OH)D was 24.9 ± 6.1 ng/ml, with 23% having 25(OH)D <20 ng/ml. No significant baseline clinical or laboratory differences were observed among groups. Overall, 64% (n = 194) completed study participation, without baseline differences between subjects lost to follow-up vs those completing participation or differences in completion rates across groups. After 6 months, a dose-dependent increase in serum 25(OH)D was observed from the VD3 intervention (P < .001), with a higher proportion of subjects ending the trial with 25(OH)D <20 ng/ml in the placebo group (30.8%) vs the low-dose (7.4%) and high-dose groups (5.1%). However, no group differences were observed in number of ARI (P = .85), ARI hospitalizations (P = .20), LL-37/cathelicidin change (P = .30), or adverse events (P = .41).
Conclusions:
While weekly VD3 supplementation, in doses equivalent to 800 IU and 1600 IU daily, was associated with improved 25(OH)D levels in preschoolers, we did not find a reduced number of ARI in this sample.
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