RESUMO
INTRODUCTION: Vitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency. METHODS: A systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted. Updated recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation system describing the strength of the recommendation and the quality of supporting evidence. Twenty-seven contributors representing different areas of expertise and medical specialties, including pediatricians, geriatricians, endocrinologists, epidemiologists, nephrologists, gynecologists and obstetricians evaluated the available published evidence related to vitamin D, formulated the goals of this document and developed a common consolidated position. The consensus group, representing six national specialist consultants and eight Polish and international scientific organizations/societies, participated in the process of grading evidence and drawing up the general and specific recommendations. RESULTS: The updated recommendations define the diagnostic criteria for the evaluation of vitamin D status and describe the prevention and treatment strategies of vitamin D deficiency in the general population and in groups at increased risk of the deficiency. Age- and weight-specific recommendations for prevention, supplementation and treatment of vitamin D deficiency are presented, and detailed practice guidance is discussed regarding the management in primary and specialized health care. CONCLUSION: Vitamin D deficiency remains still highly prevalent in Poland, in all age groups. Currently, there is a great necessity to implement a regular supplementation with recommended doses and to develop an effective strategy to alleviate vitamin D deficiency in the population. These updated recommendations are addressed to health professionals and the authorities pursuing comprehensive health policies and should also be included in public health programs aimed at preventing a broad spectrum of chronic diseases.
RESUMO
INTRODUCTION: Only few publications concern the influence of the vitamin D and calcium consumption on the bone mineralization in the developmental age. AIM OF THE STUDY: The aim of the study was the analysis of the vitamin D and calcium diet supply in relation to the bone status assessed with Quantitative Ultrasound (QUS) in growing children. MATERIAL AND METHODS: The study comprised 643 pupils (384 girls and 259 boys) at the age 9-13 years from primary schools in lódZ. The medium daily consumption of vitamin D and calcium was estimated with the computer program Dieta 2. In all children the QUS was performed. RESULTS: Extreme deficiency of vitamin D was found in the diet of nearly all examined children (in 96,7% schoolgirls and 95,7% schoolboys). Girls consumed on average 25,5% of recommended values, boys 33,3%. Considerable deficiency of diet calcium was observed in 92% schoolgirls and 81,9% of schoolboys. The medium daily consumption of calcium was higher than vitamin D and reached 59,2% of recommended values in girls and 66,2% in boys. In 48% of children an decrease of at least one of the QUS parameters was observed. The statistical analysis showed positive, significant correlation between QUS parameters and calcium consumption, it was not observed for vitamin D. CONCLUSIONS: 1. The deficiency of diet vitamin D and calcium is common in children in lódZ. 2. The extremely low supply of diet vitamin D does not meet the recommended values. 3. The lowering of the QUS parameters observed in 48% of children indicates for worse bone mineralization and bone quality. 4. The results of this study indicate for the necessity of changes in nutritional habits of children and adolescence and if it is not possible the supplementation of vitamin D and calcium.