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It's winter, are you getting enough vitamin D?


I was curious if I was getting enough vitamin D. So I did a little research and started taking a supplement. Maybe this information will help you too!


What is vitamin D?


Vitamin D is a nutrient that helps build bones. Children and adults who don’t get enough vitamin D are at risk for weak bones. Vitamin D might also help prevent cancer, heart disease, autoimmune diseases and depression.



Where does vitamin D come from?


The Sun:

  • Your skin makes vitamin D from the sun

  • Your skin can't make vitamin D in winter because of the angle of the sun's rays

Food:

  • Vitamin D is naturally found in fatty fish, egg yolks and UV-light-exposed-mushrooms.

  • Vitamin D is added to fortified foods: Milk (dairy and non-dairy), orange juice, cereal


How much vitamin D does my family need?


Vitamin D is labeled in units called micrograms (mcg) and International Units (IU)


You'll usually see mcg on food labels and IU on supplement labels (confusing!)


Infants age 0-12 months: 10 mcg (400IU)

kids + adults 1-70 years: 15 mcg (600 IU)

Pregnant/nursing women:15 mcg (600 IU)

Older adult at 70+ years: 20 mcg (800 IU)




Is my family getting enough vitamin D?


It's tricky to know if you are getting enough vitamin D. Here's 3 things to think about:


1. The skin's ability to make vitamin D changes

  • Winter sunlight isn't "strong" enough to make vitamin D

  • Wearing sunscreen stops your skin from making vitamin D (but it's still important for preventing skin cancer!)

  • Darker pigmented skin makes less vitamin D.

  • Clouds and pollution block the sun's rays that make vitamin D.

Summary: Being outside for 5-30 minutes in the summer will give you enough vitamin D. You probably don't make enough vitamin D during the winter.


2. There are not many food sources of vitamin D

  • 4 cups of milk = about 12 mcg vitamin D, you need 15 mcg per day

  • 3 ounces (size of a deck of cards) of fatty fish has 14.5 mcg, you need 15mcg/day.

  • Egg yolks only have 1 mcg, you need 15 mcg Vitamin D per day.

  • Check food labels to see how much you get from fortified foods

Summary: If you don't eat fish 2 times/week or drink 4-5 cups of fortified milk/day, you don't get enough vitamin D from food. I encourage everyone to check labels of foods you commonly eat to see how much you are getting.


3. The amount of vitamin D in breastmilk is variable

  • Breast milk is low in vitamin D.

  • Exclusively breastfed infants need to take 400 IU of vitamin D from birth until 12 months.

  • Don't give an infant cow's milk until 12 months.

  • Exclusively formula fed babies get all the vitamin D they need from formula.

Summary: If your child age 0-1 year is not taking a vitamin D supplement, check with your pediatrician about starting one.


If I don't get enough from food or sunshine, how do I choose a Vitamin D supplement?


Here's 2 things to look for in a Vitamin D supplement


1. USP Mark

Supplements are not regulated like drugs. To make sure a supplement is safe and effective, I look for the USP mark on a supplement label before I buy it. Here is an online list of USP certified supplements:

image from USP.org


2. Take an amount less than 1,000 IU


Taking too much vitamin D is dangerous and can cause high calcium levels in the blood. High calcium levels can cause nausea, vomiting, muscle weakness, kidney stones and other problems.


Do not take more than this amount of Vitamin D

Children age 0-7 months: 1,000 IU

Children age 7-12 months: 1,500 IU

Children age 1-3 years: 2,500 IU

Children age 4-8 years: 3,000 IU

Children AND adults age 9+ years: 4,000 IU


Summary:

  • Vitamin D is important for bone health.

  • You probably get enough during the summer from sun exposure (but you should definitely wear sunscreen after 5-30 minutes - depending on your skin color)

  • If you don't eat fish twice a week or drink 4 cups of milk/day (dairy or non-dairy), you probably don't get enough vitamin D during the winter.

To get enough vitamin D during the winter: drink more milk, eat fatty fish 2 times/week (salmon is a good choice) or choose a USP approved supplement that is between 400 IU and 1,000 IU. Most multivitamins have the right amount.


Have questions? Email Nicole: nicolebuhlerRD@gmail.com


References:

NIH Vitamin D Fact Sheet for Professionals: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/


Harvard School of Public; The Nutrition Source; Vitamin D: https://www.hsph.harvard.edu/nutritionsource/vitamin-d/


American Academy of Pediatrics; healthychildren.org; Vitamin D and Iron Supplements for Babies:






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