Take Your Child Outdoors And Increase Sun Exposure
One of the easiest and most inexpensive ways to get more vitamin D is to spend 10-15 minutes per day in the sun. Expose your teens skin to the suns UVB rays so that their body can make vitamin D.
Just remember that the amount of vitamin D your skin can produce will depend on the level of pigmentation of the skin. Darker skin has more melanin, which acts as a natural sunscreen, so you will need to spend more time in the sun to allow your skin to make vitamin D naturally.
Also, note that too much sun exposure can lead to skin damage, so there has to be a balance between getting enough sun to produce vitamin D and protecting your teens skin.
Impair The Effectiveness Of Niacin
Evidence suggests that taking vitamin C supplements may impair the bodys ability to increase high density lipoprotein cholesterol in people taking the combination drug niacin-simvastatin. This drug combines the vitamin niacin with the statin simvastatin , and people take it to treat high cholesterol.
Doctors consider HDL cholesterol the good cholesterol because it reduces the amount of harmful cholesterol in the blood.
If a person takes vitamin C supplements and niacin-simvastatin, they should talk to their doctor about ways to make each more effective. Doctors do not know whether vitamin C also affects the ability of other medicines similar to Zocor.
A persons body cannot make vitamin C, so people need to eat enough foods that contain vitamin C to meet their daily needs. If someone is at risk of a vitamin C deficiency, they can take vitamin C supplements.
The advise aiming for the following RDA of vitamin C each day:
People who smoke should take 35 mg more vitamin C per day than those who do not smoke.
During pregnancy or when breastfeeding, women should get the following levels of vitamin C per day:
- 1418 years: 80 mg during pregnancy and 115 mg when breastfeeding
- 19 years and older: 85 mg during pregnancy and 120 mg when breastfeeding
There is not enough research to suggest an RDA for vitamin C in those younger than 1 year of age. As a result, the ODS provide an adequate intake, which is the amount that is likely to be sufficient:
Which School Age Children Might Be At Higher Risk Of Vitamin D Deficiency
25/ Children at a higher risk of vitamin D deficiency might be:
- Those with an increased need for vitamin D
- Those who have less sun exposure on bare skin
- Living in a Northern latitude, especially above 50 degrees of latitude, as in the UK
- Those who are darker skinned, especially those of Asian or African ethnic origin.1,4,6,7,10
- Those who wear very concealing clothes.10
- Those who use an excessive amount of sunblock.
- Those who rarely go outdoors.10
- Those who will get less vitamin D from their diet
- Vegetarians, and especially vegans 5,10
- Those children who have exclusion diets e.g. those with a dairy allergy
- Those children with any malabsorption state
- Those with liver or renal disease
- Those taking certain drugs e.g. some anticonvulsants
26/ *A Consensus Vitamin D position statement has been prepared by the British Association of Dermatologists, Cancer Research UK, Diabetes UK, the Multiple Sclerosis Society, the National Heart Forum, the National Osteoporosis Society and the Primary Care Dermatology Society and is as follows:
However, there is still a lot of uncertainty around what levels qualify as optimal or sufficient, how much sunlight different people need to meet a given level of vitamin D, whether vitamin D protects against chronic diseases such as cancer, heart disease and diabetes, and the benefits and risks of widespread supplementation.
27/ This guidance was endorsed by NICE in it is 2016 guideline, Sunlight exposure: risks and benefits 12
When More Vitamin D Is Needed
Doctors may recommend that your child receive more vitamin D than these recommended amounts depending on a variety of risk factors, including:
- Certain medical problems, like obesity, celiac disease or cystic fibrosis
- If the child is healing from bone surgery
- Or if the child is taking medications that alter the way the body uses vitamin D
How Much Vitamin D Should I Give My Child
Parents need to calculate the amount of vitamin D their child gets from fortified milk, other food, and vitamin supplements to make sure the total amount does not exceed: 1,000 to 1,500 IU a day for infants 2,500 to 3,000 IU a day for children 1 to 8 years old 4,000 IU a day for children 9 years and older
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Good Sources Of Vitamin D
From about late March/early April to the end of September, most people should be able to make all the vitamin D they need from sunlight.
The body creates vitamin D from direct sunlight on the skin when outdoors.
But between October and early March we do not make enough vitamin D from sunlight. Read more about vitamin D and sunlight.
Vitamin D is also found in a small number of foods.
- fortified foods such as some fat spreads and breakfast cereals
Another source of vitamin D is dietary supplements.
In the UK, cows’ milk is generally not a good source of vitamin D because it is not fortified, as it is in some other countries.
What Is A Low Vitamin D Level
19/ There are many debates about the ideal vitamin D blood level. Deficiency has been defined as a blood level of 25 hydroxyvitamin Dbelow 25 nmol/L there is consensus that optimal levels lie above 50 nmol/L.9
20/ Some laboratories define a deficiency of vitamin D as levels below 25, or even 30, and an insufficiency of vitamin D as a level between either 25 or 30 and 50 or 70 nmol/L.
21/ School doctors may wish to check with their local biochemistry laboratory as to what is defined as deficiency or insufficiency, vitamin D test costs around £20 on the NHS. And you can ordered via LOC at a discounted cost of £35.
22/ In the latest report of the Scientific Advisory Committee on Nutrition on Vitamin D and Health , the current threshold of a vitamin D level of 25 nmol/L has remained as the level below which the risk of vitamin D deficiency increases however, while this is not a clinical threshold diagnostic of disease, it is indicative of increased risk or poor musculoskeletal health.8
How common is vitamin D deficiency in school age children?
23/ Public Health England published data in 2014 showing that in the winter months 30-40%of all age groups in the general population are classed as vitamin D deficient and that even towards the end of the summer13% of adolescents remain deficient .
24/ The latest data show the population by age with a plasma vitamin D level of < 25 nmol/L, in the 11 to 18-year age group, is 20-24% of the total.
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Kids May Need 10 Times More Vitamin D
Study: Kids Need 2,000 IU of Vitamin D, Not 200 IU Now Recommended
“Our research reveals that vitamin D, at doses equivalent to 2,000 IU a day, is not only safe for adolescents, but it is actually necessary for achieving desirable vitamin D levels,” study leader Ghada El-Hajj Fuleihan, MD, of the American University of Beirut Medical Center in Lebanon, says in a news release.
Kids are advised to get a daily vitamin D dose of 200 IU. That suggestion came from an Institute of Medicine panel that based its recommendation on the amount of vitamin D needed to prevent rickets in infants.
However, more and more vitamin D experts have begun to suggest that children and adults need much more vitamin D than previously recognized.
New evidence strongly supports this opinion. El-Hajj Fuleihan and colleagues enrolled 340 schoolchildren in a one-year study. These 10- to 17-year-old kids attended schools in Beirut, Lebanon.
A third of the kids received an inactive, sham treatment. Another third got the recommended 200 IU/day dose of vitamin D3 . And, after an earlier safety study showed it would not be toxic, the remaining third of the kids got 2,000 IU/day of vitamin D3 — 10 times the recommended dose for adequate daily intake.
Before starting your child on supplements or vitamins, always consult with your pediatrician.
How To Prevent And Treat Vitamin D Deficiency In School Age Children
28/ Identify those at higher risk and look for symptoms and signs.10
No risk factors No investigations needed
Give lifestyle advice** and consider prevention
Risk factors but no symptoms Lifestyle advice** and start prevention.
Risk factors and symptoms or signs Do blood tests and / or X-rays.
Start treatment and consider long term
prevention, at least until the child stops
- Advising about diet and the use over-the-counter supplements.
30/ ONLY test vitamin D status if someone has symptoms of deficiency or is at high risk.10
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Vitamin D Supplementation Recommended In All Children Teens
EXPERT ANALYSIS FROM AAP 16
SAN FRANCISCO Vitamin D deficiency is common among children and adolescents, particularly those with chronic disease, Catherine Gordon, MD, said at the annual meeting of the American Academy of Pediatrics.
Yet the precise definition of vitamin D deficiency and the healthy threshold for vitamin D levels lack universally agreed-upon standards. Generally speaking, levels of at least 30 ng/mL appear safe and reasonable for children with chronic disease, and additional research is confirming whether this range is appropriate for other pediatric groups as well. Although too much vitamin D can lead to hypercalcemia, vitamin D intoxication is very rare, said Dr. Gordon, director of the division of adolescents and transition medicine at the University of Cincinnati.
Severe vitamin D deficiency can lead to rickets, when bones have insufficient calcium and phosphorus levels, resulting in bone softening and weakening before growth plates close. If not treated with vitamin D and calcium supplementation, rickets becomes osteomalacia after the growth plates close.
Micronutrient Needs Of Children Ages 4 To 8 Years
For each micronutrient, the FNB sets an RDA or AI for children ages 4 to 8 years these micronutrient intake recommendations do not differ with gender for this age group. Table 1 lists the RDA for each micronutrient. As mentioned above, the RDA should be used in the planning of diets for individuals. A few select micronutrient requirements for children are discussed below.Table 1. Dietary Reference Intakes Set by the FNB:RDA for Micronutrients During Childhood, Ages 4 to 8 Years
|eConsidered an essential nutrient, although not strictly a micronutrient
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Vitamin D Supplementation In Infants Children And Adolescents
CATHERINE F. CASEY, MD DAVID C. SLAWSON, MD and LINDSEY R. NEAL, MD, University of Virginia Medical Center, Charlottesville, Virginia
Am Fam Physician. 2010 Mar 15 81:745-748.
Vitamin D deficiency in children can have adverse health consequences, such as growth failure and rickets. In 2008, the American Academy of Pediatrics increased its recommended daily intake of vitamin D in infants, children, and adolescents to 400 IU. Infants who are breastfed and children and adolescents who consume less than 1 L of vitamin Dfortified milk per day will likely need supplementation to reach 400 IU of vitamin D per day. This recommendation is based on expert opinion and recent clinical trials measuring biomarkers of vitamin D status. It is also based on the precedent of preventing and treating rickets with 400 IU of vitamin D. In addition to dietary sources, exposure to ultraviolet B sunlight provides children and adults with additional vitamin D. Although the American Academy of Pediatrics recommends keeping infants out of direct sunlight, decreased sunlight exposure may increase children’s risk of vitamin D deficiency. No randomized controlled trials assessing patient-oriented outcomes have been performed on universal vitamin D supplementation. However, vitamin D may reduce the risk of certain infections and chronic diseases. Physicians should help parents choose the appropriate vitamin D supplement for their child.
Estimates Of The Prevalence Of Inadequate Intakes Of Vitamin D From Food Must Be Interpreted With Caution
Vitamin D is unique as it can also be synthesized by the body from sunlight . In addition, vitamin D intake from supplements has not been considered in this assessment. While there appears to be a high prevalence of inadequate intakes of vitamin D from dietary sources, available clinical measures do not suggest wide-spread vitamin D deficiency in the Canadian population . Vitamin D status in some sub-populations, however, may warrant further consideration.
Figure 1. Prevalence of inadequacy for nutrients with an Estimated Average Requirement in Canadian adolescents 9-18 years
E Data with a coefficient of variation from 16.6% to 33.3% interpret with caution. F Data with a coefficient of variation greater than 33.3% with a 95% confidence interval not entirely between 0 and 3% suppressed due to extreme sampling variability. < 3 Data with a coefficient of variation greater than 33.3% with a 95% confidence interval entirely between 0 and 3% interpret with caution. * Vitamin D dietary intake data cannot stand alone and consideration must be given to serum 25OHD levels.
Vitamins and Minerals with an Adequate Intake
The median intakes of potassium among adolescents aged 9-18 years fell below the AI of 4500-4700 mg/d therefore no assessment could be made regarding the prevalence of inadequacy of potassium .
< AI – Median intake < AI no assessment can be made regarding the prevalence of inadequacy of this nutrient in this age group.
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What Are The Risk Factors
Vitamin D deficiency ebbs and flows with the seasons, with spring and winter causing vitamin D levels to drop due to a lack of sunshine and reduced time spent outside.
- Living further from the equator
- Having high pigmentation, preventing sunlight from being absorbed
- Frequently using sunscreen
- Staying indoors for school or work
- Eating a diet low in vitamin D
How Much Vitamin D Should I Get From The Sun
In addition to wondering how much vitamin D should I take, many people wonder how much vitamin D should I get from the sun.
Theres a reason that vitamin D is referred to as the sunshine vitamin. Sunlight exposure on our bare skin is the single best way to get enough vitamin D. Unfortunately most people today dont spend enough time in the sun, due to factors like working long hours inside, living in cold climates, being afraid of sunburns, etc.
In order to get enough vitamin D naturally from the sun its important to get outside and expose your skin to sunlight, without sunscreen. Aim to spend about 1020 minutes in the sun daily with as much of your bare skin exposed as you can, which will help your body produce vitamin D. You will absorb the most sunlight between about 11 a.m. and 3 p.m.
Melanin is a substance that affects how light or dark your skin color is. The amount of melanin you have in your skin also affects the amount of vitamin D you can produce, so the fairer your skin, the more easily you can make vitamin D. If you have dark skin, you will likely need more time in the sun, roughly 40 to 60 minutes daily, to make enough vitamin D.
Eating vitamin D-rich foods like eggs, raw milk and fish can also helps improve your blood levels of vitamin D.
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How Can I Make Sure My Child Is Getting Enough Vitamin D
Your childs age matters when it comes to cows milk. For children older than 12 months, plain whole cows milk is a great source of vitamin D.
Most cows milk sold in stores is fortified with vitamin D. For babies younger than 12 months, cows milk is not recommended because it may put your baby at risk for intestinal bleeding. It also has too many proteins and minerals for your babys kidneys to handle easily and does not have the right amount of nutrients your baby needs.
For babies who are fed onlybreast milk or who receive both breast milk and infant formula:
- Breast milk usually does not provide all the vitamin D a baby needs, so breastfed babies will need a supplement of 400 IU of vitamin D per day beginning shortly after birth.
For babies who are receiving onlyinfant formula:
- Vitamin D supplementation is not needed.
- Infant formulas are fortified with vitamin D.
How Can I Get The Vitamins And Minerals I Need
It is usually better to get the nutrients you need from food, rather than a pill. Thats because nutrient-dense foods contain other things that are good for you, like fiber.
Most older people can get all the nutrients they need from foods. But if you arent sure, talk with your doctor or a registered dietitian to find out if you are missing any important vitamins or minerals. He or she may recommend a vitamin or dietary supplement.
If you do need to supplement your diet, look for a supplement that contains the vitamin or mineral you need without a lot of other unnecessary ingredients. Read the label to make sure the dose is not too large. Avoid supplements with mega-doses. Too much of some vitamins and minerals can be harmful, and you might be paying for supplements you dont need. Your doctor or pharmacist can recommend brands that fit your needs.
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