Vitamin D is a fat soluble vitamin, it is important for bone and muscle health. Vitamin D helps the body absorb calcium and phosphate from food, which are important for healthy and strong bones. In India subclinical vitamin D deficiency is widespread in all age groups. Dietary intake of both calcium and vitamin D are very low in the majority of the population. Vitamin D is involved in regulation of more than 1000 human genes. Since few foods contain vitamin D,sunlight is the major determinant of vitamin D status in children. In this article, Dr. Sindhura Munukuntla, Consultant Paediatrician, Yashoda Hospitals, Hyderabad shares potential health problems that children might face due to low levels of vitamin D.
Most vitamin D is made in skin when exposed to sunlight.Vitamin D is found naturally in very few foods like some fatty fish(mackerel, salmon, sardines), fish liver, oils and egg yolk. Other sources include fortified foods particularly dairy products and some cereals.
The interest in vitamin D status has increased substantially 0ver past decade because of many roles of vitamin D in the human body. In Asia vitamin D deficiency is widespread and a prevalence of more than 70% deficiency has been reported in the general population, studies conducted in various regions of the country across all age groups indicate poor vitamin D status.
Also Read: 5 Best Sources of Vitamin D Except Sunlight
Risk Factors For Vitamin D Deficiency In Children
- Exclusively Breast Fed Infants: breast milk alone doesn't provide an infant with adequate amount of Vitamin D. Vitamin D should be supplemented to all breast fed infants till 1 year of age.
- Dark Skin: Children with dark colour skin synthesise less vitamin D on exposure to sunlight than those with light coloured skin.
- Fat Malabsorption: Certain children with conditions like cystic fibrosis, cholestatic liver disease etc have impaired absorption of dietary vitamin D as the vitamin requires fat for its absorption.
- Obesity: Obesity in children increases their risk of vitamin D deficiency.
- Inflammatory Bowel Disease: some children with Inflammatory bowel disease like crohn's disease, children who underwent bowel surgery, etc. are at increased risk of deficiency.
- Sunscreen Lotion: Use of sunscreen lotion with a sun protection factor of 8 inhibits more than 95% of vitamin D in the skin.
Health Issues Due To Vitamin D Deficiency
Many children with low vitamin D do not have symptoms, but some children with low vitamin D get bone and muscle pain. Rickets in youngsters and osteomalacia in adults who have very low vitamin D levels can both result in soft bones. Rickets exclusively affects growing children; if a youngster has weaker bones from inadequate vitamin D levels, the bones may bend and result in "bow legs" or "knock knees".
Also Read: Importance of Vitamin D for Skin and Hair
Children who have low vitamin D may also have insufficient calcium, which can result in muscle cramps. Low calcium can also cause seizures, particularly in young babies.
Low vitamin D increases child susceptibility to repeated lung infection,high blood pressure,cancer,autoimmune diseases like type 1 diabetes.
Vitamin D deficiency causes long standing muscle pain and weakness in both children and adults.
Treatment
- Children with low vitamin D should be treated with vitamin D supplementation to restore their levels to the normal range.
- Ensure adequate calcium intake in children. Cheese, yogurt and fortified soy dairy are useful sources of calcium in children who dislike cow milk. Consider supplements if they have poor intake.
- Parents and children should be educated about the duration and timings of sun exposure,one hour per day for 5 to 6 days in a week between 10 am to 3 pm.
However to avoid sunburn it is important to protect children with sunscreen with sun protection factor SPF of 15 or higher,and also limit their time in sun only between 10 am to 3 pm when the rays are strongest for formation of vitamin D in the skin.
Too much vitamin D can also cause problems. Hypervitaminosis D in children is usually accidental but may develop during treatment of rickets due to excessive consumption over and above the prescribed dose. Clinical features include loss of appetite, weakness, dull activity, lethargy and constipation.
Hence vitamin D should always be taken only after consulting your paediatrician.
