The leading children's medical organization in the United States says that it has doubled the amount of vitamin D recommended for infants, children, and adolescents.
The increase, from 200 international units (IU) to 400 IU per day, starting in the first few days of life, was detailed at a meeting of the American Academy of Pediatrics (AAP) and published in the medical journal Pediatrics.
"Four hundred IU a day is the amount that is in a teaspoon of cod liver oil, which we have used for 75 years to prevent and treat rickets in children,” says Dr. Frank Greer, a lead author on the report.
“Historically speaking, that is the amount that is in any chewable multivitamin tablet and in any liquid preparation for infants," he says.
In fact, Dr. Greer adds, today's supplements already carry a minimum of 400 IU of vitamin D.
"Four hundred is probably the minimum," agrees Dr. Don Wilson, at Texas A&M Health Science Center College.
Certain risks associated with vitamin D deficiency have been known for decades: rickets (weakening of the bones), which is still widespread in infants, children, adolescents, and adults; growth failure; lethargy; irritability; respiratory infections during infancy; and osteoporosis later in life.
More recently, however, associations have been made between vitamin D deficiency and type 2 diabetes, some cancers, multiple sclerosis, and rheumatoid arthritis.
"Among rheumatologists who treat patients with autoimmune diseases, there has been an increasing recognition that insufficiency in vitamin D may contribute to a variety of autoimmune diseases," says Dr. Nora G. Singer, at Case Western Reserve University in Cleveland, Ohio.
"If [vitamin D deficiency] really does impact innate immunity or the first line of immune defense, then maybe some of the increase in autoimmune diseases we're seeing could relate to this," she says.
Vitamin D, according to Dr. Greer, is not actually a vitamin at all but a hormone.
"It acts directly on cells to promote gene transcription," he explains. "No other 'vitamin' does this, so it really is very, very powerful."
Vitamin D deficiency is common among all age groups across the globe.
The main source of vitamin D is sunlight but experts now urge everyone to stay out of the sun or, at the very least, to wear sunscreen and protective clothing while outside.
Vitamin D is not plentiful in most foods, with the exception of fatty fish, certain fish oils, liver, and egg yolks of chickens fed vitamin D.
"We know 400 IU a day is safe and prevents rickets," says Dr. Greer. "We don't have any idea if that amount of vitamin D is enough for other diseases. We also don't know if anything over 400 is safe."
Infants who are breast-fed or partially breast-fed should receive 400 IU a day of vitamin D in supplements, beginning in the first few days of life. Many mothers are deficient in the vitamin and pass this on to their newborns.
Supplementation should be continued unless the infant starts taking at least one quart a day of vitamin D-fortified formula or whole milk, although whole milk should not be introduced until the child has turned one.
Many children, including those with a family history of obesity, should only be drinking low-fat milk.
Non-breast-fed children and older children should also receive a vitamin D supplement of 400 IU/day.
Children at increased risk of vitamin D deficiency (for example, those taking anti-seizure medications) may need higher doses, but this should only be done in consultation with a health-care professional.
Always consult your child's physician for more information.
The food guide pyramid is a guideline to help you and your child eat a healthy diet. The food guide pyramid can help you and your child eat a variety of foods while encouraging the right amount of calories and fat.
The United States Department of Agriculture (USDA) and the US Department of Health and Human Services have prepared the following food pyramid to guide parents in selecting foods for children 2 years and older.
The Food Pyramid is divided into six colored bands representing the five food groups plus oils.
Orange represents grains: Make half the grains consumed each day whole grains. Whole-grain foods include oatmeal, whole-wheat flour, whole cornmeal, brown rice, and whole-wheat bread.
Check the food label on processed foods - the words “whole” or “whole grain” should be listed before the specific grain in the product.
Green represents vegetables: Vary your vegetables. Choose a variety of vegetables, including dark green- and orange-colored kinds, legumes (peas and beans), starchy vegetables, and other vegetables.
Red represents fruits: Focus on fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed.
Yellow represents oils: Know the limits on fats, sugars, and salt (sodium). Make most of your fat sources from fish, nuts, and vegetable oils. Limit solid fats like butter, stick margarine, shortening, and lard, as well as foods that contain these.
Blue represents milk: Get your calcium-rich foods. Milk and milk products contain calcium and vitamin D, both important ingredients in building and maintaining bone tissue. Use low-fat or fat-free milk after the age of two years.
However, during the first year of life, infants should be fed breast milk or iron-fortified formula.
Whole cow’s milk may be introduced after an infant’s first birthday, but lower-fat or skim milk should not be used until the child is at least two years old.
Purple represents meat and beans: Go lean on protein. Choose low fat or lean meats and poultry. Vary your protein routine - choose more fish, nuts, seeds, peas, and beans.
Activity is also represented on the pyramid by the steps and the person climbing them, as a reminder of the importance of daily physical activity.
Always consult your child's physician for more information.
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