Last Monday, the American Academy of Pediatrics (AAP) released a recommendation that all children, from newborns to teenagers, should be getting double the amount of vitamin D that it previously recommended, because of mounting evidence that it may help prevent serious diseases.
Doctors have become alarmed at how many children, and adults, have low levels of vitamin D. Until recently, levels had not been routinely checked.
Dr. Lynnette Mazur is a professor of pediatrics at The University of Texas Medical School at Houston, and chief of pediatrics at Houston's Shriners Hospital for Children. She was "dumbfounded," she told the Chronicle, to find out that many of the children she treated had low levels of the vitamin. Now, she routinely tests for vitamin D levels.
The AAP decision follows a flood of recent research that has attributed a wide variety of health benefits to the vitamin, leading the American Medical Association last summer to call for the government to update its guidelines. Many physicians consider the findings persuasive enough that they are now offering patients routine vitamin D testing.
New research suggests that in children vitamin D can bolster the immune system and help protect against cancer and diabetes. In adults, it was observed that men with low levels of the vitamin are more likely to have heart attacks. Women with breast cancer and colon cancer victims of both sexes are less likely to survive with low levels of vitamin D.
Another study, the first to assess vitamin D levels and mortality in the United States, showed that death rates among a large population were 26 percent higher for people with low levels compared to those with high levels of vitamin D.
Doctors caution that most studies have been largely observational, and more rigorous evidence is needed. It is to be hoped that with such potential for multiple health benefits, at a relatively minimal cost, funds and resources will be forthcoming for such research, and that the government will quickly follow the academy's lead and reassess its overall recommendations.
The AAP now recommends that children get 400 units of vitamin D daily. Their last recommendation, in 2003, was for 200 units — the amount the government currently recommends for children and adults up to age 50; from age 51 to 70, the recommended amount is 400 units, and for adults over 71, 600 units. In order to meet the new recommendation, said the AAP, millions of children, including breast-fed infants and teens who drink little or no milk, will need to take vitamin D supplements.
The best source of vitamin D is sunlight, and it is also found in milk and other fortified foods, and in oily fish, such as tuna, sardines and mackerel. It is essential for absorbing calcium from food and building bones.
Since little investigational research has been undertaken, scientists have many unanswered questions about vitamin D — its impact on health and how best to increase vitamin D levels without unwanted side effects.
Dr. Mazur is in the preliminary stages of an investigational study on the differences between children with low levels and those with normal levels of vitamin D. She cited several possible causes for decreased levels of vitamin D: Children are watching more TV, playing video games and not playing outside as often, and when they do venture outdoors, it's often with sunblocks. Their diets have also become less healthy, and sodas have replaced milk in many cases.
Until more definitive answers are forthcoming, she recommends that parents make sure their kids have a healthy diet, get some sun and "by all means take a supplement — 400 units is not a lot, so there should be no bad effects."
That sounds like a modest investment that could yield valuable dividends. Only further research will prove just how valuable.
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