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Maulana RA, Fulyani F, Anjani G. Nanocarriers System for Vitamin D as Nutraceutical in Type 2 Diabetes: A Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Incidence of diabetes are common among population around the world. Diabetes may lead to other complication and increasing morbidity and mortality. Many ways have been done to treat and prevent the development of diabetes. In addition of conventional pharmacotherapy, therapeutic therapy shown good opportunity to maintain and improve diabetic conditions. Vitamin D3 is known as nutraceutical and has good opportunity to develop the medication of type 2 diabetes. In another way, vitamin D3 naturally easy to damage by environmental condition. To overcome this weakness, researcher around the world have developed the method for protecting unstable compound as vitamin D3 with encapsulation. Liprotide is one of the various materials which can be used for encapsulation. Combination of lipid and protein molecules is expected to be a carrier and protector of vitamin D3 in gastrointestinal system. Here we review the research advances of liprotide as nanocarriers and vitamin D3 as nutraceuticals to discuss in applied on type 2 diabetes.
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Metabolic and Nutritional Aspects in Paediatric Patients with Klinefelter Syndrome: A Narrative Review. Nutrients 2022; 14:nu14102107. [PMID: 35631248 PMCID: PMC9147015 DOI: 10.3390/nu14102107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 01/19/2023] Open
Abstract
Klinefelter syndrome is the most common sex chromosomal aneuploidy in males. It is well known that patients with this syndrome have greater mortality and morbidity compared to the general population due to cardiovascular diseases and endocrine metabolism disorders. This augmented risk is due both to hypogonadism and to the syndrome itself. Therefore, correct hormonal replacement therapy and early primary prevention are crucial to these patients. Even though different studies are available on this topic in adult patients, only a few authors have focused on the paediatric population. Thus, in this narrative review, we report the current knowledge of metabolic and nutritional aspects in children with Klinefelter syndrome.
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Lee SS, Subramaniam R, Tusimin M, Ling KH, Rahim KF, Loh SP. Inadequate vitamin D intake among pregnant women in Malaysia based on revised recommended nutrient intakes value and potential dietary strategies to tackle the inadequacy. Nutr Res Pract 2021; 15:492-503. [PMID: 34349882 PMCID: PMC8313385 DOI: 10.4162/nrp.2021.15.4.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/10/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Recently, the recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1-70 yrs has been revised from 5 µg/day to 15 µg/day. This study is aimed to assess the adequacy of vitamin D intake based on revised RNI and to recommend several dietary strategies to increase total vitamin D intake. SUBJECTS/METHODS Vitamin D intake from both food and supplement of 217 pregnant women was assessed using a validated food frequency questionnaire. Hypothetical effect of expanded supplementation and food fortifications strategies were modelled using the consumption data. RESULTS The results revealed that more than half (67.7%) of pregnant women had inadequate vitamin D intake (RNI < 15 µg/day). The modelling results demonstrated the potential of universal provision of 10 µg/day of multivitamins supplements in increasing vitamin D intake. Moreover, mandatory fortification of both milk and malted drink at single level of 5 µg/serving would lead to increase in vitamin D intake of Malaysians, particularly pregnant women. CONCLUSIONS The outcome of this study can be used as a reference for public health professionals to re-evaluate the existing Malaysian food fortification policies and supplementation recommendation for vitamin D for pregnant women.
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Affiliation(s)
- Siew Siew Lee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Raman Subramaniam
- Fetal Medicine and Gynaecology Centre (FMGC), 46200 Petaling Jaya, Malaysia
| | - Maiza Tusimin
- Prince Court Medical Centre, 50450 Kuala Lumpur, Malaysia
| | - King Hwa Ling
- Department of Biomedical Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | | | - Su Peng Loh
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
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Cuadrado-Soto E, López-Sobaler AM, Jiménez-Ortega AI, Aparicio A, Bermejo LM, Hernández-Ruiz Á, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, Ruiz-López MD, Soto-Méndez MJ, Valero T, Varela-Moreiras G, Gil Á, Ortega RM. Usual Dietary Intake, Nutritional Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D of Spanish Children Aged One to <10 Years. Findings from the EsNuPI Study. Nutrients 2020; 12:E1787. [PMID: 32560110 PMCID: PMC7353376 DOI: 10.3390/nu12061787] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/26/2020] [Accepted: 06/12/2020] [Indexed: 02/06/2023] Open
Abstract
Bone problems in the population begin to be establish in childhood. The present study aims to assess the usual calcium, phosphorus, magnesium, and vitamin D intakes, along with the food sources of these nutrients, in Spanish children participating in the EsNuPI (Estudio Nutricional en Población Infantil Española) study. Two 24 h dietary recalls were applied to 1448 children (1 to <10 years) divided into two sub-samples: one reference sample (RS) of the general population [n = 707] and another sample which exclusively included children consuming enriched or fortified milks, here called "adapted milks" (AMS) [n = 741]. Estimation of the usual intake shows that nutrient intake increased with age for all nutrients except vitamin D. Using as reference the Dietary Reference Values from the European Food Safety Authority (EFSA), calcium and magnesium intakes were found to be below the average requirement (AR) and adequate intake (AI), respectively, in a considerable percentage of children. Furthermore, phosphorus exceeded the AI in 100% of individuals and vitamin D was lower than the AI in almost all children studied. The results were very similar when considering only plausible reporters. When analyzing the food sources of the nutrients studied, milk and dairy products contributed the most to calcium, phosphorus, magnesium, and vitamin D. Other sources of calcium were cereals and vegetables; for phosphorus: meat, meat products, and cereals; for magnesium: cereals and fruits; and, for vitamin D: fish and eggs. These results highlight the desirability of improving the intake concerning these nutrients, which are involved in bone and metabolic health in children. The AMS group appeared to contribute better to the adequacy of those nutrients than the RS group, but both still need further improvement. Of special interest are the results of vitamin D intakes, which were significantly higher in the AMS group (although still below the AI), independent of age.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ana Isabel Jiménez-Ortega
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
- Pediatric Gastroenterology Unit, San Rafael Hospital, 28016 Madrid, Spain
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Laura M. Bermejo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
| | | | - Rosaura Leis
- Department of Pediatrics, Unit of Pediatric Gastroenterology, Hepatology and Nutrition, University Clinical Hospital of Santiago, IDIS, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain;
| | - María Dolores Ruiz-López
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (G.V.-M.)
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, crta. Boadilla km. 5.3, Boadilla del Monte, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3ªpta, Armilla, 18016 Granada, Spain; (Á.H.-R.); (M.D.R.-L.); (M.J.S.-M.); (Á.G.)
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain; (E.C.-S.); (A.A.); (L.M.B.); (R.M.O.)
- UCM Research Group VALORNUT-920030, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
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Hoevenaar-Blom MP, Wielders JP, Groeneveld H, de Leeuw E, Schmits RJ, Pepermans C, Pasker-de Jong PC, Hogeman PH. Prevalence and determinants of vitamin D deficiency in infants and toddlers in the Netherlands: a pilot study. Ann Clin Biochem 2019; 56:613-618. [PMID: 31154805 DOI: 10.1177/0004563219857772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Little is known of the vitamin D status of young infants and toddlers and its determinants in West Europe. The prevalence and determinants of vitamin D deficiency of children aged 6–48 months in the centre of the Netherlands (52°N) is investigated. Methods In a cross-sectional population study, randomly recruited infants and toddlers ( n = 150) were studied using an online questionnaire and a physical examination either in late summer ( n = 52) or in late winter ( n = 98). Vitamin D analysis was performed by capillary blood sampling using dried bloodspots plus LC-MS/MS. Results In late winter, 32% of the children were vitamin D deficient (<50 nmol/L 25OH vitamin D3) with 5% severely deficient (<25 nmol/L). In late summer, 2% were deficient. The odds of vitamin D deficiency were higher in children aged 24–48 months, for those not using formula milk and those not adhering to the supplementation guidelines. Conclusion One-third of Dutch infants and toddlers were found to be vitamin D deficient in late winter. Suggested strategies for raising the vitamin D status may include improving the adherence to supplementation, a sensible sun exposure or the use of fortified foods. Special attention is needed for the children aged 24–48 months.
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Affiliation(s)
| | - Jos Pm Wielders
- 2 Department of Clinical Chemistry, Meander Medical Center, Amersfoort, the Netherlands
| | - Henk Groeneveld
- 3 Department of Youth Health Care, Public Health Services Region, Utrecht, the Netherlands
| | - Elly de Leeuw
- 4 Department of Public Health, Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ruben Jh Schmits
- 3 Department of Youth Health Care, Public Health Services Region, Utrecht, the Netherlands.,4 Department of Public Health, Division Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Carolien Pepermans
- 3 Department of Youth Health Care, Public Health Services Region, Utrecht, the Netherlands
| | | | - Paul Hg Hogeman
- 1 Department of Pediatrics, Meander Medical Center, Amersfoort, the Netherlands
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Abstract
The consumption of high-Ca, high-protein dairy foods (i.e. milk, cheese, yogurt) is advocated for bone health across the lifespan to reduce the risk of low-trauma fractures. However, to date, the anti-fracture efficacy of dairy food consumption has not been demonstrated in randomised controlled trials but inferred from cross-sectional and prospective studies. The anti-fracture efficacy of dairy food consumption is plausible, but testing this requires a robust study design to ensure outcomes are suitably answering this important public health question. The evidence of skeletal benefits of dairy food consumption is equivocal, not because it may not be efficacious but because the study design and execution are often inadequate. The key issues are compliance with dietary intervention, dropouts, sample sizes and most importantly lack of deficiency before intervention. Without careful appraisal of the design and execution of available studies, precarious interpretations of outcomes may be made from these poorly designed or executed studies, without consideration of how study design may be improved. Dairy food interventions in children are further hampered by heterogeneity in growth: in particular sex and maturity-related differences in the magnitude, timing, location and surface-specific site of bone accrual. Outcomes of studies combining children of different sexes and maturity status may be masked or exaggerated by these differences in growth, so inaccurate conclusions are drawn from results. Until these critical issues in study design are considered in future dairy food interventions, the anti-fracture efficacy of dairy food consumption may remain unknown and continue to be based on conjecture.
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Khorasani ZM, Bonakdaran S, Rafieie HP. The Relationship Between Vitamin D Deficiency and Insulin Resistance in Pregnant Women with Gestational Diabetes. Curr Diabetes Rev 2019; 15:414-419. [PMID: 30387399 DOI: 10.2174/1573399814666181102100816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/16/2018] [Accepted: 10/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes Mellitus is one of the most common medical disorders in pregnancy. The possibility of vitamin D deficiency as a pathogenesis for impaired glucose tolerance tests show a probable role of vitamin D in insulin secretion and reduction of insulin resistance. This study was assigned to evaluate relation between serum vitamin D level and insulin resistance in Gestational Diabetes Mellitus (GDM). METHODS This cross sectional study was done throughout one year between 2015-2016 in GDM patients (age, 20-40 years). After history taking and physical examination, the laboratory tests including : Fasting Blood Sugar (FBS), Glucose Tolerance Test (GTT), calcium, phosphorous, parathormone, 25(OH) vitamin D, insulin, HbA1C, TG, LDL, HDL were performed for all patients. Insulin resistance was calculated according to HOMA-IR formula. Vitamin D level was compared between patients with and without insulin resistance. RESULTS This research was performed in 93 GDM patients with average age (30.3 ± 5.6). Thirty eight patients with insulin resistance and 55 patients without insulin resistance were detected. The prevalence of vitamin D deficiency was 91.4% in all patients. There was no significant difference in vitamin D levels between insulin resistant and non insulin resistant group (P-value=0.51). In all variable parameters, only FBS and triglyceride level in insulin resistant group were more than non insulin resistant group (P-value<0.05). CONCLUSION Obtained results showed not significant relationship between vitamin D deficiency and insulin resistance in GDM patients.
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Affiliation(s)
| | - Shokoufeh Bonakdaran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hasan Pour Rafieie
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Itkonen ST, Erkkola M, Lamberg-Allardt CJE. Vitamin D Fortification of Fluid Milk Products and Their Contribution to Vitamin D Intake and Vitamin D Status in Observational Studies-A Review. Nutrients 2018; 10:nu10081054. [PMID: 30096919 PMCID: PMC6116165 DOI: 10.3390/nu10081054] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
Fluid milk products are systematically, either mandatorily or voluntarily, fortified with vitamin D in some countries but their overall contribution to vitamin D intake and status worldwide is not fully understood. We searched the PubMed database to evaluate the contribution of vitamin D-fortified fluid milk products (regular milk and fermented products) to vitamin D intake and serum or plasma 25-hydroxyvitamin D (25(OH)D) status in observational studies during 1993–2017. Twenty studies provided data on 25(OH)D status (n = 19,744), and 22 provided data on vitamin D intake (n = 99,023). Studies showed positive associations between the consumption of vitamin D-fortified milk and 25(OH)D status in different population groups. In countries with a national vitamin D fortification policy covering various fluid milk products (Finland, Canada, United States), milk products contributed 28–63% to vitamin D intake, while in countries without a fortification policy, or when the fortification covered only some dairy products (Sweden, Norway), the contribution was much lower or negligible. To conclude, based on the reviewed observational studies, vitamin D-fortified fluid milk products contribute to vitamin D intake and 25(OH)D status. However, their impact on vitamin D intake at the population level depends on whether vitamin D fortification is systematic and policy-based.
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Affiliation(s)
- Suvi T Itkonen
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
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Current Evidence on Vitamin D Deficiency and Metabolic Syndrome in Obese Children: What Does the Evidence from Saudi Arabia Tell Us? CHILDREN-BASEL 2018; 5:children5010011. [PMID: 29342981 PMCID: PMC5789293 DOI: 10.3390/children5010011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 12/23/2017] [Accepted: 01/11/2018] [Indexed: 01/12/2023]
Abstract
Obesity and vitamin D deficiency represent major health problems among Saudi children, and have been linked to chronic diseases. Obese children are at risk of developing vitamin D deficiency, which appears to have negative influences on energy homeostasis, impeded bone mineralisation, insulin resistance and inflammation. Evidence supporting the association between vitamin D deficiency of obese children and metabolic syndrome has not specifically been studied in early childhood. The mechanisms through which vitamin D deficiency is associated with metabolic syndrome in obese children needs further elucidation. This commentary aims to (i) summarise current knowledge of the association between vitamin D deficiency and metabolic syndrome in obese children; and (ii) discuss current evidence for the association among Saudi Arabian children.
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Uday S, Högler W. Nutritional Rickets and Osteomalacia in the Twenty-first Century: Revised Concepts, Public Health, and Prevention Strategies. Curr Osteoporos Rep 2017; 15:293-302. [PMID: 28612338 PMCID: PMC5532418 DOI: 10.1007/s11914-017-0383-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Nutritional rickets and osteomalacia are common in dark-skinned and migrant populations. Their global incidence is rising due to changing population demographics, failing prevention policies and missing implementation strategies. The calcium deprivation spectrum has hypocalcaemic (seizures, tetany and dilated cardiomyopathy) and late hypophosphataemic (rickets, osteomalacia and muscle weakness) complications. This article reviews sustainable prevention strategies and identifies areas for future research. RECENT FINDINGS The global rickets consensus recognises the equal contribution of vitamin D and dietary calcium in the causation of calcium deprivation and provides a three stage categorisation for sufficiency, insufficiency and deficiency. For rickets prevention, 400 IU daily is recommended for all infants from birth and 600 IU in pregnancy, alongside monitoring in antenatal and child health surveillance programmes. High-risk populations require lifelong supplementation and food fortification with vitamin D or calcium. Future research should identify the true prevalence of rickets and osteomalacia, their role in bone fragility and infant mortality, and best screening and public health prevention tools.
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Affiliation(s)
- Suma Uday
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Wolfgang Högler
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
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Al-Sadat N, Majid HA, Sim PY, Su TT, Dahlui M, Abu Bakar MF, Dzaki N, Norbaya S, Murray L, Cantwell MM, Jalaludin MY. Vitamin D deficiency in Malaysian adolescents aged 13 years: findings from the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs). BMJ Open 2016; 6:e010689. [PMID: 27540095 PMCID: PMC5013370 DOI: 10.1136/bmjopen-2015-010689] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To determine the prevalence of vitamin D deficiency (<37.5 nmol/L) among young adolescents in Malaysia and its association with demographic characteristics, anthropometric measures and physical activity. DESIGN This is a cross-sectional study among Form 1 (year 7) students from 15 schools selected using a stratified random sampling design. Information regarding sociodemographic characteristics, clinical data and environmental factors was collected and blood samples were taken for total vitamin D. Descriptive and multivariable logistic regression was performed on the data. SETTING National secondary schools in Peninsular Malaysia. PARTICIPANTS 1361 students (mean age 12.9±0.3 years) (61.4% girls) completed the consent forms and participated in this study. Students with a chronic health condition and/or who could not understand the questionnaires due to lack of literacy were excluded. MAIN OUTCOME MEASURES Vitamin D status was determined through measurement of sera 25-hydroxyvitamin D (25(OH)D). Body mass index (BMI) was classified according to International Obesity Task Force (IOTF) criteria. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). RESULTS Deficiency in vitamin D was seen in 78.9% of the participants. The deficiency was significantly higher in girls (92.6%, p<0.001), Indian adolescents (88.6%, p<0.001) and urban-living adolescents (88.8%, p<0.001). Females (OR=8.98; 95% CI 6.48 to 12.45), adolescents with wider waist circumference (OR=2.64; 95% CI 1.65 to 4.25) and in urban areas had higher risks (OR=3.57; 95% CI 2.54 to 5.02) of being vitamin D deficient. CONCLUSIONS The study shows a high prevalence of vitamin D deficiency among young adolescents. Main risk factors are gender, ethnicity, place of residence and obesity.
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Affiliation(s)
- Nabilla Al-Sadat
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hazreen Abdul Majid
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pei Ying Sim
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maznah Dahlui
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Fadzrel Abu Bakar
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
| | - Najat Dzaki
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
| | - Saidatul Norbaya
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Liam Murray
- Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, UK
| | - Marie M Cantwell
- Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, UK
| | | | - MyHeART study group
- Faculty of Medicine, Centre for Population Health (CePH), University of Malaya, Kuala Lumpur, Malaysia
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12
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The role of fortified foods and nutritional supplements in increasing vitamin D intake in Irish preschool children. Eur J Nutr 2016; 56:1219-1231. [DOI: 10.1007/s00394-016-1171-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
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13
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Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr 2016; 115:1080-91. [PMID: 26836317 DOI: 10.1017/s0007114515005292] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We studied vitamin D intake, serum 25-hydroxyvitamin D (S-25(OH)D) concentration, determinants of S-25(OH)D and risk factors for S-25(OH)D <50 nmol/l in a population sample of Finnish children. We studied 184 girls and 190 boys aged 6-8 years, analysed S-25(OH)D by chemiluminescence immunoassay and assessed diet quality using 4-d food records and other lifestyle factors by questionnaires. We analysed the determinants of S-25(OH)D using linear regression and risk factors for S-25(OH)D <50 nmol/l using logistic regression. Mean dietary intake of vitamin D was 5·9 (sd 2·1) µg/d. Altogether, 40·8 % of children used no vitamin D supplements. Of all children, 82·4 % did not meet the recommended total vitamin D intake of 10 µg/d. Milk fortified with vitamin D was the main dietary source of vitamin D, providing 48·7 % of daily intake. S-25(OH)D was <50 nmol/l in 19·5 % of children. Consumption of milk products was the main determinant of S-25(OH)D in all children (standardised regression coefficient β=0·262; P<0·001), girls (β=0·214; P=0·009) and boys (β=0·257; P=0·003) in multivariable models. Vitamin D intake from supplements (β=0·171; P=0·035) and age (β=-0·198; P=0·015) were associated with S-25(OH)D in girls. Children who drank ≥450 g/d of milk, spent ≥2·2 h/d in physical activity, had ≥13·1 h/d of daylight time or were examined in autumn had reduced risk for S-25(OH)D <50 nmol/l. Insufficient vitamin D intake was common among Finnish children, one-fifth of whom had S-25(OH)D <50 nmol/l. More attention should be paid to the sufficient intake of vitamin D from food and supplements, especially among children who do not use fortified milk products.
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Cribb VL, Northstone K, Hopkins D, Emmett PM. Sources of vitamin D and calcium in the diets of preschool children in the UK and the theoretical effect of food fortification. J Hum Nutr Diet 2015; 28:583-92. [PMID: 25280181 PMCID: PMC4780273 DOI: 10.1111/jhn.12277] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Dietary intakes of vitamin D are very low in the UK. Dietary calcium is also necessary to promote bone health. The fortification of foods with vitamin D could be a safe and effective way of increasing intake. METHODS Diets of preschool children, 755 at 18 months and 3.5 years, from the Avon Longitudinal Study of Parents and Children were assessed using dietary records completed by parents. Energy, vitamin D and calcium intakes were calculated. Multinomial logistic regression was used to estimate the odds ratio for being in the highest/lowest quartile of intake. Intakes were recalculated to test different fortification regimes. RESULTS Vitamin D intakes were low; all children were below the UK and US dietary recommendations. Calcium intakes decreased between the two ages as a result of reduced milk consumption. Children in the lowest quartile for vitamin D intake at 18 months were twice as likely to remain in that quartile at 3.5 years (odds ratio = 2.35; 95% confidence interval = 1.56-3.55). The majority of foods provide no vitamin D with fat spreads and milk as the main sources. The contribution from breakfast cereals increased, from 6% to 12%, as a result of the increased consumption of fortified cereals. Dairy foods provided the highest contribution to calcium at 18 months but were less important at 3.5 years. Theoretical intakes from different fortification regimens suggest that milk fortified at 2 μg 100 g(-1) vitamin D would provide most children with adequate but not excessive intakes. CONCLUSIONS Dietary vitamin D intakes were very low and calcium intakes were mostly adequate. Fortification of milk with vitamin D could be a good way to boost intakes.
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Affiliation(s)
- V. L. Cribb
- Centre for Child and Adolescent HealthSchool for Social and Community MedicineUniversity of BristolBristolUK
| | - K. Northstone
- School for Social and Community MedicineUniversity of BristolBristolUK
| | - D. Hopkins
- Nutrition and Dietetic DepartmentSouthampton General HospitalHampshireUK
| | - P. M. Emmett
- Centre for Child and Adolescent HealthSchool for Social and Community MedicineUniversity of BristolBristolUK
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Mitchell PJ, Cooper C, Dawson-Hughes B, Gordon CM, Rizzoli R. Life-course approach to nutrition. Osteoporos Int 2015; 26:2723-42. [PMID: 26412214 PMCID: PMC4656714 DOI: 10.1007/s00198-015-3288-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 08/11/2015] [Indexed: 01/12/2023]
Abstract
This narrative review summarizes the role that nutrition plays in the development and maintenance of a healthy skeleton throughout the life-course. Nutrition has a significant influence on bone health throughout the life cycle. This narrative review summarizes current knowledge and guidance pertaining to the development and maintenance of a healthy skeleton. The primary objectives proposed for good bone health at the various stages of life are the following: Children and adolescents: achieve genetic potential for peak bone mass Adults: avoid premature bone loss and maintain a healthy skeleton Seniors: prevention and treatment of osteoporosis Findings from cohort studies, randomized controlled trials, systematic reviews and meta-analyses, in addition to current dietary guidelines, are summarized with the intention of providing clear nutritional guidance for these populations and pregnant women.
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Affiliation(s)
- P J Mitchell
- Synthesis Medical NZ Ltd, Auckland, New Zealand
- University of Notre Dame Australia, Sydney, Australia
| | - C Cooper
- NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - C M Gordon
- Divisions of Adolescent Medicine and Endocrinology, Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Emmett PM, Jones LR. Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children. Nutr Rev 2015; 73 Suppl 3:175-206. [PMID: 26395342 PMCID: PMC4586450 DOI: 10.1093/nutrit/nuv054] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Publications from the Avon Longitudinal Study of Parents and Children covering diet, growth, and obesity development during childhood are reviewed. Diet was assessed by food frequency questionnaires and food records. Growth data were collected by routine measurements, and in standardized clinics, body fatness was assessed by bioelectrical impedance and DXA (dual-energy X-ray absorptiometry) scans. Diets changed dramatically during the preschool period with an increase in the intake of free (added) sugars (12.3% rising to 16.4% of energy) that remained similar until adolescence. This was due to increased intake of energy-dense, nutrient-poor foods. Two periods of rapid growth were identified; infancy and mid-childhood (ages 7-11 y) and both were associated with obesity development. Diets with high energy density were associated with increasing fat mass from mid-childhood until adolescence. Genetic and dietary factors showed independent associations with increasing adiposity. At all ages studied, there were dietary inequalities related to maternal educational attainment that may influence inequalities found in obesity development. The Avon Longitudinal Study of Parents and Children has provided valuable insights into how disparities in diet and growth may affect the development of ill health in adulthood.
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Affiliation(s)
- Pauline M Emmett
- P.M. Emmett is with the Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.L.R. Jones is with the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
| | - Louise R Jones
- P.M. Emmett is with the Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.L.R. Jones is with the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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