All You Need to Know about Vitamin D Deficiency

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Vitamin D is a crucial nutrient in our body along with calcium to maintain healthy bones and good strengths. Like all nutrients, Vitamin D does not serve only one purpose for the body. It is important for our overall health, immunity, and skin and beauty. 

However, there is an estimation of one billion people who are reported to have Vitamin D deficiency worldwide. ​

Pinpointing a “suitable” Vitamin D intake level for your children is not easy. 

Just like other nutrients, getting sufficient of each but not too much of it is needed to keep a human body to function well. 

What is Vitamin D? 
Vitamin D, also known as “calciferol”, is a fat-soluble vitamin found naturally in foods and available as a dietary supplement. Interestingly, apart from food sources, Vitamin D can also be synthesized when ultraviolet (UV) rays from sunlight pass through the skin. 

Once a human body takes in Vitamin D, chemical processes in our liver will start absorbing it into our blood and directing it through our body tissues and kidneys. There, it converts into an activated form known as calcitriol. With the activated form of Vitamin D, it can now aid in calcium supply and absorption by our bones, blood and gut.  

What is Vitamin D deficiency?
When your blood test report shows that you have Vitamin D deficiency, it means that the Vitamin D level in your body has not reached the average range. 

What are the common risk factors for Vitamin D deficiency? 
Here are the 7 common risk factors: 

• Being elderly
• Having dark skin 
• Having inadequate fish or dairy food intake
• Facing obesity 
• Staying indoors for prolonged periods 
• Living far from the equator where there is little sun year-round 

People that do not live near the equator are exposed to the sun less and are therefore more likely to be Vitamin D deficient. 

• Applying sunscreen often when going out

What are the Health Effects of Vitamin D Deficiency?1. Skeletal diseases
Vitamin D deficiency is strongly associated with weak bones.

Loss of bone density is one of the common Vitamin D deficiency problems which can contribute to bone fractures and osteoporosis. 

A rare bone disease known as rickets can be found in children. It is the outcome of bone tissues that are not properly mineralized, resulting in soft bones that bend easily. 

In addition to bone pain and deformities, severe rickets may lead to developmental delay, dental abnormalities, cardiomyopathy, seizures and spasms. 

Rickets can be mostly seen in African American babies and kids whereas severe Vitamin D deficiency in adults leads to osteomalacia which causes muscle weakness, weak bones and bone pain. 

​2. Inflammatory bowel disease (IBD)
Although vitamin D deficiency is common in people with IBD, it is still not established whether the deficiency is a factor or a consequence of the disease. 
However, there is evidence proven that vitamin D deficiency may be a contributing factor that leads to the development of IBD in genetically predisposed individuals. 
At the same time, in order to absorb vitamin D, there must be sufficient dietary fat from our food intake. Fat is absorbed in the small intestine. When there is a failure of absorbing nutrients in the gastrointestinal tract, there is a higher risk for nutritional deficiencies. Additionally, IBD causes inflammation in the small intestine, leading to the decrease of fat absorption, which in turn affects the absorption of vitamin D.
3. Cognitive disorders
Vitamin D plays an important role in brain development and function regulation as well. It is responsible for a healthy nervous system. 

Vitamin D deficiency can be commonly found in patients with Alzheimer’s disease, Parkinson’s disease, depression, anxiety, dementia, schizophrenia, and elderly with cognitive decline. 

It has been reported that individuals with low Vitamin D have 2.4 times greater risk of cognitive impairment versus those with sufficient levels. 

How can you help your child to get enough Vitamin D?
You and your child can get Vitamin D in three ways: from sunlight, diet and supplements.
 
1. Sunlight 
Children need sunlight on their skin to produce Vitamin D. By having regular exposure to sunlight, they can get about 80% of Vitamin D into their body. 

However, the amount of sun that your kid needs depends a little on the skin colour. People with a natural tan need 3 to 6 times more sunlight exposure to produce the Vitamin D they need as compared to fair-skinned people. 

Age plays a role too. Individuals who are younger convert sunlight into Vitamin D better than those who are past the 50 year mark. Fortunately, the solution is simple and it doesn’t take a long time. 5 to 30 minutes of sun exposure between 10 a.m. and 3 p.m. is enough to get the needed amount of Vitamin D.  

Yet, you need to take note that too much sunlight exposure can cause sunburn, skin damage and skin cancer. 

Hence, always be sun smart especially for your children when you are having outdoor activities under hot sun. Sunscreen, sunglasses, hat, UV protection clothes and access to shady areas can be the alternatives to protect our skin. 

Without a doubt, having Vitamin D naturally from the sun is a good option. Unfortunately, kids nowadays spend most of their time indoors, especially during the COVID-19 pandemic. 

Hence, parents must provide kids with natural food sources which have adequate Vitamin D content. 

2. Food 
Unlike other nutrients, Vitamin D is generally found in a small number of foods. These include fresh fatty fish like sardines, salmon, mackerel and herring. Mushrooms, liver, egg yolks, and fortified foods such as breakfast cereals and some fat spreads also contain Vitamin D. 

Alternatively, parents could offer Vitamin D supplements for their children as not many food sources are rich in Vitamin D. 

3. Supplements
To get enough Vitamin D, children often need to consume Vitamin D supplement or multivitamin with Vitamin D. Vitamin D is occasionally labeled as Vitamin D3. For more kids-friendly options, parents can buy Vitamin D gummies, chewables, liquids and sprays in stores for your children without a prescription. 

Do make sure to consult your kid’s health care provider, pharmacies or consultant for advice on choosing the ideal Vitamin D supplement. 

How much Vitamin D do you need? 
Vitamin D is measured in international units (IU)

• Infants from birth to 12 months: 400 IU of Vitamin D per day. Baby formula generally has 400 IU per liter. Thus, if your baby is drinking at least 32 ounces of formula every day, you don’t have to worry much about his or her Vitamin D level. 
• Children from 1 to 13 year old: 600 IU of Vitamin D per day 
• Teens from 14 to 18 year old: 600 IU of Vitamin D per day
• Adults from 19 to 70 year old: 800 IU of Vitamin D per day
• Pregnant and breastfeeding women: 600 IU of Vitamin D per day

Some children might need more intake of Vitamin D, as such: 

• Those who are healing from bone surgery such as scoliosis.
• Those who have some medical problems such as cystic fibrosis, obesity, celiac disease, bone pain or multiple fractures.
• Those who are under medications such as anti-seizure medicines that prevent the way the body uses Vitamin D

Can too much Vitamin D be harmful? 
Extreme levels of Vitamin D, also known as Vitamin D toxicity can be harmful to an individual. 
The signs of toxicity include vomiting, nausea, constipation, poor appetite, weaknesses, weight loss. Excess Vitamin D also causes the damage of the kidney and increase of calcium level in the blood. High levels of calcium in the blood (hypercalcemia) can cause disorientation, confusion, and problems with heart rhythm.

Vitamin D toxicity happens when an individual over-consumes Vitamin D supplements. High exposure to sunlight won’t cause Vitamin D poisoning as the body will limit the amount of the produced Vitamin D. Yet, it is still best to control the time exposure to sunlight to avoid skin damage.

In short, as long as your child is provided a well-balanced diet with the stated food source rich in Vitamin D, you don’t have to worry much about his or her Vitamin D level! Nevertheless, make sure to talk to your health care consultant whether your kid needs a Vitamin D supplement or not.


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References
Biegner, J. (November 2020). Vitamin-D deficiency: what you should know. HUM Nutrition Blog. Retrieved from https://www.humnutrition.com/blog/vitamin-d-deficiency-what-you-should-know/

Dinerman, B. E. (January 2018). What you need to know about Vitamin D. One Medical. Retrieved from https://www.onemedical.com/blog/live-well/vitamin-d

Harbolic, B. K. (September 2019). Vitamin D Deficiency. MedicineNet. Retrieved from https://www.medicinenet.com/vitamin_d_deficiency/article.htm

‘MedlinePlus - Health Information from the National Library of Medicine’. (n.d.). Vitamin D deficiency. Retrieved from https://medlineplus.gov/vitaminddeficiency.html

‘National Institutes of Health’. (October 2020). Vitamin D. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

‘Raising Children Network’. (September 2020). Vitamin D: what you need to know. Retrieved from https://raisingchildren.net.au/teens/healthy-lifestyle/nutrients/vitamin-d