Anita Kozyrskyj, PhD, on the Impact of Vitamin D Supplementation on Infant Nutrition
The results of a recent study1 found that vitamin D supplementation in infant nutrition has been linked to changes in a their gut microbiome, specifically in the significant lower abundance of Megamonas. The findings indicated that vitamin D supplementation, regardless of whether the infant was breastfed or formula fed, was also associated with the presence of Clostridioides difficile.
The study consisted of 1157 mother-infant pairs as part of the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study from 2009 to 2012. Of the infants studied, 65% were given vitamin D supplementation. Infant gut microbiota composition was examined via fecal sample at 3 to 4 months of age.
The researchers found that not only was infant vitamin D supplementation associated with a lower presence of Megamonas, but of the infants who were exclusively breastfed, there was also a lower abundance of both Bilophila and Lachnospiraceae, and a higher presence of Haemophilus. It was also found that the likelihood of C difficile colonization was reduced in infants who breastfed from mothers who consumed vitamin-D-fortified milk.
Nutrition411 spoke with study author Anita Kozyrskyj, PhD, who is a professor in the Department of Pediatrics at the University of Alberta in Edmonton, Canada, about the importance and implications of these findings.
N411: What is currently known about the role of vitamin D supplementation in infant nutrition, especially when it comes to bone metabolism and immune system development?
Anita Kozyrskyj: Vitamin D has many actions in the body and plays a critical role in our immune system and bone metabolism. Vitamin D receptors are found on immune cells but also concentrated in cells lining the intestine. Hence, it is very likely that this vitamin is involved in host-gut microbiota interactions to maintain a healthy gut microbiota and exclude opportunistic microbes.
N411: What knowledge gaps were you hoping to bridge with your analysis?
AK: To obtain evidence on the impact of routine vitamin D supplementation of young infants on their gut microbiota. With the exception of a study in the Netherlands, this question had never been studied.
N411: Your study shows that the results were associated with a lower abundance of Megamonas, regardless of whether the infant was breastfed or formula fed. Did you anticipate these findings, or did they surprise you?
AK: We did not anticipate these findings. Little is known about Megamonas (genus of Veillonellaceae) in the gut of infants or adults. We were further surprised to find that Megamonas is the same microbe found to be more common in male infants born to mothers with asthma in another publication of ours2 from the CHILD birth cohort.3 Interestingly, maternal history of asthma is also a risk factor for more severe respiratory viral infection in infants. Recently it has been discovered that vitamin D is involved in the synthesis of body proteins used by coronavirus to replicate.
Note that the association between infant vitamin D supplementation and reduced Megamonas in gut microbiota was the only finding in our current study to be observed in breastfed and formula-fed infants.
N411: You note that maternal consumption of vitamin-D-fortified milk was the only factor that reduced the likelihood of C difficile colonization in infants. Could you tell us more about this finding?
AK: In our study, maternal prenatal consumption of 3 or more cups of fortified milk per day reduced the likelihood of C difficile colonization in exclusively breastfed infants by 60%, even after taking into account maternal or infant vitamin D supplementation and other factors. We know that tolerance of cow’s milk in infants and adults has an inhibitory influence on C difficile colonization. C difficile is capable of fermenting protein. If more cow’s milk protein is absorbed in the upper intestine, less of it will be present in the lower intestine to encourage the growth of C difficile.
Other studies have reported reduced risk of cow’s milk allergy in offspring following maternal intake of vitamin D from food during pregnancy. Fortified milk is a common source of vitamin D. All together, these findings suggest that a pregnancy diet, naturally enriched with vitamin D (that is, vitamin D in food and not supplements) can reduce intolerance to cow’s milk and colonization with C difficile in young children.
N411: An infant’s gut microbiota undergoes rapid changes in early life. How does this impact an individual’s gut health in the long term?
AK: The gut microbial community of infants is dynamic as it undergoes rapid change in composition from dominance by “pioneer” microbiota after birth to those typical in adulthood. Like our fingerprint, each one of us end up with common and unique gut microbiota that are shaped by our early life exposures. Changes to the gut microbial ecosystem during infancy are integral to the healthy development of our immune system; deviations from expected changes result in allergies and asthma, diabetes, and other chronic conditions.
References:
- Drall KM, Field CJ, Haqq AM, Kozrskyj AL, et al. Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections. Gut Microbes. 2020;12(1):1799734. https://doi.org/10.1080/19490976.2020.1799734
- Koleva PT, Tun HM, Konya T, et al; CHILD Study investigators. Sex-specific impact of asthma during pregnancy on infant gut microbiota. Eur Respir J. 2017;50(5):1700280. https://doi.org/10.1183/13993003.00280-2017
- CHILD Cohort Study. Accessed September 11, 2020. https://childstudy.ca/