Vitamin D - our children need more sun

The Nutrition Commission of the German Society for Child and Adolescent Medicine, DGKJ, expanded its previous recommendations for vitamin D supply: In the future, not only babies, but all children and adolescents in Germany should receive additional vitamin D3. The Children's Health Foundation explains the reasons for the new recommendations on vitamin D supply in its current statement.

"In Germany, the daily intake of vitamin D from food is in some cases considerably below the recommended values," says Professor Dr. Berthold Koletzko, Chairman of the Children's Health Foundation. The Munich pediatrician was significantly involved in the creation of the new recommendations. He reports: “Most children and adolescents beyond infancy are well below the values ​​for vitamin D nutrient intake recommended by international expert bodies. Particularly low vitamin D levels are measured in 11- to 13-year-old girls and 14- to 17-year-old boys, i.e. in a development phase that is particularly important for growth and bone formation".

It is not easy to ensure an adequate supply from food: Significant amounts of the vitamin are only found in oily sea fish, such as e.g. B. salmon, herring, mackerel, cod liver oil, in eggs or milk. To meet the recommended daily requirement of between 400 and 800 IU of vitamin D, one would need to eat at least three to four meals of fish per week (or eat at least 10 eggs per day).

key to health

This vitamin has an important key function for our health: a deficiency increases the risk of developing many diseases such as rickets, osteoporosis, diabetes, multiple sclerosis, high blood pressure, muscle weakness and even various forms of cancer.

The ultraviolet rays of the sun can activate the vitamin D precursor stored in the human skin and convert it into vitamin D. The body not only needs this vitamin to build bones, but also to supply the heart muscles and the nervous system with calcium.

The best prescription for vitamin D deficiency would be daily sunbathing. However, in our latitudes, in the winter months from November to February, the UV-B radiation in northern and central Europe is generally too weak to trigger sufficient production of vitamin D in the body.

Children live sitting and in the shade

In addition, there is a change in the living conditions and leisure habits of children and young people: They are getting out in the sun less and less!

Here are the facts:

• Elementary school students spend about nine hours a day sitting and only one hour moving.
• The physical activity recommended by the WHO, at least one hour a day and five days a week, is currently only achieved by a third of eleven to 15-year-old boys and a quarter of girls of the same age in Germany.
• The proportion of children who watch television or use other screen media for four or more hours a day has at least doubled compared to the past.
• On a weekday today, fourth graders watch television or videos for an average of 71 minutes and play on the computer for 30 minutes.

Babies are already at risk of a vitamin D deficiency: breast milk, which is otherwise so valuable, only contains small amounts of vitamin D, which are not sufficient for the supply of the breastfed baby. This also applies to bottle feeding. In order to keep the risk of rickets in check, almost all babies are now given vitamin D supplements as a precaution.

Also at risk are:

• overweight children,
• strictly vegan or macrobiotic children (especially infants and young children) without adequate calcium, vitamin D and fat supplements;
• Adolescents from immigrant families with darker skin color, as is regularly the case with Turkish, Arabic, Asian or African origin. The dark pigment reduces vitamin D production in the skin.

Young girls with a migration background are also considered a risk group if they dress veiled for religious or cultural reasons or avoid being outdoors.

The main new recommendations are:

• From the first week of life until the second early summer experienced, i.e. depending on the time of birth for a period of one to one and a half years, babies should receive tablets or drops with 400 to 500 units of vitamin D-3 daily in addition to breast milk or baby food, ideally combined with fluoride prophylaxis against tooth decay.
• The paediatricians should point out to the parents how sensible it is for their children to be out in the open, and to be active for at least half an hour a day, preferably with their heads uncovered and their arms and legs free.
• Beginning in year two, all children who do not get enough sun should be given a vitamin D supplement of 400 units daily.

At present, however, the costs for the additional vitamin D doses are only covered by health insurance for the first 12 to 18 months, according to the Children's Health Foundation. A cost-benefit analysis of the recommended measures is still pending but should be done soon.

Prevention is better than cure.

That is why the Children's Health Foundation, founded in 1998, is committed to improved preventive health care, promoting the research required for this and the dissemination of scientifically reliable information for doctors and families with children. Our commitment does not only apply to children with special health problems. The knowledge gained benefits all children and their families.

Source: Munich [ Children's Health Foundation ]