High-dose vitamin D3 in the treatment of severe acute malnutrition: a multicenter double-blind randomized controlled trial.
Am J Clin Nutr. 2018 May 1;107(5):725-733. doi: 10.1093/ajcn/nqy027.
Saleem J1,2, Zakar R1, Zakar MZ1, Belay M2, Rowe M3, Timms PM3, Scragg R4, Martineau AR2.
Children (6-58 months) with severe acute malnutrition
Randomized Controlled Trial gave 2 doses of 200,000 IU of Vitamin D3 (@ week 2 and week 4)
It is amazing how much improvement results from just $2 worth of Vitamin D by week 8
Can expect even better results (including weight gain) if:
- The Vitamin D levels were adjusted for infant weight
- i.e. children who weigh 2X more are given 2X larger doses
- Used a Vitamin D which is gut friendly (Suspect that many malnurished infants had poor guts)
- The results were checked months, not weeks later - when the body had a chance to make use of the Vitamin D
Missed opportunity: Give vitamin D to malnurished infants might prevent them from becoming malnurished children
Author said that he decided on the trial because vitamin D was being added locally and he wanted to see if it actually was helping
See also Vitamin D Life
- Rickets virtually cured by 90,000 IU of Vitamin D along with daily Calcium – RCT Nov 2018
- Overview Loading of vitamin D
- 100,000 IU Vitamin D weekly for 4 weeks is safe and effective for children – May 2019 similar 400,000 IU total
- Malnourished children with low vitamin D were 2.8 X more likely to be stunted – Aug 2018
- Ability to walk at age 1 is 3.9 X more likely if sufficient vitamin D – July 2019
Download the PDF from Vitamin D Life
BACKGROUND:
Vitamin D deficiency is common in children with severe acute malnutrition, in whom it is associated with severe wasting. Ready-to-use therapeutic food (the standard treatment) contains modest amounts of vitamin D that do not reliably correct deficiency.
OBJECTIVE:
The aim of this study was to determine whether high-dose oral vitamin D3 enhances weight gain and development in children with uncomplicated severe acute malnutrition.
DESIGN:
We conducted a randomized placebo-controlled trial of high-dose vitamin D3 supplementation in children aged 6-58 mo with uncomplicated severe acute malnutrition in Pakistan. Participants were randomly assigned to receive 2 oral doses of 200,000 IU vitamin D3 or placebo at 2 and 4 wk after starting ready-to-use therapeutic food. The primary outcome was the proportion of participants gaining >15% of baseline weight at 8 wk after starting ready-to-use therapeutic food (the end of the study). Secondary outcomes were mean weight-for-height or -length z score and the proportion of participants with delayed development at the end of the study (assessed with the Denver Development Screening Tool II), adjusted for baseline values.
RESULTS:
Of the 194 randomly assigned children who started the study, 185 completed the follow-up and were included in the analysis (93 assigned to intervention, 92 to control). High-dose vitamin D3 did not influence the proportion of children gaining >15% of baseline weight at the end of the study (RR: 1.04; 95% CI: 0.94,1.15, P = 0.47), but it did increase the weight-for-height or -length z score (adjusted mean difference: 1.07; 95% CI: 0.49,1.65, P < 0.001) and
reduce the proportion of participants with
- delayed global development (adjusted RR (aRR): 0.49; 95% CI: 0.31, 0.77, P = 0.002),
- delayed gross motor development (aRR: 0.29; 95% CI: 0.13, 0.64, P = 0.002),
- delayed fine motor development (aRR: 0.59; 95% CI: 0.38, 0.91, P = 0.018), and
- delayed language development (aRR: 0.57; 95% CI: 0.34, 0.96, P = 0.036).
CONCLUSIONS:
High-dose vitamin D3 improved the mean weight-for-height or -length z score and developmental indexes in children receiving standard therapy for uncomplicated severe acute malnutrition in Pakistan.
This trial was registered at clinicaltrials.gov as NCT03170479.