The new doubled recommendations for children's vitamin D levels collide headlong into our toaster-pastry, grab-and-go, fluorescent-lit lives, asking us to make breakfast the most important meal of a day and to boot the kids outside to play.
This month, the American Academy of Pediatrics (AAP) said kids need twice the usually recommended amount of vitamin D because of evidence suggesting that it may help prevent serious diseases. The new recommendation is 400 IUs, or international units, every day. That's four glasses of milk.
Specifically, the report focused on breast-fed babies and even more on their mothers, said Dr. Teresa Kovarik, a pediatrician in HealthPartners' Como Clinic in St. Paul.
"We have the majority of women as being vitamin D deficient, and because babies are born with only 70 percent of what the mom's level is, the babies are even more deficient," Kovarik said. "Then the breast milk is deficient, so we really have a snowball effect."
The AAP's report may just be the tip of the iceberg, she added.
"We need to be looking at whether the mother's level is enough and supplement the mothers first, which helps the mom and the baby," she said.
If the flap about vitamin D seems sudden and alarming, you're right. "We are having emerging data that show there really is an epidemic of vitamin D deficiency in women in our country," Kovarik said, noting that sunscreen use and spending more time indoors have put a crimp in the easiest and fastest way to get vitamin D.
Living in Minnesota winters doesn't help. The angle of the sun is so extreme that for five months of the year, we're not converting sunlight into vitamin D. A deficiency also is behind a rise in rickets, or a softening of the bones, once considered a malady of developing countries.
A solution seems easy, said Dr. David Aughey, medical director for adolescent medicine for Children's Hospital and Clinics of Minnesota.
"Ten minutes of sun exposure in spring, summer or fall is all it takes to reach the vitamin D requirement," he said.
In the winter, though, it's a couple of hours, which means supplements.
"Supplements are so easy," he said, noting how spina bifada has been largely conquered when folate was made more available. Six months ago, he upped his daily ingestion of D to 1,000 units.
A lot of murkiness
Kovarik said that children can ingest 500 to 1,000 units each day, in two doses -- a multivitamin with milk in the morning, then a calcium and vitamin D supplement with milk at night.
So it's not possible to consume too much D?
"There's a lot of murkiness right now, and we don't really know what too much is," she said. "We're getting a lot of emerging data. But on a sunny day, you can easily convert 10,000 to 20,000 units in your skin."
If sunshine isn't available and supplements aren't your cup of tea, dietary efforts can pay off. But it may require a change in routine.
"Breakfast ought to be the main meal of the day," Aughey said, adding that egg yolks are an excellent source of vitamin D. Salmon and tuna are great, as well.
The market will respond
Breakfast is when fortified cereals come into play, along with milk and juices fortified with vitamin D and calcium, said Elizabeth Ward, author of "The Complete Idiot's Guide to Feeding Your Baby and Toddler."
Ward, who also speaks on behalf of General Mills, said a good breakfast would be a serving of fortified cereal with milk and fruit, or two eggs, two slices of whole-grain toast and 8 ounces of orange juice with added calcium and vitamin D. Either would provide about 140 IU vitamin D.
Look for a number of products touting added vitamin D -- which brings us to reading those sometimes cryptic labels. Ward offered this rule of thumb:
Vitamin D is expressed as a percentage of daily value in the nutrient facts. The daily value for vitamin D is the same as the amount that the AAP says children now need on a daily basis -- 400 IUs. So if a serving contains 25 percent of the daily value for vitamin D, it contains 0.25 times 400 IUs, which is 100 IUs.
Kim Ode • 612-673-7185
