How does vitamin D affect child malnutrition?
Malnutrition is a major problem in some countries around the world. Researchers have now found that high-dose vitamin D supplements support weight gain and help develop language and motor skills in severely malnourished children.
Scientists at the University of the Punjab and the Queen Mary University of London found in their current study that taking high-dose vitamin D supplements can help undernourished children gain weight. The experts published the results of their study in the English-language journal "The American Journal of Clinical Nutrition".
About 20 million children suffer from severe malnutrition
Severe acute malnutrition is the most extreme form of malnutrition. Affected children have a very low weight for their size and suffer from severe muscle loss. They can also have swollen feet, face and limbs. Around 20 million children worldwide are severely malnourished, mainly in Asia and Africa, where it is one of the main causes of death. Children with severe acute malnutrition usually also have low vitamin D levels. This micronutrient is important for the health of muscles and bones and for maintaining a healthy immune system, the doctors explain.
Vitamin D deficiency leads to muscle wasting
Vitamin D deficiency is a well-known risk factor for muscle wasting in malnourished children, but the standard treatment - an energetic food paste - contains relatively small amounts of this vital micronutrient. Previous research suggested that vitamin D could be helpful in treating malnutrition as it has both anti-infectious and anti-inflammatory properties. These properties are specific for vitamin D, which is why the researchers examined the effects of the micronutrient in children with severe malnutrition. People with severe acute malnutrition are more susceptible to infection and excessive inflammation.
1.4 million malnourished children live in Pakistan
The investigation was carried out in southern Punjab in Pakistan. An estimated 1.4 million children with severe acute malnutrition live in this country, the researchers say. It was examined whether a high dose of vitamin D accelerates the recovery of 185 malnourished children. The age of the participating children ranged from six months to four years. The test subjects all received a standard food paste. However, the standard food paste for the treatment of malnutrition contains only relatively small amounts of vitamin D, the scientists explain.
Subjects were divided into two groups
Ninety-three children were randomly given two doses of 5 mg of vitamin D orally dissolved in 1 ml of olive oil, while 92 children were randomly given a placebo. Both groups also received standard treatment for severe acute malnutrition. During the study, neither the children, their parents, nor the study staff knew which children were in the active group or in the control group. This effect should avoid a distortion of the study results, explain the doctors.
Effects of taking vitamin D
After two months of treatment, the children who received high-dose vitamin D had a significantly better weight gain (0.26 kg additional weight gain compared to the children who received the placebo). These children also showed significantly better motor and language development, say the authors of the study. All participants were examined for symptoms of hypercalcaemia (increased blood calcium levels - a recognized complication of vitamin D toxicity). These symptoms were not seen in any of the children. At the end of the study, calcium levels were also checked in a subset of 90 children. The calcium level in children who had taken vitamin D was not higher than in children from the control group.
More research is needed
The results of the current study suggest that high-dose vitamin D could be an important cost-effective factor in the treatment of severely malnourished children. However, the results must be backed up by further studies before high-dose vitamin D can be included in the standard treatment, the experts explain. In particular, further clinical trials may be needed to determine whether the results can be reproduced in other countries where severe acute malnutrition is a problem. A larger study with a longer period of follow-up is already planned in Pakistan. This is to find out whether high-dose vitamin D can reduce mortality in children with the most severe form of acute malnutrition. (as)