In addition, existing studies on the relationship between vitamin D and health outcomes must be interpreted together with knowledge of the physiology of vitamin D metabolism, the vitamin D supply in Germany, the possibility of errors in the measurement of vitamin D, and the background of the existing vitamin D target values. However, to make a population-wide recommendation for vitamin D supplementation in childhood and adolescence, a proven benefit should preferably be demonstrated in randomized controlled intervention trials. Adverse reactions from adequately dosed vitamin D supplements (e.g., 600–800 IU/day) are unlikely, as vitamin D has a broad therapeutic index. However, vitamin D supplementation in children over the age of 2 years of age, even at low vitamin D serum levels, is becoming increasingly controversial. Vitamin D not only positively affects the skeletal system but is also postulated to be preventative of inflammatory diseases, autoimmune diseases such as type I diabetes, attention-deficit/hyperactivity disorder, asthma bronchiale, multiple sclerosis, cancers, and lifestyle-related diseases such as obesity, type II diabetes, hypertension, and heart failure. Since many children in Germany do not achieve desired vitamin D intake levels, it is debated whether and when vitamin D supplementation should take place beyond the first 12 to 18 months of life.
Routine vitamin D supplementation is not recommended in children who do not have risk factors and chronic diseases which are associated with calcium or vitamin D resorption disorders. Conclusionīased on currently available studies, routine vitamin D supplementation is not be recommended for children aged > 2 years, even when they have serum concentrations below reference values. Vitamin D supplementation has no effect on the rate of multiple sclerosis relapses, but on the number of new lesions detected by MRI. Vitamin D supplementation has no relevant effect on attention-deficit/hyperactivity disorders, cardiac failure, hypertension, or incidence of type II diabetes mellitus. Vitamin D supplementation can potentially reduce the risk for influenza infections and improve asthma bronchiale exacerbation however, it has no impact on asthma bronchiale severity. The effects of vitamin D supplementation in children > 2 years of age are analyzed based on a literature review of randomized controlled trials (RCTs). Since vitamin D serum concentrations in children and adolescents are frequently below reference values, it is debated whether vitamin D should be supplemented after infancy. Low vitamin D serum concentrations have been associated with rickets and other disorders in observational studies.
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