Vitamin D and Its Affect on Growth Rates and Bone Mineral Density Until Age 5
Vitamin D and Its Affect on Growth Rates and Bone Mineral Density Until Age 5
Abstract Background: Vitamin D affects a wide variety of functions in the body including
 regulation of calcium, phosphorus, and bone metabolism. Israeli studies have documented a
 high prevalence of Vitamin D deficiency in Israeli infants in general, which was more severe
 in infants from Ultra-Orthodox Jewish families. Modest dress requirements in this population
 drastically reduce sun exposure, known to encourage production of Vitamin D. Countless
 research has analyzed preterm as well as term neonates born to mothers with vitamin D
 deficiency, with regard to weight, height, and bone mineral density at birth. However, there
 is a paucity of information about healthy infants' vitamin D levels and its' correlation to
 these parameters during the first few years of life. Objectives: The purpose of the proposed
 study is to measure and correlate levels of 25(OH)D and bone mineral density towards the end
 of the first year of life with growth rates and bone mineral density in the same children at
 the ages of 2, 3 and 5 years. Patients and Methods: The study will be performed in the
 Ultra-Orthodox Jewish community of Beitar Illit. 25(OH)D levels will be taken between 9-12
 months of age (when routine blood tests are normally drawn for these infants) and bone
 mineral density will be measured using Quantitative Ultrasound. Infants will be divided into
 2 groups: those with those with normal 25(OH)D levels (>15ng/ml), and those with 25(OH)D
 deficiency (<15ng/ml). Group 1- normal levels will receive no intervention. Infants with
 25(OH)D below 15ng/ml will be randomly assigned into one of two groups; Group 2-those
 receiving continued vitamin D supplementation of 800 international units(IU) (4gtt/d) for one
 year, or Group 3- those receiving the placebo. Height, weight, and head circumference growth
 curves will be recorded every two months until 2 years of age. Quantitative ultrasound,
 growth charts and blood tests including 25(OH)D, serum calcium and phosphate levels,
 Parathyroid hormone (PTH), and alkaline phosphatase, taken at approximately 9-12 months will
 be repeated at 2 years of age. At that time children from Group 1 (no supplementation) will
 be divided into three: Group 1a- normal 25(OH)D levels will continue with no intervention,
 Group 1b <15ng/ml will begin receiving vitamin D 4gtt/d, Group 1c <15ng/ml will receive a
 placebo until age three. Groups 2 and 3 will continue their previous treatment until age
 three. All aforementioned tests will be repeated at age 3, when treatment will stop, and the
 same tests will be repeated at age 5.
Inclusion Criteria:

 Infants between 9-12 months old in Tipat Chalav and Kupat Holim Clalit in Beitar Illit
 undergoing a blood draw for CBC at one year of age.

 Exclusion Criteria:

 Parents that refuse to participate in this study, infants with any diagnosed chronic
 disease, and preterm infants less than 34 weeks.