Vitamin D Deficiency Linked to Heart Risk Factors in Kids

Studies find many U.S. children not getting enough

Posted: August 3, 2009

By Ed Edelson
HealthDay Reporter

MONDAY, Aug. 3 (HealthDay News) -- Most American youngsters aren't getting enough vitamin D, and that deficiency is associated with an increased incidence of risk factors for cardiovascular problems such as heart attack and stroke, two new studies find.

Simultaneous publication of both papers in the Aug. 3 online edition of Pediatrics is coincidental, the lead authors of the reports said. Both used U.S. data from the 2001-2004 National Health and Nutrition Examination Survey, and both were initiated because of a lack of information about the possible effects of low vitamin D levels on cardiovascular risk in young people.

While studies have linked vitamin D deficiency to increased risk in American adults, "few studies have looked at whether vitamin D can be associated with increased cardiovascular disease in children," said Jared P. Reis, who began his study while at Johns Hopkins University. He is now an epidemiologist in the division of cardiovascular sciences of the U.S. National Heart, Lung, and Blood Institute.

"Nobody questions that vitamin D deficiency causes rickets," said Dr. Michal L. Melamed, an assistant professor of medicine and epidemiology at Albert Einstein College of Medicine in the Bronx, who led the other study. "We wanted to explore other health outcomes and noticed that nobody had described this outcome."

The study she led looked at the overall incidence of low blood levels of vitamin D among young Americans aged 1 to 21 in the survey. There is no formal definition of vitamin D deficiency, Reis said, but many experts believe that a level of 30 nanograms per milliliter of blood is desirable.

The Melamed study found that 9 percent of young Americans -- 7.6 million -- were vitamin D-deficient, with blood levels under 15 nanograms per milliliter, and that 61 percent -- 50.8 million -- were vitamin D-insufficient, with levels between 15 nanograms and 29 nanograms per milliliter.

The high incidence of vitamin D deficiency was so surprising that "we sat on our data for six months," Melamed said. "We didn't publish until it was confirmed by other people that we had the right numbers."

Children with the lowest vitamin D levels were more likely to have higher blood pressure, high blood sugar levels and low blood levels of HDL ("good") cholesterol, the study found.

It's not entirely certain that low levels of vitamin D early in life will translate into health problems in the adult years, Melamed said. "But if you have hypertension [high blood pressure] at age 20, you have 60 more years of dealing with the consequences," she noted.

The study led by Reis was a detailed cross-sectional analysis of data on 3,577 adolescents. It found an average vitamin D blood level of 24.8 nanograms per milliliter. The average level was 15.5 nanograms per milliliter in blacks, 21.5 in Mexican Americans and 28 in whites.

There was a clear association with cardiovascular risk factors. The 25 percent of youngsters with the lowest levels of vitamin D were 2.36 times more likely to have high blood pressure, 54 percent more likely to have low HDL cholesterol levels, 2.54 times more likely to have elevated blood sugar levels and 3.88 times more likely to have metabolic syndrome, a constellation of risk factors including obesity, high blood fats and high blood pressure.

But the results should not panic parents, Reis said. "I believe we need additional research," he said. "Our study is observational, and we need additional studies to confirm it."

Specifically, parents need not turn to supplements to provide the recommended intake of vitamin D, currently set at 200 International Units a day for everyone up to age 50, Reis said. Adequate vitamin D intake can be achieved with 15 minutes a day of exposure to sunlight or consuming fortified milk, bread and other wheat products, among other foods, he said.

"Parents should focus on modifiable risk factors," Melamed said. "Children should not always be on the computer or watching television. They can drink more milk, rather than using supplements."

More information

Sources and effects of vitamin D are described by the U.S. National Library of Medicine.

One size does not fit all where Vitamin D is concerned

As a physician who has been aware of the issue of low vitamin D levels being associated with chronic pain for years, I have been doing blood levels on my patients since 2004. I can confirm that individuals vary greatly in the amount that it takes to raise their 25OHD level out of the danger zone (<30 ng/ml or <75 nmol/L). In Toronto, Canada, which is about the same latitude as northern California, the average person I have tested and retested after starting supplements requires about 4000 IU in the months October to May to get their level into the healthiest range, 60-80 ng/ml or 150-200 nmol/L. Most people use sunscreen, especially on their children, and do not take supplements or give them to their kids. It is essentially impossible to get enough vitamin D from food (including fortified foods such as milk) to prevent the long term consequences of D deficiency. It is beyond comprehension why researchers insist that there is not enough knowledge yet to advise the population to take at least 2000 IU or more per day. Go to PubMed and type in 'Vitamin D and whatever you are interested in' and you will see the huge volume of evidence to support what many of us are saying. Just google vitamin D or go to the Vitamin D Council website. The evidence is massive and it is time for our health authorities to catch up to the facts. If nothing else, the evidence that vitamin D supports the immune system and may be your best protection from the H1N1 virus should get people's attention. The fact that a study in the 1940s showed that mice with good levels of vitamin D did not get swine flu and those with low levels did makes one despair that the focus of our health officials is on getting a vaccine while this cheap, safe way of offering protection goes unmentioned except in the lay press.

LR @ Aug 22, 2009 14:24:15 PM

Vitamin D deficiency in children

The authors recommend against supplements of vitamin D. What is the bias against supplementation? The vitamin D in milk is a supplement. Relying on milk, which some people can't drink, and others won't is to propagate the serious problem of deficiency. Is the author employed by the milk industry? And sunshine doesn't work in the winter in most parts of the country. The obvious answer is supplementation. Let's say 1000 IU per day in the winter, less or none in the summer.

Edwin Hofmann-Smith, PhD, ND of OR @ Aug 05, 2009 00:03:14 AM

vitamin D deficiency

Although I grew up in So.Cal in the 1950s my mother was always afraid I would get rickets so I still remember the spoonful of caster oil daily! Believe me, you would rather go outside in the sun!

monica of AZ @ Aug 03, 2009 19:06:51 PM

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