IBD in children might be associated with low sun exposure

Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset - Aug 2018

Photochem Photobiol. 2018 Aug 29. doi: 10.1111/php.13007.
Holmes EA1, Rodney Harris RM1, Lucas RM1,2.

• 1 National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia.
• 2 Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia.

The incidence and prevalence of inflammatory bowel disease (IBD) are increasing worldwide. Some ecological studies show increasing incidence with increasing latitude. Ambient ultraviolet radiation varies inversely with latitude, and sun exposure of the skin is a major source of vitamin D. Vitamin D deficiency is common in patients with IBD. Sun exposure and vitamin D have immune effects that could plausibly reduce, or be protective for, IBD. One quarter of new IBD cases are diagnosed in childhood or adolescence, but most research is for adult-onset IBD.

Here we review the evidence for low sun exposure and/or vitamin D deficiency as risk factors for IBD, focusing where possible on pediatric IBD, where effects of environmental exposures may be clearer.
The literature provides some evidence of a latitude gradient of IBD incidence, and evidence for seasonal patterns of timing of birth or disease onset are inconsistent. High prevalence of vitamin D deficiency occurs in people with IBD, but cannot be interpreted as being a causal risk factor. Evidence of vitamin D supplementation affecting disease activity is limited. Further research on pre-disease sun exposure and well-designed supplementation studies are required to elucidate whether these potentially modifiable exposures are indeed risk factors for IBD.

Conclusions – from PDF
Inflammatory bowel disease is complex disorder arising from a combination of genetic susceptibility and environmental exposures, including those that change the gut microbiome, resulting in immune activation. Geographic patterns of disease onset suggest a role for environmental factors that vary according to latitude. Sun exposure - either through vitamin D production only, or through a wider range of pathways, has plausible, immune mediated, actions that may reduce the risk of developing IBD. We have shown that, despite support from ecological studies related to latitude, there is little evidence to support increased disease risk according to season of birth or of a season-of-onset effect. Individual-level observational studies show high prevalence of vitamin D deficiency in IBD, but the study designs generally are unable to distinguish between low 25OHD as a risk factor rather than a disease-induced consequence. Further, they are unable to distinguish between sun exposure and vitamin D as risk factors - vitamin D supplementation studies provide limited evidence of benefits for disease activity. Thus, the individual roles of low sun exposure or vitamin D deficiency - if any - in the aetiology of IBD (particularly PIBD) remain unclear.
The incidence and prevalence of IBD are increasing worldwide in both developed and developing countries. Much of what we know about IBD has been determined from studies of adults, yet a quarter of new IBD cases are diagnosed in children or adolescents. There are suggestions from this review that 25OHD levels may be less important in PIBD than IBD, but this will require further studies that are adequately powered. There is very little work on past sun exposure in relation to IBD risk, in pediatric or adult populations. Understanding any differences in disease risk factors between pediatric and adult onset IBD may shed light on the etiology of IBD.

PDF is available free at Sci-Hub   10.1111/php.13007

Diet, Sun, Physical Activity and Vitamin D Status in Children with Inflammatory Bowel Disease - Feb 2022

Nutrients 2022, 14(5), 1029; https://doi.org/10.3390/nu14051029
by Karolina Śledzińska 1,*ORCID,Piotr Landowski 2,Michał. A. Żmijewski 3,*ORCID,Barbara Kamińska 2,Konrad Kowalski 4 andAnna Liberek 1

In the course of inflammatory bowel disease (IBD) malabsorption may lead to a vitamin D deficiency and calcium–phosphate misbalance. However, the reports on the vitamin D status in children with IBD are few and ambiguous. Here, we are presenting complex analyses of multiple factors influencing 25OHD levels in IBD children (N = 62; Crohn’s disease n = 34, ulcerative colitis n = 28, mean age 14.4 ± 3.01 years, F/M 23/39) and controls (n = 47, mean age 13.97 ± 2.57, F/M 23/24). Additionally, calcium–phosphate balance parameters and inflammatory markers were obtained. In children with IBD disease, activity and location were defined. Information about therapy, presence of fractures and abdominal surgery were obtained from medical records. All subjects were surveyed on the frequency and extent of exposure to sunlight (forearms, partially legs for at least 30 min a day), physical activity (at least 30 min a day) and diet (3 days diary was analyzed with the program DIETA 5). The mean 25OHD level was higher in IBD patients compared to controls (18.1 ng/mL vs. 15.5 ng/mL; p = 0.03). Only 9.7% of IBD patients and 4.25% of controls had the optimal vitamin D level (30–50 ng/mL). Despite the higher level of 25OHD, young IBD patients showed lower calcium levels in comparison to healthy controls. There was no correlation between the vitamin D level and disease activity or location of gastrointestinal tract lesions. Steroid therapy didn’t have much influence on the vitamin D level while vitamin D was supplemented. Regular sun exposure was significantly more common in the control group compared to the IBD group. We found the highest concentration of vitamin D (24.55 ng/mL) with daily sun exposure. There was no significant correlation between the vitamin D level and frequency of physical activity. The analysis of dietary diaries showed low daily intake of vitamin D in both the IBD and the control group (79.63 vs. 85.14 IU/day). Pediatric patients, both IBD and healthy individuals, require regular monitoring of serum vitamin D level and its adequate supplementation.
 Download the PDF from Vitamin D Life

Vitamin D Life - Gut and Infant-Child

Vitamin D Life - Overview Gut and vitamin D

• Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
• Celiac disease has a strong genetic component.
  • Most, but not all, people with celiac disease have a gene variant.
  • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
  • Celiac disease causes poor absorption of nutrients such as vitamin D.
  • Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
  • The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
• Review in Nov 2013 found that Vitamin D helped
  Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
• All items in category gut and vitamin D 177 items

Vitamin D Life -Gut category

• "Ulcerative Colitis" OR UC 839 items Jan 2020
• "celiac disease" OR CD 1830 items July 2019
• IBS or IBD or IRRITABLE BOWEL in title of 37 Vitamin D Life pages as of July 2021
• Gut-Friendly forms of vitamin D
  • such as: bio-emulsion, topical, spray, sublingual, inhaled, injection .

Vitamin D Life - Overview Gut and vitamin D gut-friendly