Vitamin D update: Your kids probably need more
© 2013 Roy Benaroch, MD
Charles wrote in about Vitamin D: “I read your post about Vitamin D from 2008. I continue to read about scientists learning how Vitamin D playing an important role in the immune system and how a significant portion of the population’s health (both adults and children) would benefit from having their Vitamin D checked. My doctor checked my Vitamin D during an annual checkup and recommended I supplement. Have your thoughts on Vitamin D changed much with 5 additional years for Vitamin D research? Do you recommend children have their Vitamin D levels checked?”
I last wrote about vitamin D in 2008? Wow, it has been a while! It is about time for an update—
First: As I sort-of-predicted in 2008, the AAP did increase their recommendation for Vitamin D intake from 200 to 400 IU/day for children of all ages. They’re also recommending that all babies who get less than 1 liter a day of formula (that includes all breastfeeding babies) get a supplement of 400 IU/day. US government authorities have settled on 400 IU/day for babies less than 12 months, and 600 IU a day for older children and teens. These recommendations were based on widespread studies showing vitamin D insufficiency was common at all ages.
It’s still not entirely clear that 400 IU/day is adequate for all children—some have advocated for 1000 or 2000 IU/day for routine intake. It’s a difficult number to pin down, because many children make plenty of their own vitamin D in their skin when they’re exposed to sunlight. Less vitamin D is made that way in the wintertime, and among children with darker skin, children who live in cooler places, and children who for whatever reason don’t play much outside, or don’t have their skin exposed outside. A single, blanket recommendation for everyone may not be realistic.
What new have we learned since 2008? In addition to vitamin D’s well-known role in bone health, it seems to have some influence on the development of obesity and diabetes. It may also affect the way other hormones work, including steroid hormones and similar molecules that are used in asthma medications.
It’s also become even more clear to me that just about everyone is vitamin D deficient. I’ve been routinely checking vitamin D levels in kids (usually while drawing blood for other tests), and I will tell you that easily 90% of children are insufficient. The only “normal” vitamin D level I’ve seen recently was in my own child, who I know takes a daily supplement.
So: I’m not so sure it’s cost effective to test children, but it’s certainly a good idea to have children take a supplement routinely. 400-1000 IU a day of vitamin D3 (that’s the usual variety found in supplements) will make sure most children keep a good level of vitamin D. I’m not usually a huge fan of supplements, but this one makes sense.
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