Yes, you read it correctly. So many parents have become so conscientious about protecting their children from sun exposure that an increasing number of children are getting too little sun.
What are parents to do?
1. Several years ago we wrote: “The sun does to skin what tobacco smoke does to lungs. Both produce progressive, cumulative, and irreversible tissue damage, often culminating in cancer and other very serious health issues decades later.” In fact, information regarding the sun is becoming grimmer. Cases of skin cancer are being seen in young children, albeit, for now, very rarely. See the four articles on sun protection.
2. But we also wrote, “The amount of sun exposure skin needs to produce vitamin D for growing bones is negligible; occasional and fleeting exposure suffices to produce vitamin D.” Wrong. According to new data, 8% of children between one and five years of age and 15% of children six to eleven years of age have less than optimum vitamin D levels. For teenagers and young adults the figure is 30%.
3. “Occasional and fleeting sun exposure” may be inadequate to produce essential vitamin D levels. No one seems to know optimum exposure time. Past attempts to quantify that amount – length and frequency of exposure and the amount of skin that needs to be exposed, for example – have not been very helpful.
4. It is virtually impossible to predict how much sun exposure an individual child (or adult) requires for optimum vitamin D levels. There are too many variables: age, skin pigmentation, latitude of residence, weather, lifestyles, and time of year, to mention just a few. And what is adequate one year may be inadequate the next year.
5. Sunscreens limit vitamin D production. Sunscreens are crucial in protecting skin from sun-related damage. But they do so – and do so very effectively – by blocking the ultraviolet rays of the sun, the rays required by the skin to produce vitamin D. Sunscreens, if used as directed, may reduce vitamin D production up to tenfold. However, most people use sunscreens incorrectly; they apply insufficient amounts and reapply them too infrequently. This may raise vitamin D levels, but at the expense of skin damage.
6. Maintaining adequate levels of vitamin D is more important than previously realized. Its major function is maintaining normal body levels of calcium and phosphorus, thus helping to build and maintain a healthy skeletal system. But there is increasing evidence that vitamin D plays a role in the immune system and that low levels may increase the risk of cancer, heart disease, certain infections, and possibly, childhood diabetes.
7. “Deliberate” and “sensible” sun exposure of children to maintain their vitamin D levels is no longer recommended. There is no known sensible amount. of sun exposure. The less sun the better. (The sun also damages the eyes, for example. Have children wear protective sunglasses whenever possible. See sunglasses.) While the sun is the source of all life, it is hazardous for good health!
8. The consensus of experts: Use optimal sun protection on children and rely on food sources and vitamin supplements for vitamin D. There is no difference between vitamin D from the sun, food or from vitamin supplements. Recommended doses are 400 IU/day for infants and 600 IU/day for children between one and 18 years of age. These recommendations are especially important for children who live in the northern United States, Canada, and in northern Europe, areas with limited sun part of the year.
9. Many foods are good sources of vitamin D. See table below. Overdoses of vitamin D do not occur from sun exposure, food or recommended vitamin supplements. Overdoses may occur only from megavitamin doses taken over long periods of time.
10. Vitamin D supplements are especially important for breastfeeding infants. Though breast milk is often referred to as the perfect food, it is deficient in vitamin D. Infant formulas are fortified with vitamin D.
| Selected Food Sources of Vitamin D | ||
| Food | IUs per serving | |
| Cod liver oil, 1 tablespoon | 1,360 | |
| Salmon (sockeye), cooked, 3 ounces | 447 | |
| Mackerel, cooked, 3 ounces | 388 | |
| Tuna fish, canned in water, drained, 3 ounces | 154 | |
| Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup | 115-124 | |
| Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies) | 100 | |
| Yogurt, fortified | 80 | |
| Margarine, fortified, 1 tablespoon | 60 | |
| Liver, beef, cooked, 3.5 ounces | 49 | |
| Sardines, canned in oil, drained, 2 sardines | 46 | |
| Egg, 1 large (vitamin D is found in yolk) | 41 | |
| Ready-to-eat cereal, fortified. (Check product labels, as amount of added vitamin D varies) | 40 | |
