The Convergence of Two Epidemics: Vitamin D Deficiency in Obese School-aged Children.

PROBLEM: Vitamin D deficiency (VDD) and obesity are two interrelated global epidemics that affect school-aged children. This article will review the relationship between VDD and obesity in school-aged children and implications it has for the pediatric nurse (PN).

ELIGIBILITY CRITERIA: Original articles of studies, review articles and meta-analyses were selected from the past 5years and pooled for review. These included obese school-aged children who had vitamin D insufficiency. The latest guidelines concerning the issue were also included.

SAMPLE: Children 6-12years of age with obesity and vitamin D insufficiency.

RESULTS

This review strongly implies obesity in children being a strong risk factor for VDD. Prevention of VDD starts with lifestyle changes and adequate dietary intake of fortified foods and current screening recommendations for VDD are inconsistent. Vitamin D supplementation is recommended with inadequate intake or deficient serum 25-hydroxyvitamin D levels or signs of hypocalcemia. Supplementation doses differ based on whether VDD is being prevented or being treated and in obese children, the Endocrine Society recommends a dose that is two to three times higher than for normal weight children. Subclinical signs and symptoms of VDD include musculoskeletal pain, fractures, reduced bone density and reduced immunity.

CONCLUSIONS

Whereas obesity is a strong risk factor for VDD, more research is needed to clarify the role of VDD as a risk factor for obesity.

IMPLICATIONS: The PN plays an essential role in preventing, screening for, assessing for, treating and counseling on VDD in obese school-aged children.