By Kelly McLaughlin
You can’t pick up a health or food magazine these days without seeing a headline trumpeting the wonders of vitamin D and research claiming many of us are deficient in it. It’s only recently that children are being screened for vitamin D deficiencies, especially in the non-ambulatory population. The results are worth noting, particularly for children with cerebral palsy facing multiple surgeries.
Study results published in the April-May 2011 issue of the Journal of Pediatric Orthopedics show that nearly all children admitted to the hospital for surgeries requiring bone healing were at risk of poor bone healing due to insufficient vitamin D levels.
Study authors looked at 70 children ages 2-19 who had been admitted to hospitals over a 10 month period for surgeries for long bone osteotomies or spinal fusion. Screening showed that 90% of these children were lacking in vitamin D.
African American children were especially deficient, the study notes. Because they have darker skin, African Americans tend to absorb less vitamin D from sunlight. Many also are lactose intolerant, thus decreasing their milk consumption.
Since vitamin D is considered crucial to bone health, the researchers urge that all children, especially those of African American descent, be assessed for levels of vitamin D prior to surgeries involving bone healing.
Testing for Vitamin D
A simple blood test can test for levels of vitamin D. However, researchers still do not agree on what “optimal levels” are for disease prevention benefits. Some evidence also suggests test results vary from laboratory to laboratory so the picture is further muddied. Other large scale trials of the benefits of other nutrients, such as vitamins C and E, have not born out definitive health benefits.
How Does One Get Vitamin D?
Vitamin D is an essential nutrient that allows our bodies to absorb calcium. A recent study also reports that vitamin D appears to play a role in the immune system, affecting the ability to stave off infections, fight inflammation, and repair cells.
Our primary source of vitamin D is the sun. In fact, vitamin D is the only vitamin that our bodies make naturally when sunlight hits our skin. However, this ability appears to decrease with age. Also, use of sunscreens and general advice to stay out of the sun appears to have lowered the sun as a source for many.
Children who are non-ambulatory often have less outdoor time, reducing their exposure to sunlight and reducing their levels of vitamin D.
Few foods except fish provide vitamin D. Milk is often fortified with it. According to the Mayo Clinic, children need at least 200 IU (international units) per day, orapproximately two 8-ounce glasses of milk to meet minimum dietary needs.
Vitamin D Supplements
There are now many vitamin D supplements on the market, although recommended dosages for combating certain conditions are uncertain. A pediatrician should be consulted before a child takes any supplement. Also, vitamin D levels can be impacted by, or react adversely with, other medications. For example, children being treated with the anticonvulsant Tegretol should be monitored closely for vitamin D levels because Tegretol is known to interfere with the way the body uses vitamin D.
It makes sense that a non-ambulatory child with limited sun exposure be evaluated for bone health, including vitamin D levels, especially prior to any surgery. A pediatrician and nutritionist should be consulted before adding any supplements.