Giving your children all they need to grow big and strong may not be as simple as a gummy vitamin and three square meals. They still may be susceptible to an epidemic that's starting to gain the notice of pediatricians and bone doctors across the country: vitamin D deficiency.

Mike Stone joined a growing legion of children diagnosed with the condition when an X-ray of his 14-year-old bones revealed a skeleton so thin it appeared clear on film.

"My doctor thought the machine was broken and that they should take an X-ray on another one," says Stone, 22, a recent graduate of Tufts University in Boston.

The machine wasn't broken. Stone was seriously vitamin D deficient, and though he had felt a "snap" in his back — the impetus for the doctor's visit — he had no fractures. But his bones had become perilously thin, 50% less dense than they should have been. His doctor immediately put him on vitamin D supplements to correct the problem, Stone says.

For years, doctors have been aware that older people tend to be low in vitamin D and need extra supplements to help keep bones strong, says Lisa Callahan, co-director of the Women's Sports Medicine Center at the Hospital for Special Surgery in New York.

Pediatricians had thought the problem had been solved among children with the vitamin D fortification of milk, cereal and other foods. But an ever-lengthening roster of studies is revealing vitamin D deficiency is more common than previously believed in youngsters, including breast-fed babies and teens.

Numerous studies are showing vitamin D does much more than boost bone health in children and adults. In children, it can inhibit future hip fractures, and it may help reduce the risk of type 1 diabetes.

Sunlight, diet — particularly oily fish and enriched milk — and supplements are good sources of vitamin D, Holick says.

Vitamin D is different from other vitamins because though the body stores it, it needs ultraviolet B rays from the sun to activate it, says James Dowd, professor of medicine at Michigan State University and author of The Vitamin D Cure. Fifteen minutes a day will do the trick, he says.

Society's sunblock passion, though smart for skin health, also may be affecting vitamin D deficiency. Experts suggest at least 15 minutes of direct sun a day before slathering on sunscreen. But those at risk or with a history of skin cancer or with sun-sensitive skin conditions should check with their dermatologist first.

Dark-skinned people also are more at risk because they absorb UVBs less quickly than fair-skinned people, Edwards says.


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Adults still risk vitamin D deficiency

According to the National Center for Health Statistics, as many as 36% of Americans are vitamin D deficient.

In a review of vitamin D medical literature published last July in The New England Journal of Medicine, vitamin D expert Michael Holick, professor of medicine, physiology and biophysics at Boston University Medical School, says D deficiency in adults has been linked to an increased risk for osteoporosis, osteomalacia — the softening of bones — and certain cancers, autoimmune diseases and cardiovascular problems.

Vitamin D also may play a role in preventing diabetes and hypertension, according to the National Institutes of Health. A study in last week's Archives of Internal Medicine found that men 40 to 75 with below-normal vitamin D levels had a higher risk of heart attack.

Experts, such as Tanya Edwards, head of the integrative medicine department at the Cleveland Clinic, say Americans probably have always been deficient, but increasingly so because of poor sun exposure and diet. Also, there has been more research of vitamin D over the past several years that has raised awareness.

Older Americans, whose skin cannot synthesize vitamin D as efficiently and whose kidneys are less able to convert vitamin D to its active hormone form, aren't the only adult group at risk, Edwards says.