Insufficient Vitamin D Levels in Children Connected to Slow Fracture Healing Process

New study findings presented at the American Academy of Pediatrics 2024 National Conference & Exhibition showed that low levels of vitamin D could affect the healing process of fractures among pediatric populations. The results were found in a retrospective review of children aged 0 to 17 years with extremity fractures that recorded vitamin D levels in the year of injury from January 2015 to May 2022, according to study authors.^1,2

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Vitamin D exposure is essential in bone health as it aids calcium absorption. The nutrient can be consumed with the intake of dairy products, such as milk, cheese, and yogurt, but can also be found in fish and breakfast cereals that contain the vitamin. Additionally, study authors noted that vitamin D can be absorbed through moderate exposure to sunlight.^1,2

“Getting outside and enjoying the fresh air can do wonders for your health while also upping vitamin D absorption,” said Jessica McQuerry, MD, senior author on the study, in a news release. “What a great excuse to get outside and explore nature!”¹

Previous studies have investigated a connection in vitamin D to fracture prevention in adults, but its link to fracture prevention in pediatric populations has not been conducted. Investigators conducted a VITamin D and OmegA-3 TriaL (VITAL) study, with results published in 2022, that tested if supplemental vitamin D3 would result in lower risk of fractures compared to a placebo. The results found that the supplement did not significantly lower risk of fractures than the placebo among generally healthy midlife and older individuals that did not have vitamin D deficiency, low bone mass, or osteoporosis.³

The study authors noted that the current study analyzed the impact of vitamin D levels on clinical radiographic healing time, the effect of upper and lower extremity fractures, and the connection between vitamin D levels and healing time. The study included 187 fractures among 166 children, with the mean age of 7.9 years.²

Among the 166 children, 61.4% had low vitamin D levels that were connected to significantly longer clinical and radiographic healing times compared to normal levels of vitamin D in children. Additionally, the results found that children with low vitamin D levels with lower extremity fractures healed slower clinically and radiographically, compared to children with normal vitamin D levels. The same results were reflected among children that received surgery due to injury. The study authors noted that minimal supplementation in children with low vitamin D levels was also connected with longer radiographic healing times.^1,2

Specifically, the study results showed that children with low vitamin D levels who experience leg fractures that did not need surgery took an extra 20 days to heal clinically and 2 months more to display recovery in an x-ray. However, when surgery was needed, the healing took 1 extra month and did not reflect recovery in an x-ray until 4 months.¹

“Previous studies have focused more on how vitamin D can help prevent fractures but now we are seeing a link between low vitamin D levels and longer fracture healing times,” said McQuerry in the news release. “Children need to be given well-balanced diets that include vitamin D for overall health and to make sure when accidents do happen, they can heal appropriately.”¹

The findings suggest that parents and guardians should check their child's vitamin D levels if a fracture is exceeding the normal healing time. Pharmacists and health care providers can recommend vitamin D supplements and natural intake to increase a child’s vitamin D consumption and to confirm levels are above 30 ng/ml.^1,2

REFERENCES

1. Low Vitamin D levels in pediatric patients linked to slow healing process. EurekAlert!. News release. September 27, 2024. Accessed October 2, 2024. https://www.eurekalert.org/news-releases/1058471.

2. Low Vitamin D Levels in Pediatric Patients Linked to Slow Healing Process. American Academy of Pediatrics. News release. September 27, 2024. Accessed October 2, 2024. https://www.aap.org/en/news-room/news-releases/aap/2024/low-vitamin-d-levels-in-pediatric-patients-linked-to-slow-healing-process/#xd_co_f=MTU1ZDdkMzktMzNlMy00ZTMzLTk2N2UtNGU2MDdmZjgzOWQ5~.

3. Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults. The New England Journal of Medicine. News release. July 27, 2024. Accessed October 2, 2024. https://www.nejm.org/doi/full/10.1056/NEJMoa2202106.