FAMILY HEALTH: The ABCs of Vitamin D

By Lorel Kane


     Vitamin D and calcium are essential nutrients for healthy bones.  Vitamin D helps the body absorb calcium to build and maintain strong bones, which is especially important in growing children. 

     When kids don't get adequate amounts of vitamin D, their bones don't develop properly. They might have trouble walking or, worst case, the bones could soften and become weak, a condition called Rickets. 

     Rickets is not very common, according to Dr. Steven Abrams, a Texas Children's Hospital neonatologist and co-author of the book, "Bone Health in Children," which delves into the various consequences of vitamin D deficiency.

     Dr. Abrams says low levels of vitamin D in the blood can be seen in kids of all ages. Why is that?  Well, one reason may be that kids are spending more time inside. And when they are outside, they are usually covered in sun block.  The body makes vitamin D when it's exposed to the sun. Dr. Abrams says it's a challenge to balance a healthy amount of time in the sun with too much exposure that could increase the risk of skin cancer. "Short periods of time, ten to fifteen minutes, is probably mostly okay, but the best way to get vitamin D is from food or a vitamin supplement," Dr. Abrams said.

     Not many foods are natural providers of vitamin D. Fatty fish, like salmon, tuna and mackerel are among the best sources, but try feeding those to a fussy eater.  The best sources are foods that have been fortified with vitamin D. Milk may be the most well known food fortified with vitamin D. Almost all of the milk supply in the United States has it, usually 400 IU (International Units) in each quart. Foods made from milk, like ice cream or cheese, usually do not. You can also find breakfast cereals, bread, and some brands of orange juice, even mushrooms fortified with vitamin D.

     Baby formulas are also fortified with vitamin D so babies feeding on formula have a bit of an edge over babies feeding on breast milk. 

    "Breast-feeding parents should make sure their baby gets a vitamin D supplement and their older child has lots of food with vitamin D in it or takes a supplement," Dr. Abrams said, "but only after consulting with their pediatrician."

      Several reports over the years have linked vitamin D to improving immunity and to helping prevent viral infections and diseases, such as cancer, diabetes, and cardiovascular disease, to name a few.  But there's no substantial proof of that yet, according to Dr. Abrams, who is also a researcher at Children's Nutrition Research Center, a cooperative venture between Baylor College of Medicine, Texas Children's Hospital and the U.S. Department of Agricultural Research.

      The Institute of Medicine, the health arm of the National Academy of Sciences, has looked at many of those claims.  It reviewed one thousand studies and reports looking at vitamin D and potential benefits beyond bone health. The Institute says those studies provided "often mixed and inconclusive results and could not be considered reliable." It went on to say there is plenty of evidence, though, showing the importance of vitamin D and calcium for bone health.

      And it's important to note the danger in taking too much vitamin D. According to the Mayo Clinic, overdosing on vitamin D is rare, but it does happen and it is potentially dangerous.  So-called vitamin D toxicity can cause a build-up of calcium in the blood leading to a variety of symptoms, including poor appetite, nausea, vomiting, and even kidney problems.

      So how much vitamin D does a child need? The Institute of Medicine's Food and Nutrition Board offers some guidelines. Its Recommended Daily Allowance (RDA) for children under one year old is 400 IU per day. The RDA for children over one year old is 600 IU a day. But, remember, these are only recommendations. It's always best to talk to your pediatrician to know what's right for your child.

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