Vitamin D3 Deficiency: Breaking the Myth

Fact: Vitamin D is crucial for our children and our skin absorbs it from the sun
Myth: If my child gets enough outdoor play, she gets her dose of Vitamin D
Yes, you read it right! Playing in the sun is no longer sufficient for your child to get her required dose of Vitamin D. And in our blog, we tell you why. 
Why do we need this vitamin?
These days it’s a known fact that vitamin D3 is required, along with calcium,for healthy bones and teeth. A deficiency causes a decrease in the absorption of dietary calcium and phosphorus which leads to a generalized decrease in bone mineral density (BMD), resulting in osteopenia and osteoporosis. The deficiency also leads to weakened immune system and weakened muscles and bones.In a young child, who has little mineral in his skeleton, a deficiency of Vitamin D can lead to skeletal deformities classically known as rickets; affected children have difficulty in standing and walking. The elderly are equally prone to risks such as increasing sway and more frequent falls, thereby exposing them to fractures.
Emerging research also suggests vitamin D’s role in prevention against cancer, heart disease, fractures and falls, Type- 2 Diabetes, influenza and depression as well. 
Vitamin D3 deficiency in India
Vitamin D often known asthe “Sunshine Vitamin” hasn’t remained that shiny in our lives. A deficiency of vitamin D is becoming very common not only in children but in adults also. The air pollution prevalent in Metros and high-pollution cities is restricting the penetration of Ultraviolet B rays from the sun in our atmosphere. This reduces our skin’s exposure to these rays as well as the skin’s ability to synthesis Vitamin D3. Therefore the recommended exposure of minimum 20 minutes (infact as long as 3hours in sun) is proving to be an ineffective in conversion of this vitamin in its active form in our body.A study by paediatricians from All India Institute of Medical Sciences (AIIMS), New Delhi, found the deficiency in 66.7 per cent of healthy, breastfed infants and 81.1 per cent of mothers. (The study was published in Indian Journal of Medical Research in 2011.)

Other Reasons for a deficiency of Vitamin D3
Besides the rising air pollution, there are other reasons too which makes us susceptible to a deficiency.
- Changing lifestyles: With our preference for remaining indoors for longer duration, covering while going out in sun, using sun blocks, we inadvertently restrict our skin from absorbing this essential nutrient. Also, culturally, we are not very open to the idea of spending long durations in the sun.
- Skin tone:The darker the skin, higher the melanin in skin which again makes us further vulnerable to vitamin d3 deficiency as light coloured skin quickly converts sunlight to the vitamin.
- Dietary habits: With our preference for being vegetarian, our chances of absorbing Vitamin D from food sources, further goes down. The good sources of vitamin D3 are generally non vegetarian foods like cod liver oil, fish, egg yolk etc. 

How much do we need?
For Infants (birth – 1 year)- 200 IU
For Children (1-18 years)- 200IU
For adult Indians- 200-400 IU
For elderly – 400-800 IU 

Signs and symptoms of Vitamin D3 deficiency

A deficiency of Vitamin D3 is not very easy to spot as the symptoms are very subtle and can be mistaken for other ailments. But common symptoms are fatigue, generalised body ache, muscle ache, back ache, pain in calf muscles, etc. In case, you have any unexplained symptoms from above, it is advisable to check with your doctor.
A simple diagnostic test of Vitamin D3 levels from a reliable place can be done if symptoms mentioned above can be seen. In infants the early 2 years are critical for bone mineralization and skeleton development. Hence any symptoms of delayed hardening of the cranium ( the bone of head) needs to be investigated under medical supervision. 

Food sources of Vitamin D3

Spending time outdoors, is definitely in for a healthy you and a healthy child, but there are some food sources also, which you can try and include in your diet.

Fatty fish: especially herring, catfish, salmon, carp, trout, and halibut

Eggs and egg yolk

Butter, Butter oil

Mushrooms: certain varieties like morel, Chanterelle, Shiitake dried

Fortified foods like milk, soymilk & soy products, cereals

Cod liver oil (per 100 gms) - 10,000 IU (high intake of vitamin D can cause toxicity  

Supplements of vitamin D

In case of a very high deficiency, sometimes, a doctor may start your child on a supplement, generally a syrup. Also, if deficiency is severe, booster doses can be given but this has to be taken strictly under medical supervision as excess consumption of vitamin D is known to cause adverse health effects, which include elevated levels of calcium in blood and urine, which affects the kidney and retards growth in infants.

So, ideally, spend time outdoors and eat healthy—the perfect recipe for a healthy child. Do share your thoughts on this.