Effects of vitamin D supplementation on bone density in healthy children

Low bone mineral density is a major risk factor for osteoporotic fracture. Peak bone mass and rate of bone loss both impact on bone mineral density in later life. A 10% increase in peak bone mass is estimated to halve the risk of osteoporotic fracture in adult life. Strategies to maximize peak bone mass in children have been identified as a priority area for research.

The objective of this systematic review and meta-analysis was to determine the effectiveness of vitamin D supplementation for improving bone mineral density in children and adolescents and if effects vary with factors such as vitamin D dose and vitamin D status. Six studies totaling 343 patients on placebo and 541 patients on vitamin D were included in the meta analysis [1].

Vitamin D supplementation had no statistically significant effects on total body bone mineral content and mineral density of the hip, forearm, and lumbar spine. A small effect of vitamin D supplementation was found among participants with low serum vitamin D concentration on total body mineral content and lumbar spine bone density.

In conclusion, vitamin D supplementation is unlikely to be beneficial in children and adolescents with normal vitamin D levels. However, a subgroup analysis suggests that addition of vitamin D in deficient children could result in clinically useful improvements.

1. Winzenberg et al. BMJ. 2011;342:c7254.