Strategies to remediate vitamin D deficiency in Mongolian children

Objective To compare efficacy of supplements vs. fortified milk to correct vitamin D deficiency Methods A randomized, 45‐day study among 744 children age 9–11 comparing 5 interventions delivering the equivalent of 300 IU/day: daily supplements; “seasonal” supplement (13,700 IU at study start); fortified U.S., Mongolian, or substitute milk. Controls drank unfortified milk. T‐tests were used to compare the changes in serum 25‐hydroxy vitamin D (25OHD) levels. Results Prior to the intervention, 98% of children had 25OHD levels <20 ng/ml (mean, 8.0 ± 4.3 ng/ml). Although the mean 25OHD levels of children receiving supplements or fortified milk rose by 12.9 ± 8.1 ng/ml, compared with 0.2 ± 3.8 ng/ml for children drinking unfortified milk, 52% of children in the supplement/fortification arms remained <20 ng/ml. Levels of 25OHD levels did not differ between children receiving a daily supplement or fortified milk (p=0.15). However, among children who received the seasonal supplement, even though 25OHD levels were higher at end of study than levels in those who drank unfortified milk, 98% were deficient. Conclusion Although 300 IU daily, either as a supplement or as fortified milk, ameliorated severe vitamin D deficiency, higher doses would be required to attain optimal levels. A seasonal strategy that uses intermittent supplementation would require a larger dose and/or shorter dosing interval to achieve repletion.