Vitamin D: How much is safe for your child?

Vitamin D is a group of fat-soluble vitamins, found in vitamin D foods, responsible for increasing intestinal absorption of calcium, magnesium, and phosphate and several other biological effects. The most important compounds in this group are vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol).

As per studies and experiments conducted by experts, the significance of vitamin D in bone metabolism is very well known. Growing kids need Vitamin D in their body, as it is essential for bone growth and development, cell growth, and nerve, muscle, and immune function. It also helps maintain calcium balance in the body by regulating calcium levels and bone density. Vitamin D-rich foods are the best vitamin D source for acquiring it.

Almost one billion people worldwide are either vitamin D insufficient or deficient. Vitamin D deficiency is highly prevalent in children and adults. A diet with insufficient intake of vitamin D foods along with inadequate sun exposure causes vitamin D deficiency. Severe vitamin D deficiency in children can cause rickets, weakening of bones, impaired bone mineralization, and bone damage leading to bone-softening diseases. A deficiency in vitamin D can also cause intestinal absorption of dietary calcium to fall to a very low percentage in kids and adults. All these factors result in inhibited and improper growth of a child.

Why do children become Vitamin D deficient?

There are multiple factors that affect the vitamin D levels in a child's body. The overall risk of vitamin D deficiency increases as a result of certain conditions or lifestyle practices. Here are a few common reasons:

• Insufficient intake of Vitamin D foods - The top most reason for vitamin D deficiency in children is a diet low in vitamin D-rich foods, as sun exposure alone can never fulfill the requirement of vitamin D in the body. Vitamin D foods provide vitamin D2 (Ergocalciferol), which does not come from sunlight. Especially a vegetarian diet needs to have more vitamin D sources added to it.

• Minimal exposure to Sunlight - Sunlight is a brilliant and the most direct vitamin D3 source out there. But in this Gen-Z age or the modern-day lifestyle, children tend to get very less to negligible sun exposure, as they barely play outdoors and are keener on indoor activities. For that reason, most kids are deficient in Vitamin D3 (cholecalciferol), which penetrates through the skin from sunlight.

• Dark skin tone - Indians usually have a dark skin tone due to the climate conditions in the country. A dark skin tone has more melanin, which reduces the skin's ability to make vitamin D in response to sunlight exposure.

• Low Vitamin D absorption - Certain medical issues like celiac disease, etc. might reduce a child's intestinal ability to absorb vitamin D from vitamin D foods.

• Obesity – Obesity or excess weight gain is another risk factor causing low levels of Vitamin D in the body. Since vitamin D is fat-soluble, people with excess body fat will hide away vitamin D in fat cells, leading to lower amounts of vitamin D circulating in the blood.
Hence, obese children typically require higher amounts of vitamin D intake to maintain adequate levels of vitamin D.

What are the symptoms and Impact of Vitamin D imbalance?

Both deficiency and excess vitamin D impact the child's growth and health adversely. A balance with an optimal level of vitamin D in the body is fairly important to avoid any risk.

Vitamin D deficiency in children can lead to rickets, delayed motor development, muscle weakness, bone loss, and fractures.

Symptoms of vitamin D deficiency:
• Fatigue or tiredness
• Frequent illnesses or infections
• Bone or muscle pain
• Back pain
• Hair loss
• Muscle weakness
• Weight gain
• Anxiety
• Depression

Vitamin D toxicity is usually rare. Vitamin D overdose can cause hypercalcemia, which indicates vitamin D toxicity, and causes an increase in urination and thirst. If this condition is not treated, it results in excess deposits of calcium in soft tissues and organs such as the kidneys, liver, and heart, resulting in pain and organ damage.

Symptoms of consuming excess Vitamin D:
• Anorexia
• Nausea
• Vomiting
• Constipation
• Weakness
• Insomnia
• Abnormal bone growth
• Irritability
• Loss of appetite
• Diarrhea
• Severe depression

How much vitamin D does a child need?

Vitamin D is measured in micrograms (mcg) or International Units (IU). One an international unit equals 0.025 micrograms (mcg).

Here is the RDA (recommended dietary allowance) of vitamin D, for a child's proper growth and development:

Gender & Age	RDA (IU)	RDA (mcg)
Girls (9-13 years)	600	15
Girls (14-18 years)	600	15
Boys (9-13 years)	600	15
Boys (14-18 years)	600	15

Girls and boys both need a daily intake of 600 IU or 15 mcg of Vitamin D from vitamin D-rich foods and sun exposure.

How to increase Vitamin D intake in children?

Parents usually wonder how to increase the vitamin D daily intake in children. The best way is by adding vitamin D-rich foods to their diet plan. Some of the vitamin D foods to be included in the diet chart for your child are:

1. Mushrooms
Mushrooms are an excellent vitamin D source and have a very high content of vitamin D2 present in them. They can synthesize vitamin D when exposed to sunlight. Both wild mushrooms and commercially grown mushrooms, exposed to UV light, are vitamin D-rich food.

½ cup of White, raw mushrooms exposed to UV light contains 366 IU or 9.2 mcg of Vitamin D2.

2. Fortified Cow's Milk
Cow's milk is rich in calcium, phosphorous, and riboflavin. These nutrients are good for the over health and growth of the child. Many brands sell cow's milk fortified with vitamin D.

Since options are limited for vitamin D sources, especially in a vegetarian diet. So when you think about how to increase vitamin D consumption by being vegetarian, fortified vitamin D-rich foods are the answer.

1 cup of fortified cow's milk contains 120 IU or 2.9 mcg of Vitamin D2.

3. Fortified Soy Milk and Almond Milk
Plant-based variants of milk like soy milk and almond milk are mostly fortified with vitamin D and even with other nutrients replicating cow's milk. Soy milk or almond milk is a good vitamin D source to add to the child's diet chart.

1 cup of fortified soy milk or almond milk has approximately 119 IU or 2.9 mcg of Vitamin D2.

4. Fortified Orange Juice
Other than milk, a variation like orange juice fortified with vitamin D can also be sometimes served with breakfast or with an evening snack. Orange juice is also high in vitamin C. Lactose-intolerant children can benefit from this variant.

1 cup of fortified orange juice consists of 100 IU or 2.5 mcg of Vitamin D2.

5. Oats and Cereals
Just like milk and orange juice, cereals and oats can also be fortified with vitamin D. While picking the cereals from the supermarket for your child, choose fortified cereal or oatmeal.

6. Fortified Tofu
Tofu is an interesting option and can be cooked in delicious ways for kids. Half a block of tofu contains around 120 IU or 2.9 mcg of vitamin D2.

7. Fortified Yogurt
There are also options available for yogurt fortified with vitamin D in the market. A fortified yogurt pack can contain around 80 IU or 2 mcg of vitamin D.

8. Ricotta Cheese
Since other varieties of cheese have a comparatively low level of vitamin D, ricotta cheese is the best natural vitamin D-rich food option, in cheese category, with 25 IU or 0.65 mcg.

9. Sunlight
Apart from a diet rich in vitamin D foods, allowing children to have 10 to 15 minutes of sun time daily, before applying sunscreen, gives them sufficient exposure to sunlight to meet their vitamin D3 requirements.

How much does a vitamin D-rich food diet contribute?

Vitamin D is categorized into four types mainly:

1. Ergosterol Provitamin D2 - Sourced from plant-based vitamin D food
2. Ergocalciferol provitamin D2 - Sourced from plant based vitamin D food
3. 7- Dehydrocholestrol D3 - Sourced from animal-based vitamin D-rich food
4. Calciferol Vitamin D3 – Sourced from direct exposure to sunlight.

A vegetarian vitamin D-rich food diet helps meet the adequate intake requirements through vitamin D2. Children can either obtain D3 through animal-based vitamin D foods or through sun exposure, in case they prefer a vegetarian diet.

A vitamin D-rich food diet plays a vital role in increasing the levels of vitamin D in the body since with the changed lifestyle needs and habits of children, limited sun exposure usually cannot suffice for the same. Diet is a healthier way to naturally increase vitamin D, for kids, than supplements.

To maintain adequate levels of vitamin D for your child's healthy growth and development, make sure you lace your child's meals with vitamin D foods that serve as the best vitamin D sources.

Nt. Divya Gandhi posted this article on https://www.tayyarijeetki.in/vitamin-d-how-much-is-safe-for-your-child/