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Nutritional Influences on Bone Health pp 25–33Cite as

Vitamin D Among Children in Asia

“What children get at age 3 determine who they are at 80”

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Abstract

Puberty is the prime time for bone mineral accretion to achieve peak bone mass which is key for determining bone health and preventing osteoporosis in late adulthood. In the absence of physical ailments, the importance of bone health and vitamin D (Vit-D) among children remains under-recognized, and the epidemic of Vit-D insufficiency prevails especially in Asian countries. Studies have shown the association between Vit-D status and bone density and bone quality as measured, respectively, by dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography. In addition to the risk and injury-prone behavior among adolescents, recent literature indicates the peak incidence of pediatric fracture at puberty can be related to skeletal fragility when rapid growth in length at pubertal growth spurts outpaces mineral deposition. Apart from fracture, spinal deformity seen with adolescent idiopathic scoliosis (AIS) has been reported to be associated with low bone mass and poor bone quality. A recent randomized double-blinded placebo-controlled trial addressing the issue provided evidences that calcium plus Vit-D supplementation could improve bone health and prevent deformity progression in AIS especially for those with low baseline Vit-D levels. As far as bone health is concerned, Vit-D insufficiency, not to the extent down to the rickets level of 25 nmol/L over an extended interval of 1–2 years, may not be as asymptomatic as previously thought. For this medical condition that can be readily amendable to supplementation treatment, measures to enhance Vit-D status and good bone health should be promoted both at the public health levels and with enhanced alertness of the condition within the medical profession.

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References

  1. Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O’Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016;27(4):1281–386.

    Article  CAS  Google Scholar 

  2. Baxter-Jones AD, Faulkner RA, Forwood MR, Mirwald RL, Bailey DA. Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J Bone Miner Res. 2011;26(8):1729–39.

    Article  Google Scholar 

  3. Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992;2(6):285–9.

    Article  CAS  Google Scholar 

  4. Mithal A, Dhingra V, Lau E, editors. The Asian Audit “Epidemiology, costs and burden of osteoporosis in Asia 2009”. Nyon: International Osteoporosis Foundation; 2009.

    Google Scholar 

  5. Mithal A, Ebeling P, Kyer CS. In: Jagait CK, Misteli L, Pierroz DD, editors. The Asia-Pacific Regional Audit “Epidemiology, costs & burden of osteoporosis in 2013”. Nyon: International Osteoporosis Foundation; 2013.

    Google Scholar 

  6. Atiq M, Suria A, Nizami SQ, Ahmed I. Vitamin D status of breastfed Pakistani infants. Acta Paediatr. 1998;87(7):737–40.

    Article  CAS  Google Scholar 

  7. Du X, Greenfield H, Fraser DR, Ge K, Trube A, Wang Y. Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am J Clin Nutr. 2001;74(4):494–500.

    Article  CAS  Google Scholar 

  8. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R. Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification for vitamin D supplementation of breast-feeding infants. J Pediatr. 2003;142(2):169–73.

    Article  CAS  Google Scholar 

  9. Khor GL, Chee WS, Shariff ZM, Poh BK, Arumugam M, Rahman JA, Theobald HE. High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia. BMC Public Health. 2011;11:95.

    Article  Google Scholar 

  10. Shin YH, Kim KE, Lee C, Shin HJ, Kang MS, Lee HR, Lee YJ. High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea. Eur J Pediatr. 2012;171(10):1475–80.

    Article  CAS  Google Scholar 

  11. Laillou A, Wieringa F, Tran TN, Van PT, Le BM, Fortin S, Le TH, Pfanner RM, Berger J. Hypovitaminosis D and mild hypocalcaemia are highly prevalent among young Vietnamese children and women and related to low dietary intake. PLoS One. 2013;8(5):e63979.

    Article  CAS  Google Scholar 

  12. Kolokotroni O, Papadopoulou A, Middleton N, Kouta C, Raftopoulos V, Nicolaidou P, Yiallouros PK. Vitamin D levels and status amongst asthmatic and non-asthmatic adolescents in Cyprus: a comparative cross-sectional study. BMC Public Health. 2015;15:48.

    Article  Google Scholar 

  13. Al-Saleh Y, Al-Daghri NM, Khan N, Alfawaz H, Al-Othman AM, Alokail MS, Chrousos GP. Vitamin D status in Saudi school children based on knowledge. BMC Pediatr. 2015;15:53.

    Article  Google Scholar 

  14. Cheung TF, Cheuk KY, FW Y, Hung VW, Ho CS, Zhu TY, Ng BK, Lee KM, Qin L, Ho SS, Wong GW, Cheng JC, Lam TP. Prevalence of vitamin D insufficiency among adolescents and its correlation with bone parameters using high-resolution peripheral quantitative computed tomography. Osteoporos Int. 2016;27(8):2477–88.

    Article  CAS  Google Scholar 

  15. Ahmed AS, Ahmed T, Long KZ, Magalhaes RJS, Hossain MI, Islam MM, Mahfuz M, Gaffar SA, Sharmeen A, Haque R, Guerrant RL, Petri WA, Mamun AA. Prevalence and risk factors of vitamin D insufficiency and deficiency among 6-24-month-old underweight and normal-weight children living in an urban slum of Bangladesh. Public Health Nutr. 2017;20(10):1718–28.

    Article  Google Scholar 

  16. Chowdhury R, Taneja S, Bhandari N, Kvestad I, Strand TA, Bhan MK. Vitamin-D status and neurodevelopment and growth in young north Indian children: a secondary data analysis. Nutr J. 2017;16(1):59.

    Article  Google Scholar 

  17. Brock KE, Ke L, Tseng M, Clemson L, Koo FK, Jang H, Seibel MJ, Mpofu E, Fraser DR, Mason RS. Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney. J Steroid Biochem Mol Biol. 2013;136:214–7.

    Article  CAS  Google Scholar 

  18. Jang H, Koo FK, Ke L, Clemson L, Cant R, Fraser DR, Seibel MJ, Tseng M, Mpofu E, Mason RS, Brock K. Culture and sun exposure in immigrant East Asian women living in Australia. Women Health. 2013;53(5):504–18.

    Article  Google Scholar 

  19. Food and Nutrition Board. Dietary reference intakes for Calcium, Magnesium, Phosphorus, vitamin D, and fluoride. Washington: National Academy Press, Institute of Medicine; 1997. p. 250–87.

    Google Scholar 

  20. Norman AW, Bouillon R. Vitamin D nutritional policy needs a vision for the future. Exp Biol Med. 2010;235(9):1034–45.

    Article  CAS  Google Scholar 

  21. Mouratidou T, Vicente-Rodriguez G, Gracia-Marco L, Huybrechts I, Sioen I, Widhalm K, Valtuena J, Gonzalez-Gross M, Moreno LA. Associations of dietary calcium, vitamin D, milk intakes, and 25-hydroxyvitamin D with bone mass in Spanish adolescents: the HELENA study. J Clin Densitom. 2013;16(1):110–7.

    Article  Google Scholar 

  22. Lee EY, Kim D, Kim KM, Kim KJ, Choi HS, Rhee Y, Lim SK. Age-related bone mineral density patterns in Koreans (KNHANES IV). J Clin Endocrinol Metab. 2012;97(9):3310–8.

    Article  CAS  Google Scholar 

  23. Pekkinen M, Viljakainen H, Saarnio E, Lamberg-Allardt C, Makitie O. Vitamin D is a major determinant of bone mineral density at school age. PLoS One. 2012;7(7):e40090.

    Article  CAS  Google Scholar 

  24. Esterle L, Nguyen M, Walrant-Debray O, Sabatier JP, Garabedian M. Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls. J Bone Miner Res. 2010;25(11):2392–8.

    Article  CAS  Google Scholar 

  25. Cashman KD, Hill TR, Cotter AA, Boreham CA, Dubitzky W, Murray L, Strain J, Flynn A, Robson PJ, Wallace JM, Kiely M. Low vitamin D status adversely affects bone health parameters in adolescents. Am J Clin Nutr. 2008;87(4):1039–44.

    Article  CAS  Google Scholar 

  26. Nakamura K, Nashimoto M, Matsuyama S, Yamamoto M. Low serum concentrations of 25-hydroxyvitamin D in young adult Japanese women: a cross sectional study. Nutrition. 2001;17(11–12):921–5.

    Article  CAS  Google Scholar 

  27. Outila TA, Karkkainen MU, Lamberg-Allardt CJ. Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr. 2001;74(2):206–10.

    Article  CAS  Google Scholar 

  28. Cheng S, Tylavsky F, Kroger H, Karkkainen M, Lyytikainen A, Koistinen A, Mahonen A, Alen M, Halleen J, Vaananen K, Lamberg-Allardt C. Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr. 2003;78(3):485–92.

    Article  CAS  Google Scholar 

  29. Bacchetta J, Boutroy S, Vilayphiou N, Ranchin B, Fouque-Aubert A, Basmaison O, Cochat P. Bone assessment in children with chronic kidney disease: data from two new bone imaging techniques in a single-center pilot study. Pediatr Nephrol. 2011;26(4):587–95.

    Article  Google Scholar 

  30. Weber LT, Mehls O. Limitations of dual x-ray absorptiometry in children with chronic kidney disease. Pediatr Nephrol. 2010;25(1):3–5.

    Article  Google Scholar 

  31. Clark EM, Tobias JH, Ness AR. Association between bone density and fractures in children: a systematic review and meta-analysis. Pediatrics. 2006;117(2):e291–7.

    Article  CAS  Google Scholar 

  32. Ma D, Morley R, Jones G. Risk-taking, coordination and upper limb fractures in children: a population based case-control study. Osteoporos Int. 2004;15(8):633–8.

    Article  Google Scholar 

  33. Clark EM, Ness AR, Bishop NJ, Tobias JH. Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res. 2006;21(9):1489–95.

    Article  Google Scholar 

  34. Lam TP, Yip BHK, Tam EMS, Man GCW, Lee WYW, Lee KM, Yu FWP, Qiu Y, Ng BKW, Cheng JCY. Calcium and vitamin D for adolescent idiopathic scoliosis – a further in-depth review using finite element analysis (FEA) for a randomized double-blinded placebo-controlled trial. In: 52nd scoliosis research society annual meeting & course, 2017 Sept 6–9, Philadelphia, PA, USA; 2017.

    Google Scholar 

  35. Lam TP, Yip BHK, Tam EMS, Man GCW, Lee WYW, Lee KM, Yu FWP, Ng BKW, Cheng JCY. Preventing curve progression with calcium and vitamin D supplementation in adolescent idiopathic scoliosis (AIS) – a randomized double-blinded Placebo-controlled trial. In: Pediatric orthopaedics society of North America 2016 annual meeting (POSNA), 2016 Apr 27–30, Indianapolis, IN; 2016.

    Google Scholar 

  36. Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010;46(2):294–305.

    Article  Google Scholar 

  37. Winzenberg T, Powell S, Shaw KA, Jones G. Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis. BMJ. 2011;342:c7254.

    Article  Google Scholar 

  38. Mimouni FB. Vitamin D status in growing children: should we routinely screen for vitamin D adequacy? J Pediatr Gastroenterol Nutr. 2010;51(Suppl 3):S121–2.

    Article  Google Scholar 

  39. McCarthy M. Evidence for routine vitamin D screening is insufficient, US panel concludes. BMJ. 2014;348:g4277.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Tsz Ping Lam, Wayne Y. W. Lee, Alec Lik Hang Hung, Bobby Kin Wah Ng & Jack Chun Yiu Cheng

  2. Division of Family Medicine and Primary Health Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China

    Benjamin Hon Kei Yip

  3. Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Nelson Leung Sang Tang

  4. Lee Hysan Clinical Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

    Kwong Man Lee

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  1. Tsz Ping Lam
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Correspondence to Tsz Ping Lam .

Editor information

Editors and Affiliations

  1. Nutrition and Science, Purdue University, West Lafayette, IN, USA

    Connie M. Weaver

  2. Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland

    Heike Bischoff-Ferrari

  3. Institute for Physical Activity and Nutrition, Deakin University , Melbourne, VIC, Australia

    Robin M. Daly

  4. Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

    Man-Sau Wong

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Lam, T.P. et al. (2019). Vitamin D Among Children in Asia. In: Weaver, C., Bischoff-Ferrari, H., Daly, R., Wong, MS. (eds) Nutritional Influences on Bone Health. Springer, Cham. https://doi.org/10.1007/978-3-319-98464-3_3

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  • DOI: https://doi.org/10.1007/978-3-319-98464-3_3

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