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Wednesday, August 5, 2009

Alert-- Parents, Beware of Vitamin D Deficiency

7 Out Of 10 American Children Low In Vitamin D

Here is the shocking quotation of the day: "About 70 percent of U.S. children have low levels of vitamin D, which puts them at higher risk for bone and heart disease, researchers said today." The decline in vitamin D levels in the United States was reported widely a year ago and has been underway for 20 years, study leader Dr. Michal L. Melamed of the Albert Einstein College of Medicine of Yeshiva University reported. "We expected the prevalence of vitamin D deficiency would be high, but the magnitude of the problem nationwide was shocking," said Dr. Juhi Kumar of Children's Hospital at Montefiore Medical Center. The researchers analyzed data on more than 6,000 children, ages 1 to 21, collected by the National Health and Nutrition Examination Survey 2001-2004. ("Lack of Vitamin D in Children 'Shocking,'" LiveScience, August 3 2009) The study showed that 9 percent, or 7.6 million children across the country, were vitamin D deficient and another 61 percent, or 50.8 million, were vitamin D insufficient. Cases of rickets, a bone disease in infants, have also been increasing. (National Health and Nutrition Examination Survey 2001-2004.) CAUSES OF VITAMIN D DEFICIENCY What is the cause? Poor diet and lack of sunshine, the researchers conclude in the online version of the journal Pediatrics. Dr. Melamed recommends that children should consume more foods rich in vitamin D, such as milk and fish. "But it's very hard to get enough vitamin D from dietary sources alone," she says.

Vitamin D supplementation can help the deficiency. In the study, children who took vitamin D supplements (400 IU/day) were less likely to be deficient in the vitamin. However, only 4 percent of the study population actually used supplements. Breast milk contains relatively little vitamin D, while formula is fortified with the vitamin.

HEALTH IMPLICATIONS OF VITAMIN D DEFICIENCY

Vitamin D is necessary for a healthy immunity. Vitamin D controls the body's production of white blood cells called lymphocytes and the chemicals that they produce called cytokines.

What is at stake? Low levels of vitamin D deficiency are linked to poor bone health, lower levels of calcium, higher systolic blood pressure, and lower levels of HDL (good) cholesterol. These last three are key risk factors for heart disease.

According to the British medical journal, Lancet, lighter skin is more efficient at producing vitamin D. So, darker-skinned people produce less when exposed to sunlight. African American males may be at high risk for prostate cancer because their dark skin blocks sunlight and markedly increases the amount of sunlight that they need to make vitamin D. Also, African American women may be at high risk for lupus because their dark skin markedly increases their need for sunlight to make vitamin D.

Lancet (Nov. 3 2001) also reports lack of vitamin D may cause some cases of Crohn's disease.

Babies are at high risk for juvenile diabetes if their mothers lack vitamin D because they do not get enough sunlight. "Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction, even in glucose-tolerant subjects," according to Dr. Ken C. Chiu. "Low vitamin D is extremely common, moreover, 'our observations indicate that low vitamin D has a small but significant impact' on blood glucose metabolism and diabetes," he said.

A study at Emory University School of Medicine adds to evidence that low vitamin D is associated with Parkinson's, says first author Marian Evatt, MD, assistant professor of neurology at Emory. (ScienceDaily Oct. 17, 2008) The fraction of Parkinson's patients with vitamin D insufficiency, 55 percent, was significantly more than patients with Alzheimer's disease (41 percent) or healthy elderly people (36 percent).

Insufficient vitamin D can stunt growth and foster weight gain during puberty, according to a new study published in the Journal of Clinical Endocrinology & Metabolism. Even in sun-drenched California, where scientists from the McGill University Health Centre (MUHC) and the University of Southern California conducted their study, vitamin D deficiency was found to cause higher body mass and shorter stature in girls at the peak of their growing spurt. (Journal of Clinical Endocrinology & Metabolism, 2008)

Now also comes word low vitamin D may also be a major cause of unexplained muscle and bone pain. (Gregory A. Plotnikoff, MD, of the University of Minnesota Medical School) The worst vitamin D deficiencies in those with unexplained pain occurred in young people -- especially women of childbearing age. The findings are reported in the December issue of the journal Mayo Clinic Proceedings.

HOW TO DEAL WITH LOW VITAMIN D

So, what is the answer for parents across the country? "It would good for them to turn off the TV and send their kids outside," Dr. Melamed said. "Just 15 to 20 minutes a day should be enough. And unless they burn easily, don't put sunscreen on them until they've been out in the sun for 10 minutes, so they get the good stuff but not sun damage."

Other experts caution that extended exposure to the sun - tanning and burning - increases the risk of deadly skin cancer. The trick seems to be getting just enough sun to satisfy the body's vitamin D requirement, without damaging the skin.

THE FUTURE

Michael Holick, MD., who runs the Vitamin D Research Lab at Boston University Medical Center, believes there is a strong epidemiological case linking vitamin D deficiency with a host of cancers including those of the prostate, colon, and breast; and he says vitamin D may also help protect against heart disease, autoimmune diseases, and even type 1 diabetes. (Salynn Boyles, WebMD Health News, Dec. 10 2003)

The nation's largest dermatology group remains unconvinced about all of Holick's findings. In a recent press release, American Academy of Dermatology officials wrote that they were "deeply concerned" that the message that unprotected sun exposure may have health benefits could "mislead the public about the very real danger of sun exposure, the leading cause of skin cancer."

HAVE QUESTIONS?

To find out if you are deficient in vitamin D, ask your doctor to draw a blood test for 25 hydroxy vitamin D. "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," says Catherine Gordon, director of the bone health program at Children's Hospital Boston. (Archives of Pediatrics and Adolescent Medicine) The best preventative measure for deficiency in vitamin D is 15-20 MINUTES OF SUN A DAY FOR EVERYONE!

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