Open Access Highly Accessed Research article

Calcium and vitamin D intakes in children: a randomized controlled trial

Linda Cosenza1, Vincenza Pezzella1, Rita Nocerino1, Margherita Di Costanzo1, Anna Coruzzo1, Annalisa Passariello1, Ludovica Leone1, Marcella Savoia3, Antonio Del Puente4, Antonella Esposito4, Gianluca Terrin5 and Roberto Berni Canani12*

Author Affiliations

1 Department of Pediatrics, University of Naples “Federico II”, Naples, Italy

2 European Laboratory for the Investigation of Food Induced Diseases, University of Naples “Federico II”, Naples, Italy

3 Department of Biochemistry and Medical Biotechnologies, University of Naples “Federico II”, Naples, Italy

4 Department of Clinical and Experimental Medicine, University of Naples “Federico II”, Naples, Italy

5 Department of Women Heath and Perinatal Medicine, University of Rome “La Sapienza”, Rome, Italy

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BMC Pediatrics 2013, 13:86  doi:10.1186/1471-2431-13-86

Published: 23 May 2013



Calcium (Ca2+) and vitamin D (VitD) play an important role in child health. We evaluated the daily intake of Ca2+ and VitD in healthy children. Moreover, we demonstrate the efficacy of Ca2+ and VitD supplementation.


Daily Ca2 + and VitD intake was evaluated in consecutive healthy children through a validated questionnaire. Subjects with <70% of dietary reference intakes (DRIs) of Ca2+ and VitD were invited to participate in a prospective randomized trial with 2 groups of nutritional intervention: Group 1, dietary counseling aiming to optimize daily Ca2+ and VitD intake plus administration of a commercially available Ca2 + and VitD supplementation product; Group 2, dietary counseling alone. At the enrollment (T0) and after 4 months (T1) serum 25(OH) Vitamin D levels were assessed.


We evaluated 150 healthy children (male 50%, mean age 10 years); at baseline a low VitD intake was observed in all subjects (median 0.79 μg/die, IQR 1.78; range 0.01-5.02); this condition was associated with Ca2+ intake <70% of the DRIs in 82 subjects (55%). At baseline serum 25(OH)D levels were low (<30 ng/ml) in all study subjects and after 4 months of nutritional intervention, a normalization of serum 25(OH)D levels (≥30 ng/ml) was observed in all children in Group 1 and in only one subject in Group 2 [Group 1: T1 33.8 ng/ml (IQR 2.5) vs Group 2: T1 24.5 ng/ml (IQR 5.2), p <0.001].


Adequate Ca2+ and VitD intakes are difficult to obtain through dietary counseling alone in pediatric subjects. Oral supplementation with of Ca2+ and VitD is a reliable strategy to prevent this condition.

Trial registration

The study was registered in Clinical Trials Protocol Registration System (ID number: NCT01638494).

25-hydroxyvitamin D; Dietary counseling; Pediatrics; Ca2+ intake; VitD intake; Bone metabolism; Nutritional intervention; Vitamin D supplement; Vitamin D deficiency