Vitamin D supplements don’t prevent bone fractures in children, study finds

A major clinical trial led by Queen Mary University of London and the Harvard TH Chan School of Public Health found that vitamin D supplements do not increase bone strength or prevent bone fractures in children with vitamin D deficiency. The findings challenge widely held perceptions regarding the effects of vitamin D on bone health.

About a third of children suffer at least one fracture before the age of 18. It is a major global health problem because childhood fractures can lead to years of disability and/or poor quality of life. The potential of vitamin D supplements to improve bone strength has received increasing interest in recent years, due to the role of vitamin D in promoting bone mineralization. However, no clinical trials to test whether vitamin D supplements can prevent bone fractures in children have yet been conducted.

Working with partners in Mongolia, a country where fracture rates are particularly high and vitamin D deficiency is widespread, researchers from Queen Mary and Harvard conducted a clinical trial to determine whether vitamin D supplementation would reduce the risk of bone fractures or increase bone strength. the school kids. The study, published in The Lancet Diabetes and Endocrinologyis the largest randomized controlled trial of vitamin D supplementation ever conducted in children.

Over a three-year period, 8,851 schoolchildren aged 6 to 13 living in Mongolia received a weekly oral dose of vitamin D supplementation. 95.5% of participants were vitamin D deficient at baseline , and the supplements in the study were found to be very effective in bringing vitamin D levels back to normal. However, they had no effect on fracture risk or bone strength, measured in a subset of 1,438 participants by quantitative ultrasound.

The trial results will likely prompt scientists, doctors and public health specialists to reconsider the effects of vitamin D supplements on bone health.

Dr Ganmaa Davaasambuu, Associate Professor at Harvard TH Chan School of Public Health, said: “The absence of any effect of sustained and generous vitamin D supplementation on fracture risk or bone strength in children vitamin D deficient is striking. D supplementation works best for fracture prevention when calcium is given at the same time. Thus, the fact that we did not offer calcium alongside vitamin D to trial participants may explain the null results of this study.

Professor Adrian Martineau, head of the Center for Immunobiology at Queen Mary University of London, added: “It is also important to note that children found to have rickets during trial screening were excluded participation, because it would not have been possible. ethical to offer them a placebo (dummy drug).”

“Thus, our results are only relevant for children with low vitamin D status and who have not developed bone complications. The importance of adequate vitamin D intake for the prevention of rickets should not be overstated. ignored, and the UK government guidelines recommending a daily intake of 400 IU of vitamin D remains important and should always be followed.”