title: Randomized study of sunshine exposure and serum 25-OHD in breast-fed infants in Beijing, China. Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Factors affecting bone density in young adults. Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y. Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial. Increasing weight-bearing physical activity and calcium-rich foods to promote bone mass gains among 9–11 year old girls: outcomes of the Cal-Girls study Double Blind Study on the Need for Vitamin D Supplementation in Prepubertal Children Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. Effect of vitamin D supplementation on bone and vitamin D status among Pakistani immigrants in Denmark: a randomised double-blinded placebo-controlled intervention study. Wintertime Vitamin D Deficiency in Male Adolescents: Effect on Parathyroid Function and Response to Vitamin D3 Supplements The hospital cost of vertebral fractures in the EU: estimates using national datasets Effects of two years' milk supplementation on size-corrected bone mineral density of Chinese girls. Seasonal and geographical variations in the growth rate of infants in China receiving increasing dosages of vitamin D supplements. ED-71, a new active vitamin D3, increases bone mineral density regardless of serum 25(OH)D levels in osteoporotic subjects A positive dose-response effect of vitamin D supplementation on site-specific bone mineral augmentation in adolescent girls: a double-blinded randomized placebo-controlled 1-year intervention. School-milk intervention trial enhances growth and bone mineral accretion in Chinese girls aged 10-12 years in Beijing. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. Bone density at various sites for prediction of hip fractures [Prevention of vitamin D deficiency in adolescents and pre-adolescents. An interventional multicenter study on the biological effect of repeated doses of 100,000 IU of vitamin D3].
abstract: The hypothesis that breastfed infants in Beijing , China , have low vitamin D status and that sunshine exposure increases serum 25-hydroxyvitamin D ( 25-OHD ) concentrations was tested in a r and omized prospect i ve study involving 42 healthy infants 1 - 8 months of age . 24 controls were exposed to the usual amount of sunshine , while the 18 cases were provided with 2 hours of sunshine/day . All infants were being breastfed without vitamin D supplementation .  Serum 25-OHD concentrations at entry into the study ranged from 3 - 61 ng/ml and increased with age . 3 infants in each group were diagnosed as having rickets . Serum 25-OHD concentrations did not change significantly during the 2-month study period among controls , while serum 25-OHD values increased significantly in the experimental group . Final infant serum 25-OHD concentrations correlated with ultraviolet exposure scores ( p.001 ) . The estimate of ultraviolet score needed to maintain a serum 25-OHD of 11 ng/ml was 2.4 ( 24 minutes/day with only the face uncovered ) . Rickets has been reported in as many as 18 % of Chinese infants and seems to especially affect those 2 - 4 months of age . The fact that not all infants with rickets in this study had low 25-OHD concentrations suggests 2 possibilities : 1 ) not all rickets is necessarily related to a vitamin D deficiency , or 2 ) serum 25-OHD concentrations are not the best indicator of vitamin D status . The low serum 25-OHD concentrations in many Chinese infants may be related to low maternal milk vitamin D content result ing from the lack of vitamin D food fortification . Overall , these results suggest that the diet of breastfed Chinese infants should be supplemented with orally administered vitamin BACKGROUND Little is known about the effect of vitamin D status on bone gain in adolescents . OBJECTIVE The objective was to examine whether vitamin D status is associated with accrual of bone mineral density ( BMD ) and bone mineral apparent density ( BMAD ) . DESIGN This 3-y prospect i ve study examined the association between changes in BMD or BMAD and serum 25-hydroxyvitamin D [ 25(OH)D ] in 171 healthy Finnish girls aged 9 - 15 y.  Lumbar spine and femoral neck BMDs were measured by dual-energy X-ray absorptiometry . RESULTS Baseline 25(OH)D correlated significantly with the unadjusted 3-y change in BMD at the lumbar spine ( r = 0.35 , P < 0.001 ) and femoral neck ( r = 0.32 , P < 0.001 ) in all participants . The difference from baseline in adjusted 3-y BMD accumulation between those with severe hypovitaminosis D [ 25(OH)D < 20 nmol/L ] and those with a normal vitamin D status [ 25(OH)D > or = 37.5 nmol/L ] was 4 % ( 12.7 % , 13.1 % , and 16.7 % for the lowest , middle , and highest tertiles of 25(OH)D , respectively ; P for trend = 0.01 ) at the lumbar spine in the girls with advanced sexual maturation at baseline ( n = 129 ) . Moreover , the adjusted change in lumbar spine BMD was 27 % greater in the highest vitamin D intake tertile than in the lowest tertile in the same girls ( P for trend = 0.016 ) . CONCLUSIONS Pubertal girls with hypovitaminosis D seem to be at risk of not reaching maximum peak bone mass , particularly at the lumbar spine . Dietary enrichment or supplementation with vitamin D should be considered to ensure an adequate vitamin D status A 14-y follow-up of 581 children who took part in a r and omized controlled trial of the effect of a milk supplement on growth of children was conducted to investigate the supplement 's effect on adult bone mineral content ( BMC ) and density ( BMD ) . BMC and BMD of the nondominant forearm were measured by single-photon absorptiometry in 371 subjects ( 64 % ) aged 20 - 23 y , at a proximal site ( shaft of radius and ulna ) and at a distal site near the wrist .  BMC s and BMDs tended to be higher in the intervention group ( NS ) . Cross-sectionally , BMD was positively associated with body weight ( P less than 0.01 ) in both sexes ; inversely associated with alcohol consumption ( P less than 0.05 ) , and positively with manual occupation ( NS ) in men ; positively associated with current intakes of calcium ( P less than 0.05 ) , vitamin D ( P less than 0.01 ) , and sports activity during adolescence ( P less than 0.01 ) , and inversely with parity ( NS ) in women . In multiple linear-regression analysis body weight and sports activity during adolescence were stronger determinants of female BMD than was diet New Zeal and children , particularly those of Māori and Pacific ethnicity , may be at risk for low vitamin D status because of low vitamin D intakes , the country 's latitude ( 35 - 46 degrees S ) , and skin color . The aim of this study was to determine 25-hydroxyvitamin D concentrations and their determinants in a national sample of New Zeal and children aged 5 - 14 y. The 2002 National Children 's Nutrition Survey was design ed to survey New Zeal and children , including oversampling of Māori and Pacific children to allow ethnic-specific analyses . A 2-stage recruitment process occurred using a r and om selection of schools , and children within each school .  Serum 25-hydroxyvitamin D concentration [ mean ( 99 % CI ) nmol/L ] in Māori children ( n = 456 ) was 43 ( 38,49 ) , in Pacific ( n = 646 ) 36 ( 31,42 ) , and in New Zeal and European and Others ( NZEO ) ( n = 483 ) 53 ( 47,59 ) . Among Māori , Pacific , and NZEO , the prevalence ( % , 99 % CI ) of serum 25-hydroxyvitamin D deficiency ( < 17.5 nmol/L ) was 5 ( 2,12 ) , 8 ( 5,14 ) , and 3 ( 1,7 ) , respectively . The prevalence of insufficiency ( < 37.5 nmol/L ) was 41 ( 29,53 ) , 59 ( 42,75 ) , and 25 ( 15,35 ) , respectively . Multiple regression analysis found that 25-hydroxyvitamin D concentrations were lower in winter than summer [ adjusted mean difference ( 99 % CI ) nmol/L ; 15 ( 8,22 ) ] , lower in girls than boys [ 5 ( 1,10 ) ] , and lower in obese children than in those of " normal " weight [ 6 ( 1,11 ) ] . Relative to NZEO , 25-hydroxyvitamin D concentrations were lower in Māori [ 9 ( 3,15 ) ] and Pacific children [ 16 ( 10,22 ) ] . Ethnicity and season are major determinants of serum 25-hydroxyvitamin D. There is a high prevalence of vitamin D insufficiency in New Zeal and children , which may or may not contribute to increased risk of osteoporosis and other chronic disease . There is a pressing need for more convincing evidence concerning the health risks associated with the low  vitamin D status in New Zeal and children BACKGROUND Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period . OBJECTIVE The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition  in girls aged 10 - 12 y. DESIGN This placebo-controlled intervention trial r and omly assigned 195 healthy girls at Tanner stage I-II , aged 10 - 12 y , with dietary calcium intakes < 900 mg/d to 1 of 4 groups : calcium ( 1000 mg ) + vitamin D3 ( 200 IU ) , calcium ( 1000 mg ) , cheese ( 1000 mg calcium ) , and placebo . Primary outcomes were bone indexes of the hip , spine , and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography . RESULTS With the use of intention-to-treat or efficacy analysis , calcium supplementation with cheese result ed in a higher percentage change in cortical thickness of the tibia than did placebo , calcium , or calcium + vitamin D treatment ( P = 0.01 , 0.038 , and 0.004 , respectively ) and in higher whole-body bone mineral density than did placebo treatment ( P = 0.044 ) when compliance was > 50 % . With the use of a hierarchical linear model with r and om effects to control for growth velocity , these differences disappeared . CONCLUSIONS Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium . Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty Background A two-year , community-based , group-r and omized trial to promote bone mass gains among 9–11 year-old girls through increased intake of calcium-rich foods and weight-bearing physical activity was evaluated . Methods Following baseline data collection , 30 5th- grade Girl Scout troops were r and omized to a two-year behavioral intervention program or to a no-treatment control group . Evaluations were conducted at baseline , one year , and two years . Measures included bone mineral content , density , and area ( measured by DXA ) , dietary calcium intake ( 24-hour recall ) , and weight-bearing physical activity ( physical activity checklist interview ) . Mixed-model regression was used to evaluate treatment-related changes in bone mineral content ( g ) for the total body , lumbar spine ( L1-L4 ) , proximal femur , one-third distal radius , and femoral neck . Changes in eating and physical activity behavioral outcomes were examined . Results Although the intervention was implemented with high fidelity , no significant intervention effects were observed for total bone mineral content or any specific bone sites . Significant intervention effects were observed for increases in dietary calcium . No significant intervention effects were observed for increases in weight-bearing physical activity . Conclusion Future research needs to identify the optimal dosage of weight-bearing physical activity and calcium-rich dietary behavior change required to maximize bone mass gains in pre-adolescent and adolescent girls ABSTRACT . Fifty‐one healthy prepubertal schoolchildren were followed for 13 months in a double blind study . Twenty‐four of them were supplemented with 400 IU of vitamin D2 5–7 times weekly , while 27 received a placebo . The children were examined in winter both at the beginning and at the end of the study , and in the middle of the study in autumn . Mean 25‐hydroxyvitamin D levels in the supplemented group were significantly higher than those in the placebo group both in autumn and in winter , when the study ended . The vitamin D supplementation did not , however , affect other vitamin D metabolites , serum calcium , albumin , inorganic phosphorus , parathyroid hormone concentrations or alkaline phosphatase activity . Moreover , the supplementation caused no alterations in the weight or height gain or bone mineral content of the distal radius of the children , and thus sub clinical rickets could not be shown The objective of this study was to determine whether vitamin D supplementation of breast-fed infants during the first year of life is associated with greater bone mineral content and /or areal bone mineral density ( aBMD ) in later childhood . The design was a retrospective cohort study . One hundred and six healthy prepubertal Caucasian girls ( median age , 8 yr ; range , 7 - 9 yr ) were classified as vitamin D supplemented or unsupplemented during the first year of life on the basis of a question naire sent to participating families and their pediatricians . Bone area ( square centimeters ) and bone mineral content ( grams ) were determined by dual energy x-ray absorptiometry at six skeletal sites . Vitamin D receptor ( VDR ) 3'-gene polymorphisms ( BsmI ) were also determined . The supplemented ( n = 91 ) and unsupplemented ( n = 15 ) groups were similar in terms of season of birth , growth in the first year of life , age , anthropometric parameters , and calcium intake at time of dual energy x-ray absorptiometry . The supplemented group had higher aBMD at the level of radial metaphysis ( mean + /- SEM , 0.301+/-0.003 vs. 0.283+/-0.008 ; P = 0.03 ) , femoral neck ( 0.638+/-0.007 vs. 0.584+/-0.021 ; P = 0.01 ) , and femoral trochanter ( 0.508+/-0.006 vs. 0.474+/-0.016 ; P = 0.04 ) . At the lumbar spine level aBMD values were similar ( 0.626+/-0.006 vs. 0.598+/-0.019 ; P = 0.1 ) . In a multiple regression model taking into account the effects of vitamin D supplementation , height , and VDR genotype on aBMD ( dependent variable ) , femoral neck aBMD remained higher by 0.045 g/cm2 in the supplemented group ( P = 0.02 ) . Vitamin D supplementation in infancy was found to be associated with increased aBMD at specific skeletal sites later in childhood in prepubertal Caucasian girls Severe vitamin D deficiency is common among Muslim immigrants . The dose necessary to correct the deficiency and its consequence for bone health are not known for immigrants . The aim was to assess the effect of relatively low dosages of supplemental vitamin D on vitamin D and bone status in Pakistani immigrants . This 1-year-long r and omised double-blinded placebo-controlled intervention with vitamin D3 ( 10 and 20 microg/d ) included girls ( 10.1 - 14.7 years ) , women ( 18.1 - 52.7 years ) and men ( 17.9 - 63.5 years ) of Pakistani origin living in Denmark . The main endpoints were serum 25-hydroxyvitamin D ( S-25OHD ) , parathyroid hormone , bone turnover markers and bone mass . The study showed that supplementation with 10 and 20 microg vitamin D3 per d increased S-25OHD concentrations similarly in vitamin D-deficient Pakistani women ( 4-fold ) , and that 10 microg increased S-25OHD concentrations 2-fold and 20 microg 3-fold in Pakistani men . S-25OHD concentrations increased at 6 months and were stable thereafter . Baseline S-25OHD concentrations tended to be lower in girls and women than in men ; females achieved about 46 nmol/l and men 55 nmol/l after supplementation . Serum intact parathyroid hormone concentrations decreased at 6 months , but there was no significant effect of the intervention on bone turnover markers and dual-energy X-ray absorptiometry measurements of the whole body and lumbar spine Abstract : The first part of this study consisted of an 18 month follow-up of the vitamin D status and parathyroid function in a group of 54 French male adolescents , aged from 13 to 16 years old and all pupils of a jockey training school . During the 18 month period four samplings were made , one every 6 months . The first was during September of the first year , the second and third during March and October of the second year , and the last in March of the third year . Therefore we had two main periods : summer and winter . The summer 25-hydroxyvitamin D ( 25(OH)D ) concentrations were higher ( 71.6 ± 19.9 and 52.4 ± 16.5 nmol/l ) than the winter ones ( 20.4 ± 6.9 and 21.4 ± 6.1 nmol/l ) . Conversely , the winter intact parathyroid hormone ( iPTH ) serum levels ( 4.18 ± 1.18 and 4.11 ± 1.35 pmol/l ) were higher than the summer ones ( 2.44 ± 0.82 and 2.71 ± 0.71 pmol/l ) . At the two winter time points the 25(OH)D concentrations were lower than 25 nmol/l ( 10 ng/ml ) in 72 % ( 2nd year ) and 68 % ( 3rd year ) of the adolescents . In the second part of the study we tried a vitamin D3 supplementation procedure design ed to maintain the 25(OH)D and iPTH postsummer serum levels throughout the winter . Pairs of male adolescents matched for height , weight and Tanner pubertal stage were r and omly assigned to either vitamin D3 supplementation ( 2.5 mg , i.e. , 100 000 IU ) administered orally at three specific periods ( end of September , November and January ) or no vitamin D3 treatment ( control subjects ) . Blood was collected just before the first intake of vitamin D3 and 2 months after the last intake ( March ) . The control subjects had blood drawn at the same time points . In the vitamin D3-treated subjects , the concentrations of 25 (OH)D ( 55.3 ± 11.5 nmol/l ) and of iPTH ( 3.09 ± 1.16 pmol/l ) in March and September ( 53.8 ± 12.3 nmol/l and 2.75 ± 1.26 pmol/l ) were not significantly different . In the control subjects , March 25(OH)D levels ( 21.0 ± nmol/l were low , with values below 25 nmol/l in 78 % of subjects , and iPTH concentrations ( 3.97 ± 1.08 pmol/l ) were significantly ( p<0.001 ) higher than in September ( 2.91 ± 0.81 pmol/l ) . The constant vitamin D wintertime deficiency and wintertime rise in iPTH in adolescent French males throughout puberty has been demonstrated . In adolescents with low dairy calcium intakes , the vitamin D3 treatment was sufficient to maintain 25(OH)D concentrations at their summer levels throughout winter and to prevent an excessive wintertime rise in iPTH levels The purpose of this study was to estimate the  hospital cost of vertebral fractures in the EU using national data sets to explore some of the method ologic limitations associated with such an approach . Hospital costs for vertebral fractures across the EU were compared with the hospital costs associated with hip fractures . Additionally , these costs were placed into the health care context by making comparisons with national health care expenditure . All EU Ministries of Health were contacted to identify national data sets to estimate the average length of stay , cost per diem and the number of patients discharged with vertebral fractures .  Where national information was not available expert opinion and data from the relevant literature were used instead . Countries show a marked difference in the length of stay between men and women , with differences ranging from 0.32 days in Austria to 20.2 days in Spain . The average hospitalization rate was found to be 8 % across the EU , with higher rates found for men than for women . Interestingly a positive correlation between health expenditure per capita and hospitalization rates was found . The total cost of vertebral fractures in the EU was estimated at € 377 million per year . Across the EU the hospital cost of a vertebral fracture was on average 63 % that of a hip fracture . National data sets allow us to estimate the cost of vertebral fractures in the EU but show limitations . In the absence of largescale prospect i ve studies , national data sets need to be further refined to ensure more accurate estimations of the cost of vertebral fractures in the EU Much existing data on the effects of calcium or milk products on bone mineral accretion are based on bone mineral content ( BMC ) or areal bone mineral density ( aBMD ) , neither of which accounts for changing bone size during the growing period . The aim of this study was to investigate the effects of 2-year milk supplementation on total body size-corrected BMD in Chinese girls with low habitual dietary calcium intake . Chinese girls aged 10 years were r and omised , according to their school , to receive calcium fortified milk ( Ca milk ) , or calcium and vitamin D fortified milk ( CaD milk ) for two years or act as unsupplemented controls . Dual-energy X-ray absorptiometry  total body bone measures were obtained from 345 girls at baseline and 2 years . Size-corrected total body and regional BMD was calculated as : BMDsc = BMC /BApc , where pc was the regression coefficient of the natural logarithm transformed total body BMC and bone area . After 2 years , both supplemented groups had significantly greater gain in BMDsc of total body ( 3.5 - 5.8 % , p < 0.05 ) and legs ( 3.0 - 5.9 % , p < 0.05 ) than did the control group . Milk supplementation showed positive effects on bone mineral accretion when accounting for the changing skeletal size during growth . The effects were mainly on the lower limbs In theory , sunshine exposure is sufficient to maintain normal vitamin D concentrations for the optimal growth of newborn infants . To determine whether season of birth , latitude ( north v. south ) and increasing dosages of vitamin D supplements would influence the growth rate for the first 6 months of life , 255 healthy fall- and spring-born infants from two northern and two southern cities in China were r and omly assigned to receive either 100 , 200 , or 400 IU of vitamin D a day . The study showed that season of birth and dose of vitamin D did not affect the growth rate of infants born in the same latitude , but a significant difference was found in the gain in length over the 6-month period between infants from the north and infants from the south ( P = 0.0001 ) . Regional differences among the Chinese people , other than sunshine exposure , may have influenced the difference in length gain A previous r and omized placebo-controlled double-blinded clinical trial revealed that treatment of osteoporotic subjects supplemented with 200 or 400IU/day vitamin D3 with 0.75 microg/day ED-71 for 12 months increased lumbar and hip bone mineral density ( BMD ) by 3.4 and 1.5 % , respectively , compared to placebo group ( JCE&M 90:5031,2005 ) . These effects on BMD were stronger than any previous results using 1alpha(OH)D3 or 1,25(OH)2D3 . However , there still was a concern that the effect of ED-71 could be observed because serum 25(OH)D in many of these subjects were below its optimal level . In order to address this issue , we performed post hoc analysis to compare the effect of ED-71 on lumbar and hip BMD between subjects with upper ( > 29 ng/mL ) and lower tertiles ( < 25 ng/mL ) of serum 25(OH)D.  Lumbar BMD after 12-month treatment with 0.5 , 0.75 and 1.0 microg/day ED-71 increased similarly in both lower and upper tertile groups of serum 25(OH)D. In addition , hip BMD also showed a tendency to increase when 0.75 and 1.0 microg/day ED-71 groups were combined together in both upper and lower serum 25(OH)D tertile groups , although the increase was not statistically significant . These results demonstrate that the effect of ED-71 on bone is independent of supplementary effect for nutritional vitamin D insufficiency , and suggest that ED-71 may exert its effect as a unique VDR lig and with stronger effect on bone compared to the natural lig and , 1,25(OH)2D3 UNLABELLED The effect of vitamin D supplementation on bone mineral augmentation in 212 adolescent girls with adequate calcium intake was studied in a r and omized placebo-controlled setting . Bone mineral augmentation determined by DXA increased with supplementation both in the femur and the lumbar vertebrae in a dose-responsive manner . Supplementation decreased the urinary excretion of resorption markers , but had no impact on formation markers . INTRODUCTION Adequate vitamin D intake protects the elderly against osteoporosis , but there exists no indisputable evidence that vitamin D supplementation would benefit bone mineral augmentation . The aim of this 1-year study was to determine in a r and omized double-blinded trial the effect of 5 and 10 microg vitamin D3 supplementation on bone mineral augmentation in adolescent girls with adequate dietary calcium intake . MATERIAL S AND METHODS Altogether , 228 girls ( mean age , 11.4 + /- 0.4 years ) participated . Their BMC was measured by DXA from the femur and lumbar spine . Serum 25-hydroxyvitamin D [ S-25(OH)D ] , intact PTH ( S-iPTH ) , osteocalcin ( S-OC ) , and urinary pyridinoline ( U-Pyr ) and deoxypyridinoline ( U-Dpyr ) were measured . Statistical analysis was performed both with the intention-to-treat ( IT ) and compliance-based ( CB ) method . RESULTS In the CB analysis , vitamin D supplementation increased femoral BMC augmentation by 14.3 % with 5 microg and by 17.2 % with 10 microg compared with the placebo group ( ANCOVA , p = 0.012 ) . A dose-response effect was observed in the vertebrae ( ANCOVA , p = 0.039 ) , although only with the highest dose . The mean concentration of S-25(OH)D increased ( p < 0.001 ) in the 5-microg group by 5.7 + /- 15.7 nM and in the 10-microg group by 12.4 + /- 13.7 nM , whereas it decreased by 6.7 + /- 11.3 nM in the placebo group . Supplementation had no effect on S-iPTH or S-OC , but it decreased U-DPyr ( p = 0.042 ) . CONCLUSIONS Bone mineral augmentation in the femur was 14.3 % and 17.2 % higher in the groups receiving 5 and 10 microg of vitamin D , respectively , compared with the placebo group , but only 10 mug increased lumbar spine BMC augmentation significantly . Vitamin D supplementation decreased the concentration of bone resorption markers , but had no impact on bone formation markers , thus explaining increased bone mineral augmentation . However , the positive effects were noted with the CB method but not with IT A 2-year milk intervention trial was carried out with 757 girls , aged 10 years , from nine primary schools in Beijing ( April 1999 - March 2001 ) . Schools were r and omised into three groups : group 1 , 238 girls consumed a carton of 330 ml milk fortified with Ca on school days over the study period ; group 2 , 260 girls received the same quantity of milk additionally fortified with 5 or 8 microg cholecalciferol ;  group 3 , 259 control girls .  Anthropometric and bone mineralisation measurements , as well as dietary , health and physical-activity data , were collected at baseline and after 12 and 24 months of the trial . Over the 2-year period the consumption of this milk , with or without added cholecalciferol , led to significant increases in the changes in height ( > or = 0.6 % ) , sitting height ( > or = 0.8 % ) , body weight ( > or 2.9 % ) , and ( size-adjusted ) total-body bone mineral content ( > or = 1.2 % ) and bone mineral density ( > or = 3.2 % ) . Those subjects receiving additional cholecalciferol compared with those receiving the milk without added 25-hydoxycholecalciferol had significantly greater increases in the change in ( size-adjusted ) total-body bone mineral content ( 2.4 v. 1.2 % ) and bone mineral density ( 5.5 v. 3.2 % ) . The milk fortified with cholecalciferol significantly improved vitamin D status at the end of the trial compared with the milk alone or control groups . It is concluded that an increase in milk consumption , e.g. by means of school milk programmes , would improve bone growth during adolescence , particularly when Ca intake and vitamin D status are low BACKGROUND Despite the high prevalence of hypovitaminosis D in children and adolescents worldwide , the impact of vitamin D deficiency on skeletal health is unclear . METHODS One hundred seventy-nine girls , ages 10 - 17 yr , were r and omly assigned to receive weekly oral vitamin D doses of 1,400 IU ( equivalent to 200 IU/d ) or 14,000 IU ( equivalent to 2,000 IU/d ) in a double-blind , placebo-controlled , 1-yr protocol . Areal bone mineral density ( BMD ) and bone mineral content ( BMC ) at the lumbar spine , hip , forearm , total body , and body composition were measured at baseline and 1 yr . Serum calcium , phosphorus , alkaline phosphatase , and vitamin D metabolites were measured during the study . RESULTS In the overall group of girls , lean mass increased significantly in both treatment groups ( P < or = 0.05 ) ; bone area and total hip BMC increased in the high-dose group ( P < 0.02 ) . In premenarcheal girls , lean mass increased significantly in both treatment groups , and there were consistent trends for increments in BMD and /or BMC at several skeletal sites , reaching significance at lumbar spine BMD in the low-dose group and at the trochanter BMC in both treatment groups . There was no significant change in lean mass , BMD , or BMC in postmenarcheal girls . CONCLUSIONS Vitamin D replacement had a positive impact on musculoskeletal parameters in girls , especially during the premenarcheal period Women with low bone density in the radius or calcaneus are at increased risk of  hip fracture . To see whether bone density of the hip measured by dual X-ray absorptiometry is a better predictor of hip fracture than measurements of other bones , we assessed bone density at several sites in 8134 women aged 65 years or more . 65 women had hip fractures during a mean follow-up of 1.8 years . Each SD decrease in femoral neck bone density increased the age-adjusted risk of hip fracture 2.6 times ( 95 % CL 1.9 , 3.6 ) . Women with bone density in the lowest quartile had an 8.5-fold greater risk of hip fracture than those in the highest quartile . Bone density of the femoral neck was a better predictor than measurements of the spine ( p < 0.0001 ) , radius ( p < 0.002 ) , and moderately better than the calcaneus ( p = 0.10 ) . Low hip bone density is a stronger predictor of hip fracture than bone density at other sites . Efforts to prevent hip fractures should focus on women with low hip bone density UNLABELLED Recent studies have shown a high prevalence of calcium and vitamin D deficiencies in adolescents . The aim of this present study was to follow the changes in calcium status and 25 hydroxyvitamin D ( 25[OH]D ) and parathyroid hormone ( iPTH ) levels during winter in preadolescents and adolescents from four university hospitals in northern France . SUBJECTS AND METHODS Two groups of teenagers and adolescents ( range : 10 - 15 years ) were followed from October 1996 to June 1997 . They were given either 100,000 IU of vitamin D ( treated group n = 33 ) or a placebo ( control group n = 35 ) in October , January and April . Serum calcium , phosphate , 25(OH)D and iPTH levels were measured at inclusion and every three months thereafter . RESULTS At inclusion , plasma or serum 25(OH)D levels were < or = 10 ng/mL in 16 subjects and < 6 ng/mL in six . In control children , no significant change in 25(OH)D occurred during the study , while plasma or serum iPTH levels increased to 34 + /- 11 pg/mL. In the treated groups , 25(OH)D levels remained > 20 ng/mL in every subject ; no hypercalcemia was observed ; and the mean plasma or serum iPTH level was 25 + /- 14 pg/mL at the end of the study . CONCLUSION Teenagers presented with a high prevalence of biological vitamin D deficiency at the end of summer . The increase of iPTH during winter in the unsupplemented group suggests that this has secondary consequences on their calcium homeostasis unless they are supplemented with vitamin D. We advocate a sufficient calcium supply and a 100,000 IU vitamin D supplement given two or three times during winter to preadolescents and adolescents living in northern France
target: Vitamin D supplementation had no statistically significant effects on total body bone mineral content ( BMC ) , hip bone mineral density ( BMD ) or forearm BMD .
  These results do not support vitamin D supplementation to improve bone density in healthy children with normal vitamin D levels , but suggest that supplementation of deficient children may be clinical ly useful .
background: BACKGROUND Results of r and omised controlled trials ( RCTs ) of vitamin D supplementation to improve  bone density in children are inconsistent .
  OBJECTIVES To determine the effectiveness of vitamin D supplementation for improving  bone mineral density in children , whether any effect varies by sex , age or pubertal stage , the type or dose of vitamin D given or baseline vitamin D status , and if effects persist after cessation of supplementation .