1 International Journal of Medical and Health Research www.medicalsciencejournal.com ISSN: 2454-9142 Received: 04-06-2023, Accepted: 20-06-2023, Published: 07-07-2023 Volume 9, Issue 4, 2023, Page No. 1-6 Vitamin D deficiency in Indian child-mother pair and evaluation of calcium with or without oral vitamin D supplementation: exploring a “suitable” intervention strategy Bandana Sen 1* , Mahua Chanak 2 , Kaushik Bose 2 1 Health Research and Training Institute, Society for Applied Studies, Salt Lake City, Kolkata, West Bengal, India 2 Department of Anthropology, Vidyasagar University, Paschim Midnapore, West Bengal, India Abstract Background: Vitamin D deficiency (VDD) prevails in epidemic proportions in the Indian sub continent and other developing countries. The absence of vitamin D fortified food and a strong culture obstacle for exposure to sunlight are major causes of VDD in India. Periodically administering large doses of vitamin D supplementation is the only option to prevent VDD. Aim: Our aim was to evaluate calcium and/ or vitamin D supplementation of Indian child-mother pairs. Methods: This study was a double blind, randomized controlled trial. Intervention: Group A received a total of 3500 mg of Shelcal tablets periodically, while Group B received a total of 600,000 IU of Calcirol sachets along with 3500 mg of Shelcal tablets for children, and 900,000 IU of Calcirol sachets with 3500 mg of Shelcal tablets for mothers at 15-day intervals from day 0 to day 90. We examined the vitamin D status at baseline, 90 days post-intervention, and after a 90-day follow-up, i.e., on day 0 and day 180. Results: At baseline, 65% children and 85% mothers were Vitamin D deficient [25(OH)D<50nmol/L]. Significant increases were observed in serum 25(OH)D levels by 23.55 and 17.2, respectively, in children and mothers after 90 days of supplementing with calcium and vitamin D. Both groups (Group A and Group B) of child-mother pairs showed a decrease in calcium and alkaline phosphatase levels. After 90 days post-intervention and 90 days phone follow-up, only 21.4% children and 16.7% mothers were vitamin D sufficient. Conclusion: The supplementation of calcium with vitamin D for 90 days resulted in a significant increase in serum 25(OH)D levels in both child-mother pairs. Keywords: Vitamin D, 25-hydroxy vitamin D, alkaline phosphatase, hypovitaminosis D, Calcirol sachet Introduction Vitamin D deficiency (VDD) is a global public health problem affecting about 50% of the worldwide population (Holick & Chen 2008) [8] . Cultural and social taboos often dictate lifestyle patterns, such as clothing choices, that may limit sun exposure. The socioeconomically backward (or disadvantaged) people constitute a large percentage of the population in India. (Agarwal et al. 2002) [1] . The underprivileged generally suffer from overall poor nutrition, and access to most vitamin D supplements is limited. The typical dressing style followed in India, which allows for sun exposure, seems like a distant reality for urban Indians working indoors (Gupta & Gupta 2014) [6] . Therefore, they require more vitamin D. Vitamin D can be obtained from three sources: sun exposure, vitamin D supplements, and vitamin D fortified foods. However, traditional practices, desire for fair skin, the lack of vitamin D in food, and the unorganized nature of milk fortification make it impractical to rely solely on these sources. Vitamin D is a fat-soluble vitamin playing a vital role in human physiology. In West Bengal, VDD as determined by (based on) low blood level of 25-Hydroxy vitamin D [25(OH)D] is common in under 7 years old children and their mothers. This situation is similar to the situation in many regions of India (Gupta and Gupta 2014) [6] . Tests were conducted on families from low socio-economic group (urban poor) from the metropolitan city of Kolkata. Exposure to sunlight is minimal and is avoided by most people in India. Obtaining sufficient vitamin D from natural food sources alone is difficult. Therefore, consuming vitamin D fortified food and some exposure to sunlight are essential for maintaining a good vitamin D status. Vitamin D and Calcium recommendations often coincide as these nutrients are metabolically interrelated and serve endocrine functions (Institute of Medicine 1997). The objective of this study was to assess vitamin D deficiency and evaluate calcium supplementation with or without vitamin D of Indian children and their mothers. Materials and methods Subjects This study was a double blind Randomized Controlled Trial (RCT) conducted at the Infectious Disease (ID) hospital, Kolkata, India. Healthy non pregnant women aged 18 to 40 yrs old and their children 1 to less than 7 yrs were enrolled in this study. We recruited these children and their mothers from the family welfare clinic of a large charitable Government Hospital called “ID Hospital”, which has an outdoor clinic in the city of Kolkata, India, after obtaining written informed consent from the women. They came from