We Need to Put Vitamin D Back in Children and Adolescents

Alain Joffe, MD, MPH, FAAP

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Not until 2008 did the American Academy of Pediatrics recommend at least 400 IU of vitamin D daily for children and adolescents, so the prevalence of deficiency and insufficiency might have declined since the 2004 NHANES studies. Nonetheless, many children and adolescents today likely have suboptimal vitamin D levels. Therefore, emphasizing adequate intake of dairy products and supplements at well-child visits is important. The association between low vitamin D levels and television/video/computer use could reflect reduced sun exposure or overweight status (vitamin D is sequestered in fat cells). Since the relation between low vitamin D levels and myriad adverse physiologic processes also has been observed in adults (Arch Intern Med 2008; 168:1340), the questions arise as to whether low vitamin D levels predispose children to adult morbidities such as hypertension, type 2 diabetes, and atherosclerosis, and whether normalizing vitamin D levels can reduce these risks. The lower levels among minority youth can only exacerbate (and might to some extent explain) racial and ethnic disparities in child and adolescent health status. Maybe measurement of serum 25(OH)D levels should be part of the evaluation for conditions such as hypertension and type 2 diabetes?

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