More Evidence that Vitamin D Status Affects Health
Low maternal vitamin D status during pregnancy has been associated with offspring language impairment. A new study finds maternal vitamin D deficiency (measured at week 18 of pregnancy) is associated with impaired lung development in the child at 6y of age, neurocognitive difficulties at 10y of age, increased risk of eating disorders in adolescence, and lower peak bone mass at 20 years.
The study was a community-based cohort of 901 mother-offspring pairs in Western Australia. Hart and colleagues defined vitamin deficiency as <50 nmol/L. Within the United States, 50 nmol/L is the cut-off between ‘risk of inadequacy’ and ‘sufficiency’ (not deficiency). Within this Australian cohort, 36% of women had serum 25(OH)D3 values below 50 nmol/L. In a nationally representative evaluation of 928 pregnant women living in the US, Ginde and colleagues report the average serum 25(OH)D3 concentration of women NOT using a vitamin D dietary supplement was 46 nmol/L. Serum vitamin D levels increase with supplementation in a dose-dependent manner (see Ginde et al, 2010).
Women need to consider their vitamin D status during pregnancy. The American College of Obstetricians and Gynecologists suggest screening for all pregnant women and consider 1000-2000 IU daily to be safe during pregnancy. Based on a randomized, controlled trial in 350 women with a singleton pregnancy receiving 400, 2000 or 4000 IU of D3 daily, Hollis and colleagues reported not a single adverse event. They conclude 4000 IU of vitamin D3 is safe and most effective in achieving sufficiency (80 nmol/L in this study). Vitamin D3 is more potent than vitamin D2 in raising vitamin D status.
Low vitamin D levels have been proposed as a marker for ill health. It is unlikely that vitamin D is a panacea. However, normalizing serum 25(OH)D3 concentrations with vitamin D supplementation can improve health outcomes (see case report on a childe with autism spectrum disorder).
Every child deserves every opportunity to achieve their potential. Maternal nutrition during pregnancy is just the beginning. For optimal health throughout life, it is important to monitor and maintain adequate serum 25(OH)D3 concentrations.
Hart PH, Lucas RM, Walsh JP, Zosky GR, Whitehouse AJO, Zhu K, Allen KL, Kusel MM, Anderson D, Mountain JA. Vitamin D in fetal development: Findings from a birth cohort study. 2014 Pediatrics doi: 10.1542/peds.2014-1860
Ginde AA, Sullivan AF, Mansback JM, Carmago Jr CA. Vitamin D insufficiency in pregnant and non-pregnant women of childbearing age in the United States. 2010 Am J Obstet Gynecol doi: 10.1016/j.ajog.2009.11.036
Whitehouse AJO, Holt BJ, Serralha M, Holt PG, Kusel MMH, Hart PH. Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development. 2012 Pediatrics doi: 10.1542/peds.2011-2644
Jia F, Wang B, Shan L, Xu Z, Staal WG, Du L. Core symptoms of autism improved after vitamin D supplementation. 2014 Pediatrics doi: 10.1542/peds.2014-2121
Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and efficacy. 2011 JBMR doi: 10.1002/jbmr.463
Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: A systematic review. 2014 Lancet Diab Endocrinol doi: 10.1016/S2213-8587(13)70165-7