Vitamin D status in relation to systemic and intestinal inflammation in undernourished children, 6–59 months old: Design and rationale of a non-controlled open label trial

Abstract

Background: vitamin D deficiency is prevalent in undernourished children, even in countries with abundant sunshine. Child undernutrition is known to be associated with elevated markers of systemic and intestinal inflammation, which in turn have been related to vitamin D (vitD) status. Furthermore, vitD status has shown to be potentially associated with iron status because of shared inflammatory mechanisms. Considering the anti- inflammatory benefits of vitD, it is likely that the co-existence of high inflammation and poor iron status in undernourished children may be related to vitD status. Hence, supplementation of vitD may potentially reduce inflammation and improve the iron status of undernourished children. However, knowledge of this is limited. Objectives and methods: to assess the (1) association of vitD status with systemic and intestinal inflammation and iron status in undernourished children, (2) effect of vitD supplementation on systemic and intestinal inflammation and iron status, and (3) predictors of vitD status. Undernourished (experimental) and non-undernourished (controls) children, 6-59 months, are recruited from clinics in the JB Marks Municipality, South Africa. At baseline participant's dietary vitD intake, sunshine exposure, anthropometry, medication and nutritional supplement history are assessed. 2 mL of venous blood is collected for 25(OH)D, inflammation and iron status assessment before and after the supplementation of three doses of 50,000 IU/week of vitD. Anticipated results and conclusion: this trial will provide insights into the potential role of vitD in resolving inflammation and improving iron status in undernourished children, which will contribute to informing optimal strategies for advancing the treatment of child undernutrition.