Gates funding Vitamin D studies during pregnancy to improve growth– Dec 2012

Update - study did not find a benefit when starting at 17th week

• Vitamin D Supplementation in Pregnancy and Lactation and Infant Growth Aug 2018
  28,000 IU/week, not start until 17th week, which is too late to be a benefit
• Ensure a healthy pregnancy and baby - take Vitamin D before conception
  • 10th week is the latest to start with Vitamin D maintenance dose

A Grand Challenge: Can Vitamin D Improve Growth During Pregnancy?

Gates Foundation ==> Impatientoptimists

Overview

Daniel Roth and colleagues at the Hospital for Sick Kids in Canada will test the role of Vitamin D in improving growth during pregnancy.
We’ve known for a long time that Vitamin D is important for bone growth, but we know surprisingly little about its role in fetal growth.

Parathyroid-Vitamin D Axis Dysregulation in Early-Onset Infant Stunting in Resource-Poor Primary

Investigator: Daniel Roth, Hospital for Sick Children, Toronto, Ontario, Canada - CA

Challenge: Discover New Ways to Achieve Healthy Birth, Growth, and Development
Daniel Roth of the Hospital for Sick Kids in Canada and colleagues will test whether endocrine factors cause stunting in early infancy.
They will analyze parathyroid hyperactivity in a cohort of infants from Bangladesh, where stunting is estimated to affect almost half of all children under the age of 5. To uncover the mechanisms responsible for this hyperactivity, they will conduct a vitamin D supplementation trial and analyze maternal, cord, and infant plasma specimens for evidence of dysregulation of the parathyroid-vitamin D axis. Their goal is to understand the cause of widespread vitamin D deficiency in the region, which is under-appreciated, and its linkage to early growth retardation.

45% of children in Bangladesh are stunted – due to malnutrition and low levels of vitamin D

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See also VitaminDwiki

• Infants in Finland who got 2000 IU vitamin D daily grew to normal height – March 2011
  excellent proof that a lot of vitamin D does not harm - the only outcome appears to be a huge decrease in diabetes as the cohort got older
• Pregnancy and vitamin D meta-analysis – July 2012
• Premature or low birth weight resulted in children 3X more likely to be anxious – May 2011
• 7X more likely to have low birth weight babies when mother very low on vitamin D – March 2010
• Arab pre-term infants often have less than 10 ng of vitamin D - 2010
• All items in Pregnancy and Vitamin D 751 items
• All items in category Rickets and vitamin D 119 items
• All items in category Infants/children and vitamin D 606 items
• 50% of very low birthweight infants develop osteopenia with rickets before May 2011
• Prevention of vitamin D deficiency in mothers and infants worldwide - a paradigm shift. – Feb 2012
  Behind a $48 paywall
• Almost all newborns in India have less than 20 ng of vitamin D – Nov 2012
• Rickets in 30 % of infants in India who had low vitamin D – March 2011
• Severely deficient children had huge benefit from single huge dose of vitamin D – Sept 2012
• Infants again found to need more than 400 IU of vitamin D – Sept 2012
• Dark skin births are much riskier due to lack of vitamin D
• Overview Pregnancy and vitamin D which had the following Dec 2012

IU	Cumulative Benefit	Blood level	Cofactors	Calcium	$*/year
400	Less Rickets (but not zero with 400 IU) 3X less adolescent Schizophrenia Fewer child seizures	20-30 ng/ml	Not needed	No effect	$3
2000	2X More likely to get pregnant naturally/IVF 2X Fewer dental problems with pregnancy 8X less diabetes 4X fewer C-sections (>37 ng) 4X less preeclampsia (40 ng vs 10 ng) 5X less child asthma 2X fewer language problems age 5	42 ng/ml	Desirable	< 750 mg	$15
4000	2X fewer pregnancy complications 2X fewer pre-term births	49 ng/ml	Must have cofactors	< 750 mg	$75
6000	Probable: larger benefits for above items Perhaps prevent 2nd autistic child    clinical trials underway Just enough D for breastfed infant		Must have cofactors	< 750 mg	$85

• If heavily clothed, very little vitamin D – Dec 2012 has the following images

• How often should I take 50000 IU (1.25 mg) of vitamin D
  take a tablet once a month (on average) during pregnancy for a retail cost of less than 1 cent per day
  infant/child can take the tablet (which would be 1/2 the dose that the infants in Finland got)
  see below - fortification would dramatically reduce the cost of vitamin D

Hope that this study will consider vitamin D intervention, and fortification

• Clinical Trials for Infant Growth with vitamin D INTERVENTION 79 as of Nov 2014
• Probably can fortify foods with vitamin D: such as spices, cooking oil (mustard oil, ground nut oil), ghee (clarfied butter), etc.
  The cost such Vitamin D fortification appears to be 12 cents per person per YEAR (parents and children would all be fortified)

Overview Fortification of Vitamin D

Comment left at the Gates website by Vitamin D Life
Vitamin D has been proven to provide excellent benefits to health of both child and mother.
You can now buy vitamin D in tablets which just cost 1 cent a day which will reduce stunted growth.
There are, for example, 59 clinical trials listed for infant growth after vitamin D INTERVENTION.
Vitamin D fortification of food such as spices would reduce the cost per day to under 1/10 cent
https://www.vitad.org/tiki-index.php?page_id=3540

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About $100 more income during woking life for every $1 spent on nutrition to prevent stunting

focus on age 0-2 years, no mention of vitamin D
Every dollar spent on childhood nutrition can save up to $166 Nov 2014