sun, sunshine

Return of Rickets Has Experts Concerned About Lack of Sun Exposure

July 27, 2010 12:00 PM
by Sarah Amandolare
Rickets, a disorder resulting from a vitamin D deficiency, has reemerged, causing experts to debate the risks of too little or too much exposure to the sun.

How Much Sun Is Enough?

Doctors had considered rickets “eradicated,” but the disorder, caused by a lack of vitamin D, is “making a comeback—as are other bone density disorders,” writes Dan Collins of CBS News.

Lack of sunlight plays a major role in rickets’ return. Many people are fearful of skin cancer, and tend to avoid spending too much time outside, or apply plenty of sunscreen. Dermatologists continue to debate the issue.

Dermatologist Darrell Rigel says most people “get enough sun through casual exposure,” such as walking to the car and running errands. But Dr. Catherine Gordon suggests it is not enough, and that people should try to spend five to 10 minutes per day in the sun.

Gordon also suggests that “African-Americans may need a bit more” time in the sun to reap the benefits, and that “people living in the sun-deprived northern latitudes may need to take a vitamin D supplement” in the wintertime.

Echoing Dr. Gordon’s sentiments is Nancy Shute of U.S. News & World Report. Shute suggests that just 10 minutes of daily sunshine can significantly boost vitamin D levels in children, but only when they're not wearing sunscreen.

For sunburn-prone children, this approach can be problematic. Shute says her own daughter is extremely sensitive to the sun, so vitamin D-fortified milk and orange juice, along with a supplement, serve as a substitute.

Background: Effects of vitamin D deficiency

In August 2009, LiveScience reported that nearly 70 percent of children in the United States have a heightened risk for heart and bone disease due to low vitamin D levels, according to the findings of a nationwide study led by Dr. Michal L. Melamed of the Albert Einstein College of Medicine of Yeshiva University.

The BBC reported that a lack of vitamin D had been linked to Parkinson’s disease. In a recent edition of Archives of Neurology, it was reported that researchers at Atlanta’s Emory University had discovered that more than half of people they tested who had Parkinson’s disease also had low vitamin D levels. In healthy older adults they tested, just 36 percent had low levels of the vitamin, the BBC reported.

How Much Vitamin D do Children Need?

Infants—especially those who are exclusively breast-fed—and children need double the amount of vitamin D previously recommended, the American Academy of Pediatrics announced in October 2008, according to Reuters. The new amount children should get, starting almost at birth, is 400 international units a day. Simple lifestyle changes can ensure that kids get more vitamin D.

Mayo Clinic provides background information on vitamin D, including which foods contain high levels, correct dosages for children and adults, evidence linking vitamin D deficiency to disorders and medical safety information. 

Related Topic: Outdoor education

The popularity of computer games and television, leading children to stay indoors, may also be contributing to rickets’ resurgence, David Rose, health correspondent for The Times of London, suggests. "Scientists say that rickets is becoming ‘disturbingly common’ among  British children,” Rose writes, and “can be triggered by long periods out of natural sunlight and a poor diet.”

Forest kindergarten bucks the trend of keeping kids indoors, emphasizing the value of environmental and play-based learning, and perhaps warding off vitamin D deficiencies.

In September 2009, a private Waldorf School in Saratoga Springs, N.Y., opened a forest kindergarten, requiring students to spend three hours outdoors each day. According to Liz Leyden, writing for The New York Times, the school takes the concept of nature-based, outdoor education characteristic of all Waldorf Schools “to another level.” Although forest kindergartens are “virtually unknown in the United States,” the schools are “increasingly common in Scandinavia,” as well as in Austria and Germany, Leyden notes.

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