The leading paediatricians group in the US says children from newborns to teens should get double the usually recommended amount of
vitamin D because of evidence that it may help prevent serious diseases.
To meet the new recommendation of 400 units daily, millions of
children will need to take daily vitamin D supplements, the American
Academy of Paediatrics said. That includes breast-fed infants - even
those who get some formula, too, and many teens who drink little or no
Baby formula contains vitamin D, so infants on formula only
generally do not need supplements. However, the academy recommends
breast-feeding for at least the first year of life and breast milk is
Most commercially available milk is fortified with vitamin D, but
most children and teens do not drink enough of it - four cups daily
would be needed - to meet the new requirement, said Dr Frank Greer,
the report's co-author.
Research hints current recommendations should change
The new advice is based on mounting research about potential
benefits from vitamin D besides keeping bones strong, including
suggestions that it might reduce risks for cancer, diabetes and heart
But the evidence is not conclusive and there's no consensus on
how much of the vitamin would be needed for disease prevention.
The new advice replaces a 2003 academy recommendation for 200 units
That's the amount the government recommends for children and adults
up to age 50; 400 units is recommended for adults aged 51 to 70 and 600
units for those aged 71 and up. Vitamin D is sold in drops for young
children, capsules and tablets.
The Institute of Medicine, a government advisory group that sets
dietary standards, is discussing with federal agencies whether those
recommendations should be changed based on emerging research, said
spokeswoman Christine Stencel.
The recommendations were prepared for release Monday at an academy
conference in Boston. They are to be published in the November issue of
the academy's journal, Paediatrics.
Most children don't get enough vitamin D
Besides milk and some other fortified foods like cereal, vitamin D
is found in oily fish including tuna, mackerel and sardines. But it's hard to get enough through diet; the best source is sunlight because the body makes vitamin D when sunshine hits the skin.
While it is believed that 10 to 15 minutes in the sun without
sunscreen a few times weekly is sufficient for many, people with dark
skin and those in northern, less sunny climates need more. Because of
sunlight's link with skin cancer, "vitamin D supplements during
infancy, childhood and adolescence are necessary," the academy's report
Recent studies have shown that many children don't get enough
vitamin D, and cases of rickets, a bone disorder often associated with
malnourishment in the 1800s, continue to occur.
Greer, a University of Wisconsin paediatrician, acknowledged that
most studies suggesting vitamin D may play a much broader role in
disease prevention have been observational, not the most rigorous kind
of medical evidence.
Nonetheless, many doctors consider the research compelling and many
have begun to offer patients routine vitamin D testing.
Adrian Gombart, a vitamin D researcher at Oregon State University,
said the new recommendations are safe and conservative but that 400
units "is probably not enough."
Gombart's lab work in human tissue has shown that vitamin D helps
increase levels of a protein that kills bacteria. He said many experts
believe that between 800 and 1 000 units daily would be more effective
at helping fight disease.
Several members of an academy committee that helped write the
guidelines have current or former ties to makers of infant formula or
vitamin supplements. – (Sapa, October 2008)