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 5 years 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 6-12 years 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. (c) 2017 Elsevier Inc. All rights reserved.