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Posts Tagged ‘child diets’

Is Your Child Vitamin D Deficient?

Friday, March 12th, 2010

We were starting to think that Vitamin D deficiency was a thing of the past.  I mean, when was the last time you met someone with rickets?  But a recent study in Pediatrics showed that over six million children in the United States do not get enough Vitamin D.  That is one out of every five kids!  It seems that Vitamin D deficiency is more common than we thought.

Vitamin D is an important vitamin!  New studies are proving that vitamin D can help prevent many diseases such as cancer, depression, diabetes, hypertension, osteoporosis, chronic fatigue, autoimmune diseases and cardiovascular disease.  Other research has linked low Vitamin D levels to obesity; studies show that overweight individuals are much more likely to be Vitamin D deficient.  It is not clear, however, whether increased body fat leads to Vitamin D deficiency or if low Vitamin D levels cause a person to gain weight.  Is one responsible for the other?  More research is needed in this area.

There are a few different ways to get vitamin D.  Vitamin D may come from foods or vitamin supplements; vitamin D can also be made by the skin when it is exposed to ultraviolet rays (UV light). Fortified foods are the main dietary sources of Vitamin D as few foods naturally contain it.  Although milk is fortified with vitamin D, dairy products made from milk, such as cheese and ice creams, are generally not fortified with vitamin D.  Fatty fish and fish oils are natural sources of Vitamin D.

Vitamin D deficiency is often missed because there are no real symptoms associated with it.  Rickets and osteomalacia (softening of the bones) are the most common signs of vitamin D deficiency but there is no way for parents to tell if their child is suffering from these illnesses.  The only way to prove that your child is vitamin D deficient is by completing a blood test which screens for a particular form of vitamin D, called 25-hydroxyvitamin D (25(OH)D).

Think that name sounds complicated?  Unfortunately, many doctors do too.  In fact, doctors often order the wrong blood test when assessing vitamin D levels.  Be sure to ask for 25(OH) D blood test not 1, 25-dihydroxy-vitamin D (aka calcitriol).  With such complicated names, it is no wonder that such mistakes are made!

Vitamin D deficiency exists when 25(OH) D levels fall below 25 ng/mL.  Levels may vary depending on time of year, direct sunlight exposure, skin color and vitamin D consumption.  Levels should be between 50 – 80 ng/mL year-round for both children and adults.

As a doctor, I am finding more and more children with low levels of vitamin D, mainly because kids are spending less time in the sun.  These days, toddlers are more often inside watching TV than playing outside.  And if they are in the sun, they are lathered with sun block, which reflects the sun’s rays and decreases vitamin D formation.  Obviously, sunscreen is important and should not be avoided!  But it does lead to lower levels of vitamin D. Also, many toddlers do not get enough vitamin D to meet their needs since there are limited food sources of high vitamin D content.

The current recommendation is 400 IU per day in the form on of vitamin D3 (cholecalciferol).    New studies are showing that higher levels may be needed to prevent the diseases discussed above.  Many are now recommending 1,000 IU per day in the form of vitamin D3 (cholecalciferol).  If your child doesn’t get this amount of vitamin D in his diet, you may want to consider a multivitamin that contains vitamin D.

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Whole Milk Is Not Appropriate For Kids: So Why Are Schools Still Serving It?

Friday, March 5th, 2010

Recently, America’s school lunch menus have been under fire and parents are becoming increasingly concerned about the state of their children’s health and well-being.  Federal law, under the School Lunch Act, provides nutritional guidelines and criteria to which schools must adhere.  These guidelines include the amount and type of foods the cafeteria must offer, in addition to placing limits on nutrients like saturated fat, cholesterol and sodium.  Specifically, school lunches must provide 1/3 of the Recommended Daily Allowance (RDA) for protein, calcium, iron, vitamin A, vitamin C, and 1/3 of the Recommended Energy Intake (REI) for calories.  In addition, the cafeteria must offer 5 components as part of a school lunch, of which three of the five must make their way onto the child’s lunch tray.  These include a starch, meat (or meat substitute), fruit, vegetable and milk.  There are similar guidelines for schools that serve breakfast as well.  These guidelines are especially important because many children eat the majority of their meals at school.

Milk contributes a good portion of nutrients to school lunches.  It is a valuable, nutrient-dense source of protein, calcium and vitamin D, all of which are important for achieving adequate nutrition and optimal growth in school-age children.  However, whole milk can significantly contribute to the saturated fat and cholesterol content of a meal.

According to the American Academy of Pediatrics (AAP) whole milk and other full-fat dairy products are only appropriate for children under the age of 1-2 years old. Children under two, who are in a stage of rapid growth and brain development,  have high energy and dietary fat requirements.  They need the extra fat that whole milk contains.

Everybody else, however, should choosing low fat dairy products, including skim milk.  In fact, the AAP states that no child over the age of two should be drinking whole milk.  Skim milk is identical to whole milk in terms of nutritional value, but is markedly lower in saturated fat, cholesterol and calories.  Diets high in saturated fat are associated with increased risk for obesity, heart disease and certain cancers.  Saturated fat intake causes harmful buildup in the arteries and blood vessels of healthy individuals, starting in young children.  It is important to begin healthy eating habits as a child and to continue making healthy choices throughout life.

A good portion of a child’s learning happens through modeling.  That is, by watching their parents or other caregivers’ actions, they learn how to be an adult.  This is especially important when it comes to eating:  your food preferences as an adult are closely related to the foods you saw your parents eating.  But what happens when your child is eating 2 out of 3 meals a day at school, plus a snack?  Because they are eating so many meals outside the home or the care of their parents, kids are increasingly reliant on teachers, caregivers and cafeteria staff to guide them to make healthy choices and model healthy eating behaviors.

The fact is, the people who are responsible for serving food to or eating with your children usually receive no formal nutrition education.  In most cases, a position as a preschool classroom aide or a kitchen worker requires a high school level education.  Regardless, whatever their educational background, it is a common misconception for people to think that whole milk has a nutritional advantage over skim milk.  It is also very common that parents encounter teachers or caregivers who have different beliefs than their own when it comes to feeding their child.  Especially when you’re talking about the welfare of a child’s health, when a parent feels one way but their caregiver feels another way, this can create some tension.  A well-meaning day care worker just may not be aware of or understand the reasons why full-fat milk can be dangerous, even for young children.  Parents often have a difficult time getting this message across but should continue to be an advocate for their child’s health.

In situations like this, as a parent you have the right to decide what your child does and does not eat.  You can stress this issue to the teacher in a polite way while still standing firm.  If needed, refer them to an appropriate resource, such as www.MyPyramid.gov, the American Academy of Pediatrics, your pediatrician, or even a local dietitian for further advice on this matter.  Your child’s health comes first!

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