Vitamin D and Kids: How Much Sun Should They Get to Stay Healthy? By Nancy Shute, US News & World Report online, August 03, :12 PM ET

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1 Vitamin D and Kids: How Much Sun Should They Get to Stay Healthy? By Nancy Shute, US News & World Report online, August 03, :12 PM ET Name: Right after I coated my kid with SPF 70 sunscreen and dropped her off at camp this morning, I picked up the newspaper and read: "Millions of Children in U.S. Found to be Lacking Vitamin D." Sunscreen was listed as a main culprit for the deficiency, which can put children at risk of developing high blood pressure, high blood sugar, heart disease, and weak bones. Yikes! I've been slathering on sunscreen so my pasty-white kid doesn't get skin cancer. But heart disease doesn't sound good, either. The fact that increasing numbers of American children are lacking in vitamin D isn't new, but this latest report is the first nationwide assessment of vitamin D intake among kids, based on federal data. Nine percent of children up to age 21 were found to be seriously deficient in D. Another 61 percent, while they had higher blood levels of D, still had higher blood pressure and lower levels of good cholesterol. Girls, teenagers, and children with darker skin are more likely to be lacking. The main culprits? More time indoors with video games and computers; less milk, which is fortified with vitamin D; and sunscreen. But being in the sun is the easiest and safest way to get vitamin D, because the skin makes the prohormone in response to sun exposure. It's impossible to get too much of it this way, unlike the vitamin in supplement form. Doctors recommend 10 to 15 minutes a day in the sun without sunscreen for children who can handle it. "Parents know their children," they say. "If your child is very sun sensitive, obviously you don't want them to get a sunburn." Since my child falls into that category, I'll be following other advice: having her drink milk or orange juice fortified with vitamin D. But a child would have to drink a quart of milk to get the 400 IU currently recommended for children, and that's not happening in my house. So I'll be looking at vitamin D supplements, particularly when winter comes around.

2 Vitamin D and Nutrition Over the last few hundred years human lifestyles have changed. The industrial revolution resulted in more indoor work and less exposure to sunlight. Many societies around the world wore more clothing over the centuries, further reducing skin exposure to sunlight. These changes have brought with them a significant reduction in the natural production of vitamin D and subsequent diseases. Countries responded to these changes by fortifying some foods with vitamins D2 and D3, examples include breakfast cereals, bread, pastries, oil spreads, margarine, milk and other dairy products. Not that many foods contain vitamin D. Some fish, such as salmon, tuna and mackerel, as well as fish liver oils are considered to be the best sources. Some vitamin D is also present in beef liver, cheese and egg yolks. Most of these are Vitamin D3. Some mushrooms provide variable amounts of vitamin D2. Most of the food-sourced vitamin D in the western diet comes from fortified foods - where vitamin D is artificially added. Most US milk is fortified with 100 IU/cup of vitamin D. In the 1930s milk was fortified in many countries to combat Rickets, a disease which was a major health problem then. What Do We Need vitamin D For? * It is crucial for the absorption and metabolism of calcium and phosphorous, which have various functions, especially the maintenance of healthy bones. * It is an immune system regulator. * It may be an important way to arm the immune system against disorders like the common cold * It may reduce the risk of developing multiple sclerosis. * Vitamin D may have a key role in helping the brain to keep working well in later life, according to a study of 3000 European men between the ages of 40 and 79. * Vitamin D is probably linked to maintaining a healthy body weight, according to research carried out at the Medical College of Georgia, USA. * It can reduce the severity and frequency of asthma symptoms, and also the likelihood of hospitalizations due to asthma * It has been shown to reduce the risk of developing rheumatoid arthritis in women.

3 * A form of vitamin D could be one of our body's main protections against damage from low levels of radiation, say radiological experts from the New York City Department of Health * Various studies have shown that people with adequate levels of vitamin D have a significantly lower risk of developing cancer, compared to people with lower levels. Vitamin D deficiency was found to be prevalent in cancer patients regardless of nutritional status, in a study carried out by Cancer Treatment Centers of America. What is vitamin D Deficiency? Vitamin D deficiency is when your body, and specifically your blood, doesn t have enough vitamin D. Vitamin D deficiency can lead to the following conditions and illnesses: * Rickets - a disease of children and infants that interferes with normal bone formation - a failure to mineralize bone. Bones become distorted and bend wrongly because they are soft. During the first three decades of the 20th century Rickets was mainly caused by lack of direct exposure to sunlight. The ultraviolet rays necessary for vitamin D synthesis do not pass through ordinary window glass. * Osteomalacia - softening of the bone caused by demineralization (loss of mineral), mainly loss of calcium from bone. This disorder only affects adults and can cause severe musculoskeletal pain. * Osteoporosis - reduced bone mineral density and increased bone fragility. Vitamin D deficiency has also been linked to the following diseases: * Hypertension (high blood pressure) * Heart failure, according to US researchers. * Ischemic heart disease * TB (tuberculosis) * Cancer * Periodontal disease * MS (multiple sclerosis) * Chronic pain * SAD (seasonal affective disorder) * Peripheral artery disease * Cognitive impairment * Cardiovascular disease among patients with diabetes * Parkinson's disease (possibly: we are not sure whether Parkinson's causes low vitamin D levels, or whether low vitamin D causes Parkinson's) * Alzheimer's disease, suspected by researchers from the Sunlight, Nutrition, and Health Research Center. Distorted and bent leg bones caused by Rickets * Immune system problems - a University of Missouri nutritional sciences researcher found that vitamin D deficiency is associated with inflammation, a negative response of the immune system, in healthy women.

4 Mixed Messages Regarding Sun Exposure For decades we have been told to stay out of the sun, to wear hats and cover ourselves with sun block to protect against skin cancer - and also significantly reducing our levels of vitamin D. Add to that a growingly sedentary lifestyle where we and our children spend more time indoors either watching TV or in front of a computer monitor, and it is not surprising that millions of people have excessively low levels of vitamin D in our system. Then we are told that sunlight can rapidly make up for any vitamin D shortfall, while at the same time the American Academy of Dermatology continues to recommend that the public obtain vitamin D from nutritional sources and dietary supplements, and not from unprotected exposure to ultraviolet radiation because of the skin cancer risk. Telling people to get their vitamin D from just food and supplements obviously does not work. People have been told that for the last twenty years and vitamin D deficiency or insufficiency has increased significantly. It is estimated that 50% of American elderly women consume far less vitamin D in their diet than recommended. Consequently, vitamin D deficiency is a serious problem among the elderly in the USA. It is understandable why a dermatologist, who is in direct contact with skin cancer patients, advises people to stay out of the sun. However, millions of people are and will develop other very serious diseases because their vitamin D levels are too low. Skin cancer is one factor, but there are many other factors. Large studies are required that can clearly tell us: 1. Why is the current policy of telling people to get just their vitamin D from nutritional sources not working? 2. Is the current vitamin D problem greater than the skin cancer problem? 3. Is it possible to estimate what the impact of recommending 15 minutes twice a week of sun exposure would be on skin cancer numbers, and the health benefits from a resulting lower incidence of vitamin D deficiency in the population?

5 Some health authorities are starting to change their recommendations. Here is a quote from the Cancer Council, Australia (2009): "Sun exposure is the cause of around 99% of non-melanoma skin cancers and 95% of melanomas in Australia. However, exposure to small amounts of sunlight is also essential to good health. A balance is required between avoiding an increase in the risk of skin cancer by excessive sun exposure and achieving enough exposure to maintain adequate vitamin D levels." QUESTIONS How many minutes EVERY DAY can be spent in direct sunlight to get the adequate levels of vitamin D? 2. How much milk would a child have to drink EVERY DAY to get the recommended levels of vitamin D? 3. What is RICKETS? 4. A person who lives a SEDENTARY lifestyle might spend time doing: 5. What is the controversy about getting vitamin D from direct sunlight? 6. What are FIVE different health problems that are related to a deficiency in vitamin D? A. B. C. D. E. 7. What is the author s PURPOSE in writing this article?

6 Vitamin D SURVEY: Record important titles, subtitles, bold-faced words, captions, etc. QUESTION: Write out at least 3 "Who, What, When, Where, Why, or How" questions based on your survey. 1.) 2.) 3.) READ: As you read, look for and write down answers to the questions from above. 1.) 2.) 3.) RECITE: Complete the FREEWRITE: "What are some ways you can help to increase your vitamin D intake?" You might want to think about the following in your response: 1.) How do you spend your time? Do you get outdoors enough each day? 2.) What foods do you eat that can help increase your vitamin D? 3.) What are the advantages of getting enough vitamin D? 4.) What can happen to you if you don t get enough vitamin D?

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