Research presented at the American Academy of Pediatrics (AAP) 2024 National Conference & Exhibition underscores the critical role of vitamin D in the recovery of pediatric fractures, showing that low levels can significantly delay bone healing in children.
Beyond Prevention
The study, presented on Sept. 28 by Michael Guyot, a medical student from the University of Florida involved in the research, analyzed 186 cases of extremity fractures among children treated between 2015 and 2022 and discovered a consistent link between low vitamin D levels and increased healing time.
The findings suggest that children with nonsurgical leg fractures with low vitamin D levels took an additional 20 days for clinical healing. Additionally, the same group displayed a nearly two-month delay before radiographic evidence showed that the fractures were healing.
For fractures requiring surgical procedures, recovery took an entire month longer clinically, with indicators of healing taking close to four additional months to show.
This research may shift the narrative regarding vitamin D from having a preventative role in fractures to highlighting its essential function during the healing process.
Past recommendations focused on how adequate vitamin D helps strengthen bones, reducing fracture risk. However, this new investigation found potential complications when a child’s vitamin D levels are inadequate during recovery.
Dr. Jessica McQuerry, the study’s senior author, emphasized the importance of a well-balanced diet rich in vitamin D for children.
The researchers advise that if a child’s fracture is not healing within the usual timeframe, health care providers may need to evaluate the child’s vitamin D levels.
The implications of these findings extend beyond clinical settings, emphasizing the importance of diet and lifestyle factors in recovery from bone injuries. McQuerry encourages outdoor activity for children to promote health through exercise and enhance vitamin D production from sunlight.
“Getting outside and enjoying the fresh air can do wonders for your health while also upping vitamin D absorption,” McQuerry said in a press release. “What a great excuse to get outside and explore nature!”
Bone Health
Vitamin D aids in the absorption of
calcium and phosphorus, two minerals critical for bone development.
Dr. Vishal Sarwahi, a pediatric orthopedic surgeon at Cohen Children’s Medical Center in New York, told The Epoch Times that vitamin D is crucial in promoting bone health in children as it helps build strong bones and prevent fractures.
He explained that deficiency in this essential nutrient is linked to various health issues, making it vital for parents to ensure their children receive adequate amounts through diet and sunlight exposure.
Research shows that children with adequate vitamin D levels are less likely to experience bone-related problems, such as rickets, characterized by soft and weak bones, which can lead to deformities and fractures. According to Sarwahi, who wasn’t associated with the study, ensuring children get sufficient vitamin D can help promote overall skeletal health as children grow and prevent a variety of conditions, including rickets.
Rickets
“Vitamin D deficiency can lead to rickets, which results in deformity of the bones, legs, short stature, and higher risk of fractures,” Sarwahi explained. “Bent and deformed legs, resulting in changes in weight bearing, can cause major issues later on such as arthritis, difficulty walking, and increased risk of fractures.”
Rickets is most common in babies and young children between 3 and 18 months of age and adolescents between 12 and 15 years old. However, low vitamin D levels can also affect adult bones.
Sarwahi noted that “adults with low vitamin D can develop osteomalacia, which is a condition with ‘soft’ bones and can cause bone pain, deformities, and increased risk of fractures.”
Other Conditions
Sufficient vitamin D levels can also combat the following conditions:
- Cardiovascular disease: Vitamin D deficiency may be associated with pediatric cardiovascular diseases like hypertension, orthostatic intolerance, and Kawasaki disease.
- Infections: Children with vitamin D deficiency are more likely to develop respiratory infections. Low levels also increase the risk of developing respiratory conditions that include asthma and chronic obstructive pulmonary disease (COPD).
- Pain and weakness: Low vitamin D can cause muscle bone pain and muscle weakness in children and adults.
- Irritability, depression, and anxiety: Vitamin D deficiency can cause aggressive behavior, depression, and anxiety in school-age children.
- Multiple sclerosis: Vitamin D deficiency in childhood may contribute to the risk of multiple sclerosis.
Daily Recommended Intake of Vitamin D
“The American Academy of Pediatrics (AAP) recommends that children aged 1 to 18 years receive a daily intake of 600 international units (IU) of vitamin D,” Sarwahi said. “This can typically be achieved through a combination of diet, supplements, and sunlight.”
Monitoring vitamin D levels is especially important in regions with limited sunlight exposure or during winter. Parents are encouraged to consult health care providers if they have concerns about their child’s vitamin D status.
Sarwahi pointed out that our skin cells manufacture vitamin D in the presence of sunlight, so encouraging children to play outside in the sun helps.
“In addition, mechanical loading on bones that occur during physical activity such as playing keeps bones strong,” he continued. “However, this sunlight exposure is usually not enough.”
Sarwahi said that the body needs at least 1,000 IU of vitamin D daily for good bone health starting at age 5, but getting enough from what we eat is difficult, with one glass of milk only containing about 100 IU. “As a result, AAP recommends all children take vitamin D supplements to meet daily requirements,” he said.
5 Foods Rich in Vitamin D
Five dietary sources of vitamin D can help children meet their daily requirements. Foods rich in vitamin D include the following:
- Fatty fish: Salmon and mackerel are excellent sources of vitamin D. A single serving can provide a significant portion of the daily recommended intake.
- Fortified foods: Many products, including milk, orange juice, and some breakfast cereals, are fortified with vitamin D. Checking labels can help parents select the best options for their children. However, prioritize whole foods over processed foods like cereals when able.
- Dairy products: Milk, cheese, and yogurt are good sources of calcium and are often fortified with vitamin D.
- Eggs: Egg yolks contain small amounts of vitamin D, making them a tasty source for children.
- Mushrooms: Certain varieties of mushrooms, particularly those exposed to ultraviolet light, can provide a plant-based source of vitamin D.
