Maternal vitamin D in pregnancy may influence not only offspring bone mass but other aspects of musculoskeletal health and adiposity
Section snippets
Vitamin D
Vitamin D status, measured as the circulating 25-hydroxyvitamin D (25OHD) level, is a key determinant of production of 1,25-dihydroxyvitamin D (1,25(OH)2D), the secosteroid hormone required for normal bone growth and mineralisation [1], and for increasing the number and size of muscle fibres [2].
Vitamin D does not naturally occur in the majority of unfortified foods [3]; hence, in many countries vitamin D is derived predominantly from sun exposure [4]. Personal sun exposure may have decreased
Musculoskeletal health
Extant literature suggests that the risk of osteoporosis and consequent fragility fractures in adult life might be programmed by environmental influences during gestation [12]. There are also data to suggest that maternal vitamin D status during pregnancy affects intrauterine skeletal mineralisation [13] and skeletal growth in children [14]. Maternal veiling in pregnancy, a surrogate for low vitamin D levels, has been associated with reduced bone mass among adolescent boys [15]. In a
Adiposity
There is evidence from two studies that adult body mass index and the prevalence of obesity vary as a function of month of birth [24], [25]. Greater adiposity was found for men and women born in winter–spring, possibly reflecting fetal exposure to low vitamin D during the second or third trimester of pregnancy.
Vitamin D deficiency is also emerging as a risk factor for the metabolic syndrome in adults [26]. The evidence supports an inverse relationship between serum 25OHD and components of the
Conclusion
There is an emerging body of evidence to suggest that intrauterine vitamin D insufficiency may also be associated with later development of autoimmune and cardiovascular diseases, type I diabetes, schizophrenia, seasonal affective disorder and some cancers [7], but we have focussed on the hypothesis that maternal vitamin D insufficiency during pregnancy affects bone mass and other aspects of musculoskeletal development and adiposity in the offspring. We emphasise that adequate maternal vitamin
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