The Relationship Between Vitamin D Deficiency and Asthma Disease in Children Research Paper

Introduction

This chapter presents an account of published information by accredited research scholars regarding the connection between vitamin D and asthma disease in children. From the review, the paper emphasizes on the need of more studies to investigate whether vitamin D supplements can be used for prevention and treatment of asthma in children.

Asthma prevalence

Asthma is a huge public health problem that affects an estimated 300 million persons worldwide and 22 million persons in the United States. A lot of burden of the disease is a result of asthma exacerbations. This causes the patient to have problems such as: increased absence from school, missed time from work, and increased health care expenditures. In children younger than the age of 15, the disease is considered to be the third leading cause of hospitalization. At the same time, the disease has 26.2 discharges per 10,000 populations. The heath care cost of the disease is estimated to be 19.7 dollars in the United States alone every year. One third of this amount mainly comes from hospitalizations as a result of exacerbations.

The prevalence rate of the disease and any other related allergic diseases has grown worldwide, particularly from the 1960s. The burden of asthma in both developing countries and the developed is significant and worth the need for drastic action. It is increasing at a very high rate with more than 300 million people in the world affected by the disease. The developed countries that are far away from the equator have the highest prevalence rate of the disease. This includes countries such as New Zealand, Australia, and the United Kingdom. In children, asthma and other allergy related diseases are known be among the causes of morbidity. This represents 90% of all cases according to a research done by Edar et al. which focused on children of 6 years old. The disease has remained in children as they grow up with the effects of the disease until adulthood. This incurs significant and huge health cost to the families of the patients.

Vitamin D and asthma

Recent studies have shown that receptors of vitamin D are found in all tissues of the human body. Deficiency of this vitamin is a widely spread disease, especially among children. The reaction of the host on the respiratory infections is closely correlated with the deficiency of the vitamin D. The level of vitamin D in the serum is expected to be within a range that helps the host react appropriately against respiratory infections. When serum vitamin D levels are low, the risk of respiratory infection in children is high. It may also contribute to morbidity rate and asthmatic symptoms. The effects of vitamin D occur outside the osseous endocrine loop. However, new discoveries that suggest association of vitamin D deficiency with non skeletal conditions have shifted research focus on vitamin D by generating new interest in Vitamin D system. The article by Wittke et al. also suggests that there is a wide spread of vitamin D deficiency among Hispanic and black children. The article further indicates that vitamin D deficiency takes a seasonal pattern. This means that in summer, the level of vitamin D is higher compared to other seasons.

More studies indicate association of vitamin D with obesity. Serum levels of vitamin D are low among children who are obese. The main reason behind this effect is the fact that vitamin D is soluble in fat that it is deposited on the adipose tissue. The editorial by Wang et al. sought to investigate whether the relationship between vitamin D and asthma in children is true or just a panacea. According to the article, the result of research studies that link vitamin D deficiency with asthma, allergic condition and respiratory diseases are too good to be true. This is because of the suggestion that providing vitamin D supplements to patients with low serum level of vitamin D and also asthma patients helps to prevent occurrence of the disease. The research study also suggests that vitamin D supplements help reduce further impairment and development of the disease to those who already have it. Hosts would sometimes fail to respond effectively to persistent asthma, however, with the vitamin D supplements, clinical response to glucocorticoid is enhanced.

Wang et al. further suggest two important aspects that create the possible link between vitamin D and asthma. The first one is that in early life, deficiency of vitamin D is highly associated with development of asthma or a wheezing illness in children. This assertion is based on a birth cohort data. The birth cohort studies identify a pathway in which the risk of asthma can be reduced. Despite the birth cohort studies, the first assertion still remains uncertain. A recent research study indicated otherwise about the first assertion. It reported lack of any association between low level of vitamin D and asthma incidence in children at five years.

The second important issue presented in the editorial is the assertion that vitamin D supplements help prevent asthma. This implies that vitamin D levels in the serum relate to characteristics such as exacerbation risks, treatment response, airway hyper-responsiveness, and lung function. A research by Brehm indicates that insufficient vitamin D status is linked to an increased risk of asthma exacerbation. The observations made by researchers tend to suggest that exacerbation risk is reduced with high levels of vitamin D. However, the problem with this research study is that it is hard to identify the pathway in which the risk of asthma can be mediated.

The impacts of vitamin D concerning calcium and bone homeostasis are well established. The parameters of serum phosphate and serum calcium levels are subjected to tight control. Deficiency of this vitamin is a widely spread disease, especially among children. The reaction of the host on the respiratory infections is closely correlated with the deficiency of the vitamin D. The level of vitamin D in the serum is expected to be within a range that helps the host react appropriately against respiratory infections. When serum vitamin D levels are low, the risk of respiratory infection in children is high. It may also contribute to morbidity rate and asthmatic symptoms. The effects of vitamin D occur outside the osseous endocrine loop.

Genetic role of Vitamin D in asthma

Based on incident cases, the presence of asthma in children is very common especially for rare cases of extreme obese children. The problem is that such cases of extreme obese adolescents are on the rise and this could project that asthma among adolescents could also be on the rise. Nonetheless, if a child or adolescent has less vitamin D at that early age, then most likely the risk of developing the disease can be influenced by the body weight. The risk is also equally high if the child or adolescent is underweight. According to a research study conducted in America, more than 2000 self participants who were obese reported that they were underweight at one point in the childhood and teenage life. This figure was high compared to those who reported to have normal body weight. The implication here is that being outside the normal range of healthiness puts one at risk of developing certain conditions including asthma. Because, this study was done through self reporting, the findings cannot be entirely relied on for the purposes of decision making.

Obesity is one of the main risk factors that contribute to the development of 2 Asthma. Because of this knowledge, if intervention measures are put in place to reduce the occurrence of obesity in both children and adults, then most likely the disease will be managed or reduced. Vitamin D is reduced by fat that deposits in the body. Obesity is a serious problem in the world today. It is common with both men and women of age between 25 and 60. According to reports on obesity in developed countries, more than half of both men and women aged between 40 and 60 are either overweight or obese. Obesity is not only common among adults but also in children. Since obesity is one of the major risk factors for Asthma, when its prevalence is on the rise it creates an implication about Asthma. Body weight and the prevalence of Asthma are strongly associated.

According to data from 11 developed countries in the world, the association between the mean body weight of the population and prevalence weight of Asthma was found to be almost 1. This means that individual body weight is strongly correlated with the ease of developing Asthma. For instance, during the Second World War, there was a lot of food rationing in the UK and this lead to a sharp decrease of death resulting from obesity. This was assumed to be the main factor that helped to reduce body weight among the current aged population. There is evidence of the relationship between obesity and prevalence rate of Asthma in the urban population. Also the evidence is very much clear on the population that transited rapidly from the rural or traditional lifestyle and the urban lifestyle.

Based on evidence, body mass index is an imperfect way of measuring total adiposity in adults (Delahunty, et al., 2001). The main reason for this is that the relationship between adiposity and body mass index can differ with race or ethnicity (Forman, et al., 2009). For instance, this relationship is different among Europeans and Asians. Asians, especially Indians and Aborigines have more body fats compared to the white Europeans (McClain & Splett, 2007). Vitamin D levels in the serum relate to characteristics such as exacerbation risks, treatment response, airway hyper-responsiveness, and lung function. A research by Brehm indicates that insufficient vitamin D status is linked to an increased risk of asthma exacerbation

Vitamin D and the immune system

Vitamin D has been assumed to play a preventive role in Asthma. Considering the above discussion, the emerging literature linking vitamin D and asthma remains compelling and in need for further development. Even though research studies support the assertion of preventive effect of vitamin D, there are reports that suggest a different point of view. Vitamin D supplementation can instead be a risk factor for asthma and other atopic disorders. In a birth cohort study conducted in Finland, for example, subjects who were regularly given supplements of vitamin D in the first year of life (about 200 IU/day) had a marginally significant higher risk of asthma, atopy, and allergic rhinitis at 31 years of age than un-supplemented controls. In addition, a Swedish study demonstrated that vitamin D intake greater than 400 IU a day in 5-month-old infants correlated significantly with the risk of eczema at 6 years of age. On the other hand, several epidemiological studies have suggested that vitamin D deficiency is associated with an increased incidence of asthma and allergy symptoms, and a number of hypotheses have been advanced to explain the pathogenetic link between asthma and vitamin D deficiency.

Conclusion

This chapter has presented an account of published information by accredited research scholars related to the relationship between vitamin D and asthma disease in children. Asthma is a huge public health problem that affects an estimated 300 million persons worldwide and 22 million persons in the United States. From the review, we can come to a conclusion that there is a need for more emphasis on research studies to investigate whether vitamin D supplements can be used for prevention and treatment of asthma in children.

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