Nutrition Week – Calcium And Vitamin D Deficiency In Children

How is Calcium and vitamin D related

• Calcium and vitamin D work together to protect your bones—calcium helps build and maintain bones, while vitamin D helps your body effectively absorb calcium. So even if you're taking in enough calcium, it could be going to waste if you're deficient in vitamin D.
• Vitamin D is essential in helping the body absorb and use calcium; in fact, the body cannot absorb calcium at all without some vitamin D. Vitamin D comes from two sources. It is made in the skin through direct exposure to sunlight, and it comes from the diet.
• Vitamin D helps the intestines absorb calcium. However, the vitamin D must first be activated or "turned on" by parathyroid hormone (PTH). Once activated, vitamin D acts to greatly increase the amount of calcium that the intestines can absorb from food, sometimes by as much as two to four times.
• Lack of calcium in our diet forces the body to take calcium from bones to keep blood levels normal, which weakens bones

Vitamin D

• Vitamin D helps your body absorb calcium. Calcium is one of the main building blocks of bone. Vitamin D also has a role in your nervous, muscle, and immune systems.
• In children and adults, symptoms of vitamin D deficiency include bone pain or tenderness, dental deformities, impaired growth, increased bone fractures, muscle cramps, short stature, and skeletal deformities such as rickets. “Rickets is a medical condition tied to low vitamin D levels.
• Severe vitamin D deficiency in children can cause a disease called rickets – a disorder that softens and weakens the bones and can occasionally lead to skeletal deformities.
• Vitamin D in three ways: through your skin, from your diet, and from supplements. Body forms vitamin D naturally after exposure to sunlight.

What causes vitamin D deficiency?

• You can become deficient in vitamin D for different reasons:

• When you don't get enough vitamin D in your diet
• When vitamin D is not absorb enough from food (a malabsorption problem)
• When you don't get enough exposure to sunlight.

Who is at risk of vitamin D deficiency?

• Breastfed infants, because human milk is a poor source of vitamin D.
• Older adults, because your skin doesn't make vitamin D when exposed to sunlight as efficiently as when you were young, and your kidneys are less able to convert vitamin D to its active form.
• People with dark skin, which has less ability to produce vitamin D from the sun.
• People with disorders such as Crohn's disease or celiac disease who don't handle fat properly, because vitamin D needs fat to be absorbed.
• People who have obesity, because their body fat binds to some vitamin D and prevents it from getting into the blood.
• People who have had gastric bypass surgery
• People with osteoporosis
• People with chronic kidney or liver disease.
• People with hyperparathyroidism (too much of a hormone that controls the body's calcium level)

How can I get more vitamin D?

There are a few foods that naturally have some vitamin D:

• Fatty fish such as salmon, tuna, and mackerel
• Cheese
• Mushrooms
• Egg yolks
• You can also get vitamin D from fortified foods. Foods that often have added vitamin D include
• Milk
• Breakfast cereals

Note:

• Excess vitamin D can also damage the kidneys. Too much vitamin D also raises the level of calcium in your blood. High levels of blood calcium (hypercalcemia) can cause confusion, disorientation, and problems with heart rhythm.
• Most cases of vitamin D toxicity happen when someone overuses vitamin D supplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces.
• If you have vitamin D deficiency, the treatment is with supplements. Check with your health care provider about how much you need to take, how often you need to take it, and how long you need to take it.

Calcium

• Calcium is a mineral found in many foods. The body needs calcium to maintain strong bones and to carry out many important functions
• The body also needs calcium for muscles to move and for nerves to carry messages between the brain and every body part. In addition, calcium is used to help blood vessels move blood throughout the body and to help release hormones and enzymes that affect almost every function in the human body.

What causes Calcium deficiency?

• Insufficient intakes of calcium do not produce obvious symptoms in the short term because the body maintains calcium levels in the blood by taking it from bone. Over the long term, intakes of calcium below recommended levels have health consequences, such as causing low bone mass (osteopenia) and increasing the risks of osteoporosis and bone fractures .

What happens if I don’t get enough calcium?

• Symptoms of serious calcium deficiency include numbness and tingling in the fingers, convulsions, and abnormal heart rhythms that can lead to death if not corrected. These symptoms occur almost always in people with serious health problems or who are undergoing certain medical treatments.

Factors that affect calcium absorbed

• Age. Efficiency of calcium absorption decreases as people age. Recommended calcium intakes are higher for people over age 70.
• Vitamin D intake. This vitamin, present in some foods and produced in the body when skin is exposed to sunlight, increases calcium absorption.
• Other components in food. Both oxalic acid (in some vegetables and beans) and phytic acid (in whole grains) can reduce calcium absorption. People who eat a variety of foods don’t have to consider these factors. They are accounted for in the calcium recommended intakes, which take absorption into account.

Pavithra. N. Raj, Chief Dietician, Columbia Asia Referral Hospital Yeshwanthpur