In the world of nutrition, vitamin D is somewhat of a “celebrity” lately: while it receives a lot of controversial press, it mostly earns red carpet treatment. Vitamin D is involved in bone health, heart health, immune function, and appears to help prevent chronic and autoimmune diseases, including type I diabetes, asthma, hypertension and cancer. In children, asthma is on the rise and rickets (weakened bones related to severe vitamin D deficiency) is making a comeback. Accordingly, the American Academy of Pediatrics (AAP) is very active in making a statement about the role of vitamin D in the prevention of these and other diseases, and also the effect of “hypovitaminosis D” (low vitamin D status) on growth and development in children.
It’s a sticky situation, since the original, and arguably the best way to achieve vitamin D adequacy is through sun exposure. However, we’ve also been taught the importance of slathering sun block on our kids to avoid sunburns and skin cancer in later life, and have been warned to keep infants under 6 months old out of the sun since they’re especially sensitive to UV rays. Herein lies the paradox: as appropriate as sun avoidance is for children to protect them from skin damage, vitamin D deficiency in infants and toddlers in the U.S. may be as high as 65%. The AAP doesn’t yet have enough data to confirm exactly what “optimal” vitamin D levels in the blood look like beyond the minimum level known to prevent rickets. However, they do suggest that nearly all children need to supplement vitamin D in order to reach the daily recommendations of 400 IU per day for optimum health.
Children most at risk include:
- breast-fed infants
- kids living in northern latitudes
- non-Hispanic Blacks
- children with a fat malabsorption disease like cystic fibrosis or Crohn’s disease
Also, if respiratory infection or type I diabetes run in the family, you may be able to protect your child by maintaining adequate vitamin D status yourself during pregnancy and providing supplements to them in early childhood to help maintain their Vitamin D levels.
Based on AAP recommendations, take the following steps to ensure that your kids reach optimal vitamin D status.
- Supplement with an age appropriate liquid vitamin containing 400 IU vitamin D, especially if your child (of any age) is not drinking at least a quart (32 oz) of vitamin D-fortified low-fat milk or infant formula. Over-the-counter and prescription versions exist, so ask your dietitian or physician for their preferred brand. The FDA recently released a word of caution about using appropriate droppers and following instructions on the packaging for liquid vitamin D supplements, especially in infants. Read more here.
- Encourage older children to eat vitamin D rich foods like white albacore tuna, sockeye salmon, fortified lowfat milk/yogurt, and fortified breakfast cereals.
- Keep slathering on the sunscreen – it’s better to serve more yogurt and tuna sandwiches now than risk cancer later, don’t you think?
- Be adventurous with your kids by eating more vitamin D rich “superstar” foods – add dried (rehydrated) shiitake mushrooms in stir-fry, bring a Greek salad with sardines on a picnic, or make salmon salad sandwiches for your kids lunches.