Bone Abstracts

Objectives: Randomised controlled trials (RCTs) of vitamin D to reduce the incidence of infections among children have yielded variable results (Holland, 2012; Camargo, 2012). We performed a RCT of supplementation with vitamin D3 (cholecalciferol) along with calcium or supplementation with zinc in order to assess their effect on the incidence of infections in rural Indian school children.

Methods: A double-blind, placebo-controlled RCT was conducted on 465 children (248 boys), aged 6–12 years from Western India (18°N). Fifty-four children dropped-out of the study and supplements were administered to the remaining children as follows daily for 6 months: vitamin D (1000 IU) and calcium (500 mg) supplementation was administered to 124 children, zinc (10 mg) to 142 children and a placebo was given to 145 children. Detailed anthropometry, dietary and environmental data were collected at baseline and endline. Information on infection-related symptoms was collected fortnightly for 6 months using a validated questionnaire administered to parents and children. Biochemical assessments included serum 25OHD and zinc.

Results: After removal of outliers, final results have been presented on 361 children – 119 (vitamin D+ Calcium group), 118 (zinc group) and 124 (placebo group). All the three groups had similar anthropometric characteristics, environmental characteristics, personal hygiene habits and nutritional intakes at baseline and endline. The mean serum vitamin D concentration at baseline was 58.7±10.7 nmol/l with no significant difference among the three groups. At 6 months there was significant increase (P<0.05) in serum vitamin D levels in vitamin D and calcium supplemented group (82.2±27.8 nmol/l vs 61.7±16.4 in placebo and 56.5±15.5 nmol/l in the zinc group). There was no significant difference noted in the serum zinc levels among the theree groups at endline. No significant differences in morbidity status viz respiratory infections, gastrointestinal infections, or skin infections were noted at baseline or endline among the three groups using Kruskal–Wallis test.

Conclusion: Supplementation with vitamin D or zinc in school-children did not help to reduce the incidence of infections.

Disclosure: The authors declared no competing interests.