Since it's finally starting to be warm and sunny in Chicago, I thought that this month is a good month to talk about our sunshine vitamin, vitamin D -- nicknamed this because the sun activates its production in our skin. However, this hormone is now being coined as the new "wonder vitamin," being almost more important to consume than calcium itself.
Why do your kids need it? Most people associate vitamin D with bone health, and it's true, maintaining bone health is one of its most important jobs! Vitamin D helps the body to absorb calcium, assisting the body in building and maintaining healthy bones and teeth. This absorption is essential -- when our body is low in calcium, the body draws it from bones to keep a healthy level in the blood. This leaves the bones weaker over time. However, we're learning that this vitamin is essential to much more. Every tissue and cell in our body contains receptors for D. The thought and research is looking at vitamin D's importance to cell growth and the immune system.
The Vitamin D challenge: There's been a startling increase of vitamin D deficiency over the last several years. The result can be stunted growth, deformation of bones (bowed legs for instance), or bones can be weak and easily broken. In 2008, the Institute of Medicine, Food and Nutrition Board as well as the American Association of Pediatrics came out with new recommended daily allowances: 400 IU (international units) for infants up to age 12 months; 600 IU for children age 1-18.
So, why do so many of us score so poorly in our kids' D intake? Well, normally, on a sunny day, the body can make sufficient vitamin D with a just a few minutes of mid-day sun exposure. However, with the push of sunscreen for skin cancer prevention, many kids are not getting this unprotected sun time and are reliant only on food sources of D. This poses even another challenge as most of the good sources of D, such as sardines, aren't exactly popular with kids.
Other groups that are having difficulty achieving healthy D levels include those with darker skin or health issues such as cystic fibrosis or inflammatory bowel. And, lastly, because Vitamin D is a fat-soluble vitamin that gets stored in the body's fat cells, obesity increases a person's risk for vitamin D deficiency.
Good sources and the supplement question: Our bodies cannot produce Vitamin D so it has to come from outside sources like the sun, food, or supplements. As with all nutrients, it is best to get this vitamin from food first. And, since vitamin D is stored in fat and can become toxic, always always always check with your child's pediatrician before providing a supplement.
First, addressing the wee ones: Breast milk doesn't contain D and since babies shouldn't drink cow's milk until the age of 1, the AAP recommends providing partially or exclusively breast-fed babies with a liquid vitamin such as Tri-Vi-Sol which will provide them with the recommended D levels. At your first baby check-up, your pediatrician most likely will discuss this with you.
For older kids, here is a list of vitamin D rich sources, with the amount of IUs following each food:
• Cod liver oil, 1 tablespoon, 1,360
• Swordfish, cooked, 3 ounces, 566
• Salmon (sockeye), cooked, 3 ounces, 447
• Tuna fish, canned in water, drained, 3 ounces, 154
• Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies), 137
• Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup, 115-124
• Yogurt, fortified with 20 percent of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV), 80
• Sardines, canned in oil, drained, 2 sardines, 46
• Liver, beef, cooked, 3 ounces, 42
• Egg, 1 large (vitamin D is found in yolk), 41
• Ready-to-eat cereal, fortified with 10 of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV), 40
You may now be looking at that list and thinking, "Well, that's a great list, but how do I get my preschooler to eat any of this?" Here are a few ideas:
• Serve ½ cup of fortified orange juice with oatmeal made with ½ cup fortified milk at breakfast (about 100 IUs)
• For snack, make a berry smoothie with 6 oz of fortified yogurt (about 80 IUS)
• Serve 1 cup of milk with both lunch and dinner (about 220 IUs)
• Make sandwiches stuffed with tuna into fun shapes -- my boys love the super hero cookie cutters! (about 150 IUS)
I hope this helps clear up any D confusion -- enjoy our sunny Chicago skies this May!
Contact me: If you have any feedback, comments or questions on this topic or any others, I would love to hear from you! You can send me an email firstname.lastname@example.org with your thoughts.
•Christina Fitzgerald, a registered dietitian and licensed dietitian nutritionist, is the owner of Nourished, Nutrition and Wellness, nourishedliving.com. She lives with her husband and three young sons in the Northwest suburbs.