A must-read on Vitamin D deficiency: Causes and management

A must-read on Vitamin D deficiency: Causes and management

A child needs various macro and micronutrients to grow up steadily and happily. And vitamin D is an important one among them. Also known as vitamin D3, this nutrient is essential for strong bone health. It helps in maintaining the optimal levels of phosphate and calcium in the blood. And the right levels of calcium and phosphate are necessary for normal mineralization of bones, nerve conduction, contraction of muscles, and general cell functions. Vitamin D also helps the intestines to absorb calcium more efficiently, which would otherwise get excreted by the kidneys. So, are you worried that your little one is not getting enough vitamin D? Read on to learn about the importance of this essential nutrient and how to fulfil its requirements.

Role of vitamin D

The deficiency of vitamin D during pregnancy can influence bone growth and foetal development. Infants and children need a sufficient amount of vitamin D as low levels can lead to calcium mobilization from the bone, as well as bone resorption (break down of bone and the release of bone minerals into the blood), which can further lead to a condition called rickets. Getting a sufficient amount of vitamin D helps prevent autoimmune conditions, infections and type 2 diabetes in infants and children.

Your doctor can confirm vitamin D deficiency in your child through a blood test which analyses the levels of 25-hydroxy vitamin D. It might help you to know that RDA (Recommended Dietary Allowance) for vitamin D in children from 1-9 years is 5 mcg /day, as per ICMR, 2010.

Sources of vitamin D

Around 90% of the required vitamin D is synthesized in the skin, when you are exposed to sunlight (ultraviolet B). Exposure to sunlight for even 10 to 15 minutes will be sufficient to generate 10,000 to 20,000 IU of vitamin D. It can also be procured from some dietary sources like fish, fortified foods and supplements. Vegetables and grains are considered poor sources of vitamin D.

Are Indian children deficient in vitamin D?

Are you wondering why a child in India might have a low level of vitamin D? Your concern is not misplaced as India is a country that receives abundant sunlight almost throughout the year.

Hence, some of the reasons for vitamin D deficiency are as follows:

  • Skin pigmentation - The synthesis of vitamin D depends on the skin pigmentation, and area of the skin exposed. Children with darker pigmentation will need 10 times the length of exposure to sunlight, compared to children with lighter pigmentation, to get sufficient vitamin D.
  • Dietary habits - Poor dietary habits can cause lowered intake of calcium and vitamin D. Vegetarian food especially is not an ideal source of vitamin D.
  • Cultural aspects - Children in India are usually covered with long-sleeved or full-length clothes, which limit their exposure to sunlight.
  • Pollution - Rapid industrialization has increased pollution over the past few years. And the synthesis of vitamin D gets hampered due to pollution.
  • Indoor lifestyle - More and more Indian kids are getting used to a sedentary lifestyle and spending time on mobile or TV screens. Hence, the lack of outdoor activity limits their exposure to sunlight too.
  • Pregnancy-related - Vitamin D deficiency is usually worse in those children who are born from unplanned pregnancies or in those whose births are not properly spaced out.

According to FAO/WHO, vitamin D requirement for both infants and kids is 5 mcg /day.

Foods rich in vitamin D and Indian recommendations

Your child will be able to get a sufficient quantity of vitamin D from adequate exposure to sunlight. This nutrient can also be obtained from the following dietary sources:

  • Egg yolks
  • Salmon
  • Fishes like hilsa and rohu
  • Cod liver oil
  • Shrimps
  • Mushrooms

The natural sources which provide vitamin D are very limited. Also, vegetarian sources do not provide the optimal levels of vitamin D. Some natural sources mentioned provided below might be fortified with vitamin D.

  • Cow's milk - It is a good source of calcium, phosphorus, and riboflavin and can be fortified with vitamin D.
  • Soy milk - Plant-based milk substitutes like soy milk might be fortified with vitamin D to support the needs of vegetarians.
  • Orange juice - Fortified orange juice can be helpful for those who are lactose-intolerant or have milk allergy.
  • Cereal and oatmeal - Certain cereals and oatmeal are fortified with vitamin D for daily consumption.

Tips to get enough vitamin D

Exposure to sunlight is the best way for your child to get a sufficient amount of vitamin D. However, children younger than 6 months of age should not be exposed to direct sunlight.

Vitamin D supplementation can help prevent deficiency too. The preferred form of supplementation is cholecalciferol (Vitamin D3), for children. Children with problems related to fat malabsorption and those who are on medications for seizures will need higher doses of supplementation. The levels of 25-hydroxy vitamin D should be monitored every 3 months in these children. Along with it, your child’s doctor might also monitor the parathyroid hormone and bone mineral status every six months.

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