Image: PD
1. Supplementation with vitamin D was not associated with a reduced risk of recurrent diarrheal illnesses in children 1 to 29 months.
2. The incidence of diarrheal illness was 3.46 and 3.62 episodes/year in young children with and without vitamin D supplementation, respectively.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Diarrheal illness is a significant global health problem, resulting in the deaths of many children <5 years of age. Observational studies have demonstrated a relationship between hypovitiminosis D and increased risk for infectious disease; however, few studies have investigated the role of vitamin D in the reduction of diarrheal illness. This study aimed to evaluate the role of vitamin D supplementation in diarrheal illness prevention among infants 1 to 29 months of age in Kabul, Afghanistan. Patients were randomized to either quarterly vitamin D supplementation or placebo. There were no significant differences between the two groups in home water source or sanitation. The risk of diarrheal illness did not differ between those who received placebo and those receiving vitamin D. No benefit was seen when patients were stratified by age, nutritional status or season. This study is strengthened by its large study size with robust randomization, but was limited by caregiver evaluation of diarrheal illness. The findings of this study suggest that vitamin D repletion may not aid in the prevention of diarrheal illness among young children. Further research is needed to better understand the immunologic properties of vitamin D.
Click to read the study in Pediatrics
Relevant Reading:Vitamin D deficiency associated with increased incidence of gastrointestinal and ear infections in school-age children
In-Depth [double-blind, placebo controlled trial]: This study randomized 1524 and 1522 infants between the ages of 1 and 29 months from Kabul, Afghanistan to quarterly vitamin D or placebo supplementation, respectively. Diarrhea was defined as three or more loose stools in 24-hrs and diarrheal episodes were recorded by caregiver report. There was no significant difference in incidence of diarrhea in the control and intervention groups, with 3.46 and 3.62 episodes of diarrhea per year in the respective groups. The risk of recurrent diarrheal illness in patients with vitamin D supplementation was statistically equivalent to that of patients receiving placebo (OR = 1.05, 95% CI, 0.98-1.12, p = 0.14).
By Emilia Hermann and Leah H. Carr
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