Background: Achieving optimal levels of vitamin D (VitD) and calcium (Ca) is essential for developing children, especially in patients with inflammatory bowel disease (IBD). VitD and Ca play a major role in bone health and recently VitD has shown to potentiate the effect of anti-inflammatory treatments. However, achieving a sufficient oral intake is difficult in this group taking into account young age, modern eating habits and the nature of IBD itself. The purpose of this study was to evaluate if children with IBD seen in our centre achieve optimal Vit D and Ca intake according to recommendations made by the British Scientific Advisory Committee on Nutrition and the UK Department of Health.
Methods: A prospective dietetic survey was conducted among sequential IBD children seen in clinics over a 12 month period. Ca and VitD intakes were assessed through a 24-hour recall of dietary intake questionnaire. Children who had been placed on restricted diets for allergic disease were excluded as well as children under 4 years. Included patients were classified according to age into 2 groups: 4–10 and 11–18 years. Sources of VitD were divided into dairy, oily fish, fortified cereals and egg. Analysis was performed using absolute values, percentages and means in Microsoft Excel.
Results: Survey was conducted in 151 patients, this represents 68.3% of all IBD patients under follow-up. 94 patients were included for analysis and 57 were excluded. 43/94 (45.7%) were females. Overall, only 26.6% and 21.3% of the surveyed population achieved the current recommended intake for Ca and VitD respectively. In the younger group, only 7/31 (22.6%) met the current VitD recommendations, the same figure repeats with regards Ca intake. In the older group, only 13/63 (20.6%) and 18/63 (28.6%) met the Ca and VitD recommendations respectively. In both groups dairy was the main source of vitamin D (61.3% young ones and 58.7% older ones). Less than 1/3 of the patients have an optimal intake of oily fish and egg (sufficient intake 19%, 9% for children and 30%, 26% for adolescents).
Conclusions: Paediatric IBD patients living in the UK do not meet the minimum requirements of VitD and Ca intake and therefore are at risk of having poor bone health, calcium homeostasis imbalance and VitD deficiency. In the great majority, Ca and VitD sources come from diary whereas the contribution of oily fish and egg as a VitD source is minimal. We recommend that paediatric IBD patients receive frequent counseling on healthy eating habits and proactive intake monitoring. Routine VitD supplementation recommended by local authorities must be followed as there is an insufficient vitD oral intake among these population.