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Last Updated 1/2010

The information contained on this web site is not a substitute for direct examination and treatment by a physician. If any of this material is unclear or confusing, or if you have additional questions or concerns, please call the office at 778-6762. 

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Calcium and Vitamin D

Calcium is American children's greatest nutritional deficiency.  The rising popularity of sodas and sports drinks means many children who are not consuming the calcium equivalent of at least three glasses of milk a day may be at serious risk for calcium deficiency.  "Relatively few children and adolescents achieve dietary calcium intake goals," reported the American Academy of Pediatrics (AAP) in a 1999 Policy Statement on calcium requirements. We need calcium all our lives for building and maintaining strong bones and teeth, to help blood to clot, and for muscles and nerves to function.  The need for calcium is especially important during periods of rapid growth and development such as during the first few years of life, the teen years, during pregnancy, and after menopause. Adequate calcium is necessary for the development of peak bone mass, which is needed to reduce the risk of osteoporosis in later adulthood.  In addition, low calcium can be an important risk factor for fractures in adolescents.  During the teen years, about 15% of adult height is added, so this age group needs even more calcium than those in grade school. Exercise is another very important part of attaining maximum peak bone mass.  Weight-bearing exercise is best (walking and jumping rope are better than swimming). Risk Factors for Calcium Deficiency:

• Misconception that dairy products will lead to weight gain (especially among adolescent girls)
• Beverage of choice is bottle water, soda, tea, coffee, or juice
• Reliance on processed foods and “fast food”
• Lactose intolerance or milk protein allergy. (If you use soy or rice milk, check the label for calcium and vitamin D content.)

  Vitamin D is essential for the body to utilize calcium.  It is necessary for building strong bones and teeth.  It also helps prevent diabetes and it helps fight off infectious diseases. Vitamin D is made in the skin from cholesterol precursors after exposure to ultraviolet radiation in sunlight.  Only a few foods naturally contain significant amounts of vitamin D (as cholecalciferol): fatty fish and fish oils (salmon, canned tuna, sardines), beef liver, some cheeses, and egg yolks from hens that have consumed feeds containing vitamin D.  The main dietary sources of vitamin D are fortified dairy products and some fortified breakfast cereals. A typical, one-a-day vitamin and mineral supplement contains 400 IU (10 μ g) of vitamin D, the current recommended daily requirement for adults.  At a minimum, children and teenagers should get 200 IU (5 μ g) of vitamin D every day, the amount contained in 16 ounces of fortified milk or juice.  Risk factors for Vitamin D deficiency:

• Consuming less than 16 oz/day of formula, milk, or fortified juice.
• Darkly pigmented skin decreases the production of vitamin D from sun exposure.  A white man in swim trunks who spends 10-12 minutes out in the sun on a summer day without sunscreen can produce adequate vitamin D for his daily needs.  An African-American man in swim trunks would need 120 minutes of summer sun exposure to produce the same amount of vitamin D.
• Sunscreen with an SPF of 8 or more, completely blocks sunlight from the skin and prevents vitamin D from being made.
• All people living in the northern United States (above latitude 40 ° - which includes Elko , NV ) do not get enough sunlight during the winter.
• Breast fed babies are at risk for Vitamin D deficiency.  They should receive a Vitamin D supplement of 400 IU/day.

Who should be tested for vitamin D status?   If you have a family history of Diabetes or Osteoporosis, or if your child has Cystic Fibrosis, Celiac Disease, or signs of poor bone health, ask your pediatrician if a test of vitamin D status should be done.  D status can be determined by a blood test and, if a deficiency is found, supplements can remedy the problem.

Daily Calcium and Vitamin D requirements change with age and stage of life:

Source: Food and Nutrition Board, Institute of Medicine

Calcium content of some common foods:

Commonly used calcium and vitamin D supplements: