Our great grandmothers knew that vitamin D deficiency was a big problem for her children, hence the daily fight over giving your grandfather his cod liver oil. Great Grandma didn’t know what vitamin D was or what was in cod liver oil, but she knew it kept her kids healthy. How did she figure all this out, long before the era of biochemistry? I don’t know. All I can figure is that she was truly a genius. But now this old fashion disease, vitamin D deficiency, and its many variants, are making a comeback. So in this pedcast, we are going to learn more about vitamin D and how you can avoid your children from becoming D-ficient in this important chemical of their bodies.
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Musical Intro
Pediatricians Catch on Faster than Adult Doctors
I think it is fair to say that pediatricians catch on faster than adult doctors. First, diseases are recognized in babies, then in older people. That’s the way it seems to play out. Remember toxic shock back in the 70’s that terrible deadly ICU type disease that adult women were getting. Eventually, that disease was pinned down to these women’s use of super-absorbent tampon that promoted an overgrowth of a toxigenic staph aureus. This germ was deadly. Pediatricians had recognized a similar disease in non-tampon using children years earlier and called it staph scalded skin disease. Oh, and what about in the 1980’s when the flesh eating strep made an appearance? Well, pediatricians have known about that for a long time as well. They called it erysipelas. Oh and shingles, don’t forget shingles. Well, shingles is nothing more than chickenpox, a baby disease, coming out in a localized way. Now old people get a chickenpox shot to make sure that they don’t get this dreaded old age disease. Well, the latest baby disease to make adult headlines is rickets and vitamin D deficiency. Rickets is a baby bone disease usually caused by vitamin D deficiency. And you know it; adult doctors have begun to recognize that many of adults are vitamin D deficient. Furthermore, many adult diseases are being tracked down to vitamin D deficiency. Adults don’t get rickets because they are not growing but they can have other problems from a lack of vitamin D, as you are about to see.
Science Lane- Essential facts to Know about Vitamin D
Sometimes in these talks, I take a stroll down Opinion Lane, but today, we are going to make a detour down Science Drive. Vitamin D, what is it? It’s a fat-soluble vitamin, meaning this vitamin is stored in fat for long periods of time. A little vitamin D comes from foods, but the vast majority of the vitamin D that your child has in their body comes from their own production of it. Production occurs in their skin when they are exposed to ultraviolet light, particularly UVB light. Once this vitamin/hormone is formed in their skin, their livers and kidneys put some final touches on it and it becomes an active substance in their bodies. And here is a key point to remember- vitamin D unlocks your child’s absorption of calcium and phosphorus, the minerals that are needed for them to make strong bones. Without enough vitamin D, infants, children and adults just can’t keep their bone strength optimal. There are just not enough minerals absorbed to make their bones really hard. If there is a severe deficiency of minerals in the bones, we call that disease rickets in babies or osteoporosis in adults.
Vitamin D deficiency is not just for babies anymore.
As I said before, the whole vitamin D story has been getting more complicated recently now that adult investigators have linked its deficiency to a whole host of adult diseases—namely multiple sclerosis, adult onset diabetes, immune dysfunction and certain types of cancer- colon and breast. It turns out that there are vitamin D receptors on every cell in your body so it makes sense that vitamin D deficiency may cause some other disease processes other than simply bone diseases. Which brings us back to great grandma and to today’s Doc Smo pearl, “Grandma, didn’t waste her time, recommending things that weren’t important.
So if vitamin D deficiency is so terrible, how can parents avoid it in their children?
So if vitamin D deficiency is so terrible, how can parents avoid it in their children? By making sure your children get a minimum of 30 minutes of sunlight, without sunscreen, between 10am-2pm. UVB light happens to be maximal during those hours. Oh and by the way, putting junior in front of a window won’t work since very little UVB light comes through glass. If your children have dark skin, you may need a lot more than just 30 minutes a day. Asian or Indian need 90 minutes and African may need 180 minutes. These are just estimates, but let’s get those children outside every day right at birth. Yeah, you heard me right, unless the weather is extreme; it’s never too early to go outside. And for infants, that’s children less than a year of age, they should likely get a vitamin D supplement daily. Ask your child’s doctor about this to get the most current recommended dose. And diet is important. Older children need three vitamin D fortified dairy servings a day—that’s milk, cottage cheese, yogurt or the like. If your child is milk allergic, use an elemental formula instead. In my original pedcast on this subject I recommended a soy formula but experts no longer do. Your child’s calcium intake should be about 700mg a day for young children and about 1200 mg for teens (see the chart in my show notes for the most recent recommendations). Avoid juice soda and other sweetened beverages. Not only are there no minerals in these drinks, but also every soda is one less serving of milk that they will get. It’s also important for your children to be active for at least an hour a day. Gravity helps make their bones strong. With trauma comes bone regrowth. This makes their bones strong for the long haul. And remember, every hour of screen time your children get is an hour of physical activity lost. You know what they say, “use it or lose it.” And that is really accurate when it comes to bone health. Now here is something you need to know—you can only increase your bone density up to about age twenty. After that age, there is a slow steady progressive loss of bone density for the rest of your children’s lives. Moral of that story, the better your bone density is at 20, the better it will be at 90. So let’s get your children active and make sure that they also get vitamin D in their diet along with daily sunshine.
Check the food chart for dietary content of vitamin D in foods.
Groups most at risk and Prevention of D-ficiency
Getting 400 IU of vitamin D3 is especially important for infants born in the winter because of their lack of sun exposure, premature infants whose bones are poorly mineralized at birth, exclusively breastfed infants since most breast milk is low on vitamin D, and dark skinned infants who need far more light to produce vitamin D in their skin. Any baby vitamin generally has vitamin D added but don’t go overboard because you can give too much. Follow the recommendations I posted in the show notes.
Adults generally shouldn’t take more than 2000 unless it is done under the direction of their doctor. And be careful about those gummy vitamins. All that sticky sugar us likely to make dentists very rich. And don’t forget about fish, it’s a great source of vitamin D because fish live outside and therefore are full of vitamin D. Try and get fish incorporated in your family’s diet at least twice weekly.
Summary
Sounds like grandma wrote the AAP guidelines over 100 years ago. Here is what she said:
-Drink your milk with each meal!
-Don’t drink that soda, it’s bad for you!
-You need to eat fish, at least twice weekly! Its good for you.
-Get outside and don’t play inside.
-And take your cod liver oil every day to stay healthy, especially in the winter months.
Right on grandma
Outro
As always, thanks for tuning in. My goal, to make you one of the best-informed parents in the room! If you enjoy learning about child health with pedcasts, consider rating our podcast on your pod catcher like Apple podcasts. Your rating really helps us. This is Doc Smo, hoping you now feel free, to make sure your children get enough vitamin D. Until next time.