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Article on vitamin D published today in journal "Pediatrics"


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Since this is discussed frequently, I thought this was timely.

 

Here is the Yahoo news article.

1 in 5 kids get little vitamin D, study says

 

CHICAGO – At least one in five U.S. children aged 1 to 11 don't get enough vitamin D and could be at risk for a variety of health problems including weak bones, the most recent national analysis suggests.

By a looser measure, almost 90 percent of black children that age and 80 percent of Hispanic kids could be vitamin D deficient — "astounding numbers" that should serve as a call to action, said Dr. Jonathan Mansbach, lead author of the new analysis and a researcher at Harvard Medical School and Children's Hospital in Boston.

The findings add to mounting evidence about vitamin D deficiency in children, teens and adults, a concern because of recent studies suggesting the vitamin might help prevent serious diseases, including infections, diabetes and even some cancers.

While hard evidence showing that low levels of vitamin D lead to disease or that high levels prevent it is lacking, it's a burgeoning area of research.

Exactly how much vitamin D children and adults should get, and defining when they are deficient, is under debate. Doctors use different definitions, and many are waiting for guidance expected in an Institute of Medicine report on vitamin D due next year. The institute is a government advisory group that sets dietary standards.

The new analysis, released online Monday by the journal Pediatrics, is the first assessment of varying vitamin D levels in children aged 1 through 11.

Previous studies in the journal this year found low levels were prevalent in U.S. teens, and also showed kids with low levels had higher blood pressure and cholesterol levels, and were more likely to be overweight.

The new analysis uses data from a 2001-06 government health survey of nearly 3,000 children. They had blood tests measuring vitamin D levels.

Using the American Academy of Pediatrics' cutoff for healthy vitamin D levels, 6.4 million children — about 20 percent of kids that age — have blood levels that are too low. Applying a less strict, higher cutoff, two-thirds of children that age, including 90 percent of black kids and 80 percent of Hispanics, are deficient in vitamin D.

A Pediatrics editorial says the strongest evidence about effects of vitamin D deficiency in kids involves rickets, a bone disease common a century ago but that continues to occur.

Rickets can be treated and prevented with 400 units daily of vitamin D, the editorial says. The pediatricians' group recently recommended that amount for all children, saying that most need vitamin supplements.

Mansbach says his study, funded by the National Institutes of Health, supports that recommendation.

Children can get 400 units daily by drinking four cups of fortified milk, or eating lots of fish, but many don't do that.

The body also makes vitamin D when sunlight hits the skin, but many children don't spend enough time outdoors. That's one reason why lower vitamin D levels are found in children living in colder climates and those with darker skin, which absorbs less sunlight.

 

Here's the abstract.

 

Full text requires a subscription.

 

 

Published online November 1, 2009

PEDIATRICS Vol. 124 No. 5 November 2009, pp. 1404-1410 (doi:10.1542/peds.2008-2041)

Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D?

 

Jonathan M. Mansbach, MDa, Adit A. Ginde, MD, MPHb and Carlos A. Camargo, Jr, MD, DrPHc

a Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts

b Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado

c Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

OBJECTIVE: Single-center studies have suggested that hypovitaminosis D is widespread. Our objective was to determine the serum levels of 25-hydroxyvitamin D (25[OH]D) in a nationally representative sample of US children aged 1 to 11 years.

METHODS: Data were obtained from the 2001–2004 National Health and Nutrition Examination Survey. Serum 25(OH)D levels were determined by radioimmunoassay and categorized as <25, <50, and <75 nmol/L. National estimates were obtained by using assigned patient visit weights and reported with 95% confidence intervals (CIs).

RESULTS: During the 2001–2004 time period, the mean serum 25(OH)D level for US children aged 1 to 11 years was 70 nmol/L (95% CI: 68–73). Children aged 6 to 11 years had lower mean levels of 25(OH)D (68 nmol/L [95% CI: 65–71]) compared with children aged 1 to 5 years (74 nmol/L [95% CI: 71–77]). Overall, the prevalence of levels at <25 nmol/L was 0.7% (95% CI: 0.4–1.3), <50 nmol/L was 15% (95% CI: 12–18), and <75 nmol/L was 65% (95% CI: 58–71). The prevalence of serum 25(OH)D levels of <75 nmol/L was higher among children aged 6 to 11 years (71%) compared with children aged 1 to 5 years (56%); girls (67%) compared with boys (62%); and non-Hispanic black (89%) and Mexican American (77%) children compared with non-Hispanic white children (54%).

CONCLUSIONS: On the basis of a nationally representative sample of US children aged 1 to 11 years, millions of children may have suboptimal levels of 25(OH)D, especially non-Hispanic black and Mexican American children. More data in children are needed not only to understand better the health implications of specific serum levels of 25(OH)D but also to determine the appropriate vitamin D supplement requirements for children.

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