ESPEYB16 13. Global Health for the Paediatric Endocrinologist Micronutrients (2 abstracts)
13.16. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries
Roth DE , Abrams SA , Aloia J , Bergeron G , Bourassa MW , Brown KH , Calvo MS , Cashman KD , Combs G , De-Regil LM , Jefferds ME , Jones KS , Kapner H , Martineau AR , Neufeld LM , Schleicher RL , Thacher TD & Whiting SJ
Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, Texas; NYU Winthrop Hospital, Mineola, New York; The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, New York; Bill & Melinda Gates Foundation, Seattle, Washington; U.S. Food and Drug Administration, Silver Spring, Maryland; Cork Centre for Vitamin D and Nutrition Research, University College Cork, Cork, Ireland; Tufts University, Medford, Massachusetts; Nutrition International, Ottawa, Ontario, Canada; Centers for Disease Control and Prevention, Atlanta, Georgia; MRC Elsie Widdowson Laboratory, Cambridge, United Kingdom; Independent Contractor, New York, New York; Blizard Institute, Queen Mary University of London, London, United Kingdom; Global Alliance for Improved Nutrition, Geneva, Switzerland; Mayo Clinic, Rochester, Minnesota, USA; University of Saskatchewan, Saskatoon, Saskatchewan, Canada. daniel.roth@sickkids.ca
Ann N Y Acad Sci. 2018 Oct;1430(1):44–79. DOI: 10.1111/nyas.13968
• This technical report reviews the global prevalence and public health disease burden of vitamin D deficiency.
• Funded by the Bill & Melinda Gates foundation, the working group of content experts from North America and Europe provide a roadmap outlining population-based strategies to improve vitamin D status in low- and middle-income countries (LMICs).
Population representative data on vitamin D status in LMICs are scarce, particularly in youth. Despite predominantly low-quality literature, the available evidence to date suggests that vitamin D deficiency and nutritional rickets may be widespread globally (1), especially in regions where fortification programs do not exist. Most affected are populations residing in Asia, the Middle East, and Africa, as well as immigrants from these regions living in countries at higher latitudes. This report gathers evidence on global prevalence estimates and on functional consequences of vitamin D deficiency, outlines criteria to define vitamin D deficiency as a public health problem and provides an approach to reduce the associated health burden. While there are no surprising or new conclusions with regards to the recommended method to determine vitamin D status (25-OHD measurements), the cut-off to define deficiency (<30 nmol/L), the availability of reliable sources of vitamin D (most foods and UVB radiation are not), or the known consequences of vitamin D deficiency, novelty lies in the clearly outlined roadmap for action to address the global burden.
The suggested approach is a collaborative action between national ministries of health and international organizations. The roadmap starts with an assessment of vitamin D status, whereby the population status is deemed insufficient warranting public health interventions if more than 20% of the populations have 25-OHD levels <30 nmol/L, or in the absence of available 25-OHD data if the prevalence of rickets is >1%. Next, intervention via introduction of mandatory fortification of staple foods and/or supplementation of at-risk subgroups is recommended as appropriate based on the assessment. Options for vehicles for food fortification including dairy products, edible oils, and flour are mentioned. Lastly, monitoring and evaluation processes accompany the roadmap. The report ends with a list of research opportunities that reflect the many knowledge gaps that are still to be filled. Much is still to be learned, but a first step at tackling vitamin D deficiency and its complications in LMICs has been made.
References: 1. Cashman KD, Sheehy T, O’Neill CM. Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur. J. Nutr. 2019 Feb;58(1):433-453. doi: 10.1007/s00394-018-1607-3.
2. Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J. Steroid Biochem. 2014; Mol. Biol. 144: 138–145.
Volume 16
Article tools
My recent searches
My recently viewed abstracts
Authors
ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more