Project Details

The Effect of Early Life Vitamin D on Child Bone Health – A Personalized Approach

Nicklas Brustad, MD, PhD

Summary

BACKGROUND: The prevalence of vitamin D insufficiency among pregnant women is high and low levels of 25(OH)D in pregnancy is related to childhood bone disorders such as rickets and craniotabes. GAP: Vitamin D deficiency has increased in the last few decades possibly due to changing lifestyles and dietary habits and Vitamin D supplementation in pregnancy has been suggested to have effects on early life bone mineralization and fracture risk, but the effect seem to depend on several factors including the genetic profile. HYPOTHESIS: Vitamin D sufficiency in pregnancy and childhood improves bone mineralization and reduces the risk of fractures during childhood and adolescence. The effect of prenatal vitamin D supplementation on child bone outcomes are influenced by the genetic profile of the mothers and children. METHODS: The COPSAC2010 randomized controlled trial of high-dose (2800IU/day) vs. standard-dose (400IU/day) vitamin D supplementation from week 24 in pregnancy until 1 week after birth. The COPSAC2010 cohort is a Danish population-based mother-child cohort with longitudinally clinical follow-up of the children with 15 scheduled visits including dual-energy x-ray absorptiometry (DXA) scans at age 3- and 6-years until age 12 years and genotyping of the mothers and the children. RESULTS: High-dose vitamin D supplementation in pregnancy improved offspring bone mineralization through age 6 years compared with the standard dose. (Brustad et al, 2020 JAMA Pediatr. 2020;174(5):419-427). IMPACT: This is the leading large mother-child RCT within this field and the project has the potential to change current guidelines of vitamin D intake during pregnancy in order to improve bone health and prevent fractures in childhood and later life as well as add knowledge to the development of a personalized vitamin D supplementation strategy based on our genetic analyses. Website Link: copsac.com.