Interim report on vitamin D by the Panel on Child Nutrition : first report by the Panel on Nutrition of the Elderly.

  • Great Britain. Panel on Child Nutrition.
Date:
1970
Catalogue details

Licence: Public Domain Mark

Credit: Interim report on vitamin D by the Panel on Child Nutrition : first report by the Panel on Nutrition of the Elderly. Source: Wellcome Collection.

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    occurred after the 1960 survey. Rather, the difference is likely to have arisen out of the different methods of investigation adopted; in the one, health visitors asked mothers questions directly related to a limited number of Vitamin D-containing foods and medicinal preparations and these, perforce, must have been leading in nature, whereas in the second, a record of all food consumed was kept under the supervision of lay investigators; thus, no special attention was drawn to Vitamin D-containing foods. (Also, though mothers were asked to record it, not all may have regarded the administration of vitamin preparations as part of feeding.) The truth as regards intakes may well lie somewhere between the two sets of findings. The most relevant findings are given as the Table in paragraph 20 and shown in the diagram. From these, and from the Scottish study and that made by the commercial firm, the impression emerges that nearly all babies receive variable but substantial amounts of Vitamin D during the first 6-12 months of life, but thereafter the intakes of some children must be well below the allowance of 400 i.u. put forward by most countries. The recom- mended allowance is not, of course, to be interpreted as synonymous with the requirement for Vitamin D. Rather, it is the amount above which it can with fair confidence be said that no benefit will accrue. 23. During the first year fortified milks and fortified cereals supply important amounts of Vitamin D. From the second year on this is no longer so. Once the foods which are specially intended for infants are no longer consumed, the only fortified food in the diet is margarine, of which the consumption is variable and in any case less than it once was. As the histograms show, intakes of Vitamin D are substantially lower in the second year of life and subsequent years. 24. The Scottish survey of feeding practices was analysed differently from the British (commercial) study and it is not easy to compare the two. In Scotland 2.7 to 27.7 per cent of all children under 3 months were fed liquid milk depending on the locality (Arneil, 1967). In the British survey 2.8 per cent of children aged 0-3 months had been given cow’s milk on the previous day; by 3-5 months and 6-8 months, these figures had risen to 16 and 33 per cent respectively. Both reports indicate that most of those who did not drink fortified milk received some additional Vitamin D, for example in infant cereals consumed in unstated amounts. “Idiopathic” hypercalcaemia of infancy 25. The British Paediatric Association’s Report (1964) “Infantile Hyper- calcaemia, Nutritional Rickets and Infantile Scurvy in Great Britain”’ stated that 80 per cent of cases of hypercalcaemia occurred in the first six months of life. Although the reported cases could not clearly be divided into “‘mild”’ or “‘severe”’ types it appeared that at least 8 per cent were “severe”. Twenty-eight per cent of fifty cases reported between 1960 and 1961 were stated to have received no Vitamin D supplements before the onset of the disease. Nearly all of the fifty cases had had fortified milk and at least 40 per cent were receiving some addi- tional form of Vitamin D supplementation. It was impossible to be sure from the records of the extent to which excess of Vitamin D might have been a cause of the hypercalcaemia. It is probable that an excessive post-natal intake of Vitamin 8