Our bodies need vitamin D, an important nutrient, to stay healthy. Many children are in need of more vitamin D, says Shamir Tuchman, MD, MPH, a pediatric nephrologist at Children's National. Dr. Tuchman is the medical director of the Urinary Stone Clinic and has a special interest in pediatric kidney stone disease as well as calcium, phosphorus, and vitamin D metabolism.
So, what is vitamin D?
It is fat-soluble vitamin that acts as a mineral-controlling hormone in the body and helps to maintain normal blood levels of calcium and phosphorus. It is among the key determinants of bone health in children; along with genetics, the presence of chronic medical conditions, exercise, and adequate calcium intake. Children's National’s Bone Health Program, headed by orthopedic surgeon Laura Tosi, MD, focuses on helping patients maintain strong bones.
Sufficient levels of circulating vitamin D helps prevent nutritional rickets in children and osteomalacia (softening of the bones, typically through a deficiency of vitamin D or calcium) in adults. Determining the nutritional vitamin D status can be done through checking vitamin D levels in blood tests.
Vitamin D precursors can be made in our skin from sunlight exposure or obtained from the diet in some of the foods we eat.
What foods provide vitamin D?
The U.S. Department of Agriculture provides a list of foods containing vitamin D. Some of the following foods provide it naturally, while others are fortified with vitamin D2 or D3:
Who is at risk of vitamin D deficiency?
- Fatty fish such as mackerel, salmon, and tuna
- Beef liver, cheese, egg yolks, and some mushrooms
- Most milk in the United States is fortified with 400 international units (IU) of vitamin D per quart
- Fortified foods include breakfast cereals, some orange juice, yogurt, margarine, and soy beverages
Groups at risk of deficiency include exclusively breastfed infants, people with limited sun exposure, and people with conditions that disrupt their ability to absorb dietary fat such as ulcerative colitis, cystic fibrosis, and Crohn’s disease.
Most people get their vitamin D needs met through exposure to sunlight. Dr. Tuchman said concerns about staying protected from the sun due to skin cancer concerns may affect whether people are getting enough vitamin D from sun exposure.
“What I do with my own kids: when we go to the beach, I let them run around for five to 10 minutes and then I lather them up with a high SPF sunblock,” Dr. Tuchman said. “It doesn’t take more than five to 10 minutes of direct sunlight to exposed skin to make a significant amount of vitamin D precursors.”
In colder climates such as the mid-Atlantic states, when winter comes, “people spend more time indoors or if they are outdoors, they’re very bundled up so they get fewer opportunities to get vitamin D efficiently when the sun is less intense,” Dr. Tuchman saidHow much vitamin D do I need?
The American Academy of Pediatrics
’ (AAP) guidelines for vitamin D call for a minimum of 600 IUs daily in children ages 1 to 7 and 800 IUs daily for children 7 and older. The AAP’s recommended range is 600-1000 IUs daily for children.
“It’s relatively safe to be on 1,000 IU per day without running the risk of vitamin D toxicity,” Dr. Tuchman said, especially in the winter and among individuals in high-risk groups.
If you think your children are not getting enough vitamin D, ask your child’s pediatrician or healthcare provider for more information.