Open Access Highly Accessed Open Badges Study protocol

The influence of early exposure to vitamin D for development of diseases later in life

Ramune Jacobsen1, Bo Abrahamsen2, Marta Bauerek1, Claus Holst1, Camilla B Jensen1, Joachim Knop1, Kyle Raymond1, Lone B Rasmussen3, Maria Stougaard1, Thorkild IA Sørensen1, Allan A Vaag4 and Berit L Heitmann15*

Author affiliations

1 Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals - a part of Copenhagen University Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark

2 Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, Odense, DK-5000, Denmark

3 Danish Veterinary and Food Administration, Ministry of Food, Agriculture and Fisheries, Stationsparken 31-33, Glostrup, DK-2600, Denmark

4 Institute of Clinical Medicine, Orthopedics and Internal Medicine, Rigshospitalet, Blegdamsvej 9, Copenhagen, DK-2100, Denmark

5 National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5 A, DK-2000 Copenhagen, Denmark

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Citation and License

BMC Public Health 2013, 13:515  doi:10.1186/1471-2458-13-515

Published: 28 May 2013



Vitamin D deficiency is common among otherwise healthy pregnant women and may have consequences for them as well as the early development and long-term health of their children. However, the importance of maternal vitamin D status on offspring health later in life has not been widely studied. The present study includes an in-depth examination of the influence of exposure to vitamin D early in life for development of fractures of the wrist, arm and clavicle; obesity, and type 1 diabetes (T1D) during child- and adulthood.


The study is based on the fact that in 1961 fortifying margarine with vitamin D became mandatory in Denmark and in 1972 low fat milk fortification was allowed. Apart from determining the influences of exposure prior to conception and during prenatal life, we will examine the importance of vitamin D exposure during specific seasons and trimesters, by comparing disease incidence among individuals born before and after fortification. The Danish National databases assure that there are a sufficient number of individuals to verify any vitamin D effects during different gestation phases. Additionally, a validated method will be used to determine neonatal vitamin D status using stored dried blood spots (DBS) from individuals who developed the aforementioned disease entities as adults and their time and gender-matched controls.


The results of the study will contribute to our current understanding of the significance of supplementation with vitamin D. More specifically, they will enable new research in related fields, including interventional research designed to assess supplementation needs for different subgroups of pregnant women. Also, other health outcomes can subsequently be studied to generate multiple health research opportunities involving vitamin D. Finally, the results of the study will justify the debate of Danish health authorities whether to resume vitamin D supplementation policies.

Vitamin D; Food fortification; Prenatal exposure; Prevention; Type 1 diabetes; Obesity; Fractures