Just "D" Facts about Vitamin D

Benefits of Moderate UV Sunshine Exposure

Lack of Vitamin D Rampant in Infants and Teens

Posted by D3forU on July 16, 2010

Giving your children all they need to grow big and strong may not be as simple as a gummy vitamin and three square meals. They still may be susceptible to an epidemic that’s starting to gain the notice of pediatricians and bone doctors across the country: vitamin D deficiency.

Mike Stone joined a growing legion of children diagnosed with the condition when an X-ray of his 14-year-old bones revealed a skeleton so thin it appeared clear on film.

“My doctor thought the machine was broken and that they should take an X-ray on another one,” says Stone, 22, a recent graduate of Tufts University in Boston.

The machine wasn’t broken. Stone was seriously vitamin D deficient, and though he had felt a “snap” in his back — the impetus for the doctor’s visit — he had no fractures. But his bones had become perilously thin, 50% less dense than they should have been. His doctor immediately put him on vitamin D supplements to correct the problem, Stone says.

For years, doctors have been aware that older people tend to be low in vitamin D and need extra supplements to help keep bones strong, says Lisa Callahan, co-director of the Women’s Sports Medicine Center at the Hospital for Special Surgery in New York.

Pediatricians had thought the problem had been solved among children with the vitamin D fortification of milk, cereal and other foods. But an ever-lengthening roster of studies is revealing vitamin D deficiency is more common than previously believed in youngsters, including breast-fed babies and teens.

“Vitamin D deficiency is much more of a health problem than anyone realized,” says Catherine Gordon, director of the bone health program at Children’s Hospital Boston. In the June issue of the Archives of Pediatrics and Adolescent Medicine, Gordon and her colleagues found that 40% of infants and toddlers tested below average for vitamin D. In a previous study, Gordon and fellow researchers discovered that 42% of adolescents were vitamin D deficient.

“Vitamin D deficiency was twice as common in teens as we assumed it would be,” she says.

A review of vitamin D medical literature published last July in The New England Journal of Medicine by Michael Holick, professor of medicine, physiology and biophysics at Boston University Medical School and director of the Bone Health Care Clinic there, indicated that numerous studies are showing vitamin D does much more than boost bone health in children and adults. In children, it can inhibit future hip fractures, and it may help reduce the risk of type 1 diabetes.

Sunlight, diet — particularly oily fish and enriched milk — and supplements are good sources of vitamin D, Holick says.

Vitamin D is different from other vitamins because though the body stores it, it needs ultraviolet B rays from the sun to activate it, says James Dowd, professor of medicine at Michigan State University and author of The Vitamin D Cure.

Fifteen minutes a day will do the trick, he says. When vitamin D is dispatched to the liver and kidneys, it is changed into forms that body tissues can use. It helps the body absorb and regulate calcium and promotes mineralization of teeth and bones. Current recommendations by the Institute of Medicine suggest 200 IUs of vitamin D a day for children and 400 IUs for adults, but Callahan, who serves on an institute committee that aims to update those guidelines, says she suggests higher levels to many of her patients, at least 800 to 1,000 IUs a day.

Overdosing on vitamin D is unlikely if you are obtaining it only from diet, Gordon says. But parents should consult their pediatrician before raiding pharmacy shelves for supplements because of different dosages and types. She also says the doctor might want to run a blood test because vitamin D deficiency is hard to detect.

“There aren’t any obvious early symptoms. It may be silent until it manifests in more serious ways, like rickets — weak bones and teeth — in children,” Gordon says.

Parents surprised by their children’s vitamin D deficiency diagnosis may ask why it occurs in a culture in which good nutrition seems a no-brainer. Experts say there may be a genetic link, but other factors also are at play.

“Breast milk is not D-rich, so rickets is seen more often in infants now that breast-feeding is popular again. It’s also not abundant in many foods,” says Tanya Edwards, head of the integrative medicine department at the Cleveland Clinic. Also, she says, children don’t play outside as much as they used to.

Society’s sunblock passion, though smart for skin health, also may be affecting vitamin D deficiency. Experts suggest at least 15 minutes of direct sun a day before slathering on sunscreen. But those at risk or with a history of skin cancer or with sun-sensitive skin conditions should check with their dermatologist first.

Dark-skinned people also are more at risk because they absorb UVBs less quickly than fair-skinned people, Edwards says.

Stone, who with brother Doug has produced an educational video about vitamin D for schools, says taking supplements religiously and ramping up his diet with lots of fish, milk and yogurt over the years has helped him grow normally and avoid bone and other problems as an adult.

But he also is careful not to overdose on calcium in the process, which can lead to kidney stones.

“I feel great,” says Stone, who is 5-foot-9 and weighs in at a slim but healthy 155 pounds. “I play tennis, squash, and I’m training for my first Boston Marathon next year.”



One Response to “Lack of Vitamin D Rampant in Infants and Teens”

  1. Lack of Vitamin D Rampant in Infants and Teens « Just ?D? Facts ……

    I found your entry interesting do I’ve added a Trackback to it on my weblog :)…

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