Vitamin D: from Gestation to Adolescence in Health and Disease

Vol. 77, Suppl. 3, 2019 Vitamin D: From Gestation to Adolescence in Health and Disease Editor Carlos Lifschitz , Buenos Aires Editorial Board Jatinder Bhatia, Augusta, GA Weili Lin, Chapel Hill, NC Carlos Lifschitz, Buenos Aires Andrew Prentice, Banjul/London Frank M. Ruemmele, Paris Hania Szajewska, Warsaw Supported by Basel • Freiburg • Hartford • Oxford • Bangkok • Dubai • Kuala Lumpur • Melbourne • Mexico City • Moscow • New Delhi • Paris • Shanghai • Tokyo https://www.nestlenutrition-institute.org Reprint of Annals of Nutrition and Metabolism Vol. 76, Suppl. 2, 2020 Sponsor Note This publication was supported by an unrestricted educational grant by the Nestlé Nutrition Institute. The institute is a not-for-profi t association which was created to provide latest medical and scientifi c information to health professionals in the fi eld of pediatric and adult nutrition and nutrition-related disorders (available at www.nestlenutrition-institute.org). Any liability of the sponsors for the content of the papers is hereby expressly excluded. Disclosure Statement Editor C.L. was a member of the Faculty Board of the Nestlé Nutrition Institute at the time of manuscript preparation and has received honoraria from Danone, Mead Johnson Nutrition, the Nestlé Nutrition Institute and Wyeth. S. Karger Disclaimer All rights reserved. Medical and Scientifi c Publishers Th e statements, opinions and data contained in this publica- No part of this publication may be translated into other tion are solely those of the individual authors and contributors languages, reproduced or utilized in any form or by any means, Basel • Freiburg • Hartford • Oxford • and not of the publisher and the editor(s). 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Box, CH–4009 Basel (Switzerland) Th e authors and the publisher have exerted every eff ort to en- e-ISBN 978–3–318–06796–5 sure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precau- tions. Th is is particularly important when the recommended agent is a new and/or infrequently employed drug. [email protected] www.karger.com/anm Vol. 77, Suppl. 3, 2019 Contents DOI: 10.1159/000510225 Vitamin D: From Gestation to Adolescence in Health and Disease– Infographic – Poster 11 Editorial Lifschitz, C. (Buenos Aires) Vitamin D: From Gestation to Adolescence in Health and Disease 15 Focus on: Vitamin D in Preterm and Full-Term Infant s 16 Vitamin D in Preterm and Full-Term Infant s Abrams, S.A. (Austin, TX) 15 Focus on: Early-Life Effects of Vitamin D: A Focus on Pregnancy and Lactation 16 Early-Life Effects of Vitamin D: A Focus on Pregnancy and Lactation Wagner, C.L.; Hollis, B.W. (Charlerston, SC) 29 Focus on: Vitamin D in Toddlers, Preschool Children, and Adolescents 30 Vitamin D in Toddlers, Preschool Children, and Adolescents Taylor, S.N. (New Heaven, CT) The above articles were originally published as a supplementary issue of Annals of Nutrition and Metabolism and are reprinted here with permission. [email protected] © 2020 Nestlé Nutrition Institute, Switzerland/ S. 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Karger AG, Basel Editorial Reprinted with permission from: Ann Nutr Metab 2020;76(suppl 2):1–4 DOI: 10.1159/000508423 Vitamin D Carlos Lifschitz Department of Pediatrics, Section of Gastroenterology, Hepatology and Transplantation, Hospital Italiano, Buenos Aires , Argentina The editorial role for this issue of Annales Nestlé was initially cipal food sources of vitamin D are fish that are oil rich, such assumed by Dr. Jatinder Bhatia. For unforeseen reasons, he as salmon, mackerel, and herring, as well as organ meats, liv- was not able to complete this work. His friends at the Nestlé er, and egg yolk. However, how much and how frequently do Nutrition Institute and the Institute’s Faculty members would most children consume these natural dietary sources of vita- like to dedicate this issue to him. We look forward to his con- min D? In humans, dermal synthesis is the major natural tinued support and valuable contributions to the activities of source of the vitamin. Individuals who do not have sufficient the Nestlé Nutrition Institute. sun exposure, especially infants, require supplemental vitamin In the mid-1600s, two authors independently published in D from fortified foods or supplements. Vitamin D deficiency Latin a description of rickets. In 1840, Sniadecki, a Polish phy- is frequent in children and adults and leads to serious health sician, observed that cases of rickets occurred in children liv- problems worldwide. In recent years, vitamin D has notably ing in the industrial center of Warsaw, while they did not occur attracted scholars’ attention because of its influences on cell among those living in the country outside Warsaw. He hy- growth and differentiation, immune and cardiovascular func- pothesized that lack of exposure to sunlight in the cramped tion, as well as calcium and phosphate homeostasis [1] . city streets, with considerable pollution due to the burning of In this issue, firstly, Carol L. Wagner and Bruce W. Hollis wood and coal, was the cause of the disease. However, the discuss the early-life effects of vitamin D in their article “Early- concept that the sun could have any useful benefit on the Life Effects of Vitamin D: A Focus on Pregnancy and Lacta- skeleton was not well accepted at that time. Since then, much tion.” They describe that the active form of vitamin D – has been learned about vitamin D. Undoubtedly, vitamin D 1,25-dihydroxyvitamin D (1,25[OH]2 D) – increases during plays a fundamental role in the development and mainte- pregnancy and remains elevated throughout, and unlike at nance of the musculoskeletal system. But its function goes other times during the lifecycle, it is directly affected by the well beyond hormone-like regulation, as it can also be gener- circulating 25-hydroxyvitamin D (25[OH]D) concentration. ated by simple unicellular organisms. When a mother is vitamin D deficient, her milk is deficient, Vitamin D is a prohormone absorbed from food sources or which can be remedied by direct infant supplementation; supplements and also synthesized in the skin following expo- however, this treats only the infant. A safe alternative during sure to ultraviolet light. The prohormone subsequently is con- lactation to infant supplementation is direct maternal vitamin verted to the metabolically active form in the liver and then D supplementation at higher doses than usual (6,400 IU/day), the kidneys. Few foods naturally contain vitamin D. The prin- improving the vitamin D status of the mother and the content [email protected] © 2020 Nestlé Nutrition Institute, Switzerland/ Carlos Lifschitz, MD S. Karger AG, Basel Department of Pediatrics, Section of Gastroenterology, Hepatology and Transplantation Hospital Italiano, Juan D. Peron 4190 Buenos Aires, C1181ACH (Argentina) carlos.lifschitz @ hiba.org.ar of the milk and, consequently, the vitamin D status of the in- opment mechanisms, on the other, are closely interrelated fant, effectively treating both mother and infant. and represent mutually dependent processes [2] . A study con- In the second article, Steven A.

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