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Händel MN, Frederiksen P, Osmond C, Cooper C, Abrahamsen B, Heitmann BL. Prenatal exposure to vitamin D from fortified margarine and risk of fractures in late childhood: period and cohort results from 222 000 subjects in the D-tect observational study. Br J Nutr 2017; 117:872-881. [PMID: 28393739 PMCID: PMC5426325 DOI: 10.1017/s000711451700071x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/16/2017] [Accepted: 03/03/2017] [Indexed: 12/15/2022]
Abstract
Prenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification programme, we examined the risk of fractures among 10-18-year-old children from proximate birth cohorts born around the date of the termination of the programme. For all subjects born in Denmark during 1983-1988, civil registration numbers were linked to the Danish National Patient Registry for incident and recurrent fractures occurring at ages 10-18 years. Multiplicative Poisson models were used to examine the association between birth cohort and fracture rates. The variation in fracture rates across birth cohorts was analysed by fitting an age-cohort model to the data. We addressed the potential modification of the effect of vitamin D availability by season of birth. The risk of fractures was increased among both girls and boys who were born before the vitamin D fortification terminated in 1985 (rate ratio (RR) exposed v. non-exposed girls: 1·15 (95 % CI 1·11, 1·20); RR exposed v. non-exposed boys: 1·11 (95 % CI 1·07, 1·14). However, these associations no longer persisted after including the period effects. There was no interaction between season of birth and vitamin D availability in relation to fracture risk. The study did not provide evidence that prenatal exposure to extra vitamin D from a mandatory fortification programme of 1·25 µg vitamin D/100 g margarine was sufficient to influence the risk of fractures in late childhood, regardless of season of birth. Replication studies are needed.
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Affiliation(s)
- Mina Nicole Händel
- Department of Clinical Research, Odense Patient Data
Explorative Network (OPEN), Odense University Hospital,
University of Southern Denmark, 5000 Odense
C, Denmark
- Research Unit for Dietary Studies, Bispebjerg and
Frederiksberg Hospital, The Parker Institute and the Institute of
Preventive Medicine, 2000 Frederiksberg,
Denmark
| | - Peder Frederiksen
- Research Unit for Dietary Studies, Bispebjerg and
Frederiksberg Hospital, The Parker Institute and the Institute of
Preventive Medicine, 2000 Frederiksberg,
Denmark
| | - Clive Osmond
- Medical Research Council Lifecourse Epidemiology Unit,
University of Southampton, Southampton SO16
6YD, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit,
University of Southampton, Southampton SO16
6YD, UK
| | - Bo Abrahamsen
- Department of Clinical Research, Odense Patient Data
Explorative Network (OPEN), Odense University Hospital,
University of Southern Denmark, 5000 Odense
C, Denmark
- Department of Medicine, Holbæk Hospital,
DK-4300 Holbæk, Denmark
| | - Berit L. Heitmann
- Research Unit for Dietary Studies, Bispebjerg and
Frederiksberg Hospital, The Parker Institute and the Institute of
Preventive Medicine, 2000 Frederiksberg,
Denmark
- Section for General Practice, Department of Public
Health, Copenhagen University, Øster Farimagsgade 5, opg. Q,
1014, Copenhagen K, Denmark
- The Boden Institute, Charles Perkins Centre, University of
Sydney, D17, Johns Hopkins Drive, Camperdown NSW 2006,
Sydney, Australia
- National Institute of Public Health, University of
Southern Denmark, Øster Farimagsgade 5A, 2. 1353 Copenhagen
K, Denmark
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