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Fewer Kids at Risk for Deficient Vitamin D: SmartyPants Comments

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A recent study found that fewer kids are vitamin D deficient than previously thought. In fact, the researchers found that only 10% – as opposed to the 2009 estimate of 70% – of kids had inadequate levels of vitamin D. Whereas we once thought 38.5 million children had low levels of D, only 5.5 million in fact do.

So what has happened in the past 4 years? What, exactly, are we doing right?

Is vitamin D fortified milk working?

Are kids getting more beach time?

Have children finally abandoned their Playstations for the outdoors?

The answer to all of the above is, sadly, no. Or, not so much as to explain these numbers. While improvements in some of these areas may have occurred, nothing so drastic has happened in such a short period of time so as to reduce our vitamin D woes by 33 million children.

Simply put, the reason why these numbers are so improved is that the Institute of Medicine (IOM) changed what’s considered a passing vitamin D grade. In other words, they lowered the bar.

In 2009, researchers found that 70% of American children (38.5 million) were either vitamin D deficient or insufficient based on then current IOM guidelines for adequate Vitamin D levels. The IOM recommended level they measured against was a vitamin D blood saturation of 30 ng/mL (nanograms per milliliter).

In 2010, the IOM released new guidelines for both Vitamin D and Calcium intake, dropping the vitamin D level requirement to 20 ng/mL.  Based on these new guidelines, researchers evaluated the same data and, in 2014, released a study finding that only 5% of children are deficient and 10.3% are insufficient, not 70%.

The IOM now says that children need 33% less vitamin D than previously thought.  Considering this assessment, insufficiency estimates drop from 38.5 million children to 5.5 million children.  As a result, the IOM believes 33 million children no longer need to take vitamin D supplements.

So why did the IOM suddenly change their mind?  Do kids actually need less vitamin D?

The IOMs new guidelines are based on nearly 1,000 published studies and testimony from scientists and experts in the field and view bone health as the primary and only currently verifiable purpose of vitamin D in the human system. But institutions like the Harvard School of Public Health and The International Osteoporosis Foundation (IOF) claim the IOM’s guidelines are inadequate for even that.  Citing two 2009 meta-analyses of double-blind randomized control trials (RCTs), the gold standard for clinical research, the Harvard experts Dr. Heike Bischoff-Ferrari and Walter Willett (the chair of the department of nutrition at Harvard School of Public Health) state that a threshold of 20 ng/mL was not adequate for fracture or fall reduction (study 1 and study 2).  Bone density also increased with higher vitamin D levels far beyond 20 ng/ml in both younger and older adults, suggesting that the IOM threshold recommendation is too low for optimal bone health.

The IOF also disagrees with the IOM, instead recommending 30 ng/mL for optimal fall and fracture reduction.

So too does the American Academy of Pediatrics, stating, “Supplements for All: The AAP recommends vitamin D supplements for infants, children, and adolescents, including those who are breastfed.”

Who, exactly, should you believe?

Really, the best way to know what’s right for you and your family is to get a blood test to set a baseline and identify any deficiencies. A blood test will cost $150 approximately and most are covered by insurance if recommended by your doctor. You then will pay for a doctor visit (which can also be covered, though not in all cases) to help interpret the result. However, until the insurance industry catches up with preventative health (and realizes that making it cheap to find out about our own health profile saves a great deal of money down the road), a supplement can be an affordable way to get the nutrient gap safely covered.  Just be sure you look for a supplement that uses D3 (cholecalciferol) not D2 (ergocalciferol), as D3 is the form your body best knows how to use. The safe upper limit for vitamin D intake is 2500 IU for children between 1 and 3, 3000 for children 3-8, and 4000 IU for everyone over 9.   Almost all supplements provide far below that.  Generally, 400-600 IU is considered optimal for kids and 1000-2500 IU considered optimal for adults.

 

 


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