By Steven Reinberg
HealthDay Reporter

(HealthDay News) — While the optimal amount of vitamin D is still subject to debate, a new study finds one thing is sure: over 6 million American children are getting too little of this essential nutrient.

“There are a lot of studies demonstrating associations between low levels of vitamin D and a laundry list of poor health outcomes,” noted lead researcher Dr. Jonathan Mansbach, an assistant professor of pediatrics at Harvard Medical School and a pediatrician at Children’s Hospital Boston.

“Given the preponderance of data and the safety profile of vitamin D, we believe many U.S. children would likely benefit from more vitamin D,” he said.

The American Academy of Pediatrics recommends that children attain blood levels of vitamin D of at least 50 nanomoles per liter (nmol/L), while for adults, studies have found at least 75 nmol/L and perhaps up to 100 nmol/L could lower the risk of heart disease and specific cancers, researchers say.

For the study, reported in the November issue of Pediatrics, Mansbach and colleagues collected data on about 5,000 children under age 12 who participated in the 2001-2006 National Health and Nutrition Examination Survey.

Based on these data, the researchers found that 6.3 million U.S. children — almost one in 5 — were at less than the recommended 50 nmol/L level of vitamin D.

Moreover, more than two-thirds of children (24 million) have vitamin levels below 75 nmol/L, including 80 percent of Hispanic children, 92 percent of black children and 59 percent of white children, Mansbach said.

Children taking multivitamins that included vitamin D had higher levels overall, but less than half of all children were taking a multivitamin, the researchers said.

How children should get much-needed vitamin D is also a topic of debate, and the researchers recommend further study in this area.

Sun exposure is best for obtaining vitamin D, because the skin manufactures the nutrient upon exposure to sunlight. However, during the winter, UVB rays in the Northeast are insufficient for vitamin D production, experts say, and sunscreen use in summer can also reduce the skin’s ability to produce vitamin D. Only a few foods contain vitamin D naturally, namely fatty fish such as salmon, egg yolks, some cheese and some meats, including liver. Milk and some cereals are fortified with vitamin D.

Mansbach recommends vitamin D supplements, especially for those living in areas where the sun is scarce in the winter. Here again, the authors say more research is needed to determine the appropriate dosage.

“Summer sunlight exposure is the major source of vitamin D for most people,” he said. “But [too much] sun exposure can cause sunburns and eventually skin cancer. Until more research is performed, we think the safest bet is to take vitamin D supplements,” he said.

Some experts argue that more foods, such as pasta and bread, should be fortified with vitamin D.

“Food fortification would raise the levels of vitamin D for the U.S. population as a whole, but not everyone in the U.S. is vitamin D-deficient,” Mansbach said. “Therefore, on a population basis, it’s probably easier to have people take vitamin D supplements.”

Samantha Heller, a registered dietitian, clinical nutritionist and exercise physiologist in Fairfield, Conn., also agreed that children should take vitamin D supplements. “Vitamin D deficiency has been linked to osteoporosis, fractures, muscle strength and falls, and low levels of vitamin D have been associated with several kinds of cancers, and there may be a link with cardiovascular disease,” she said.

Adults would benefit from vitamin D supplements too, Heller said. Adults and children need somewhere between 800 and 1,000 International Units (IUs) of vitamin D a day, she said.

Dr. Michael F. Holick, professor of medicine, physiology and biophysics and director of the Vitamin D, Skin and Bone Research Laboratory at the Boston University School of Medicine, said that “we estimate that vitamin D deficiency is the most common medical condition in the world.”

“Children should take vitamin D supplements and be less afraid of sensible sun exposure,” Holick said.

“At a minimum, from the time a child is born, they should be on 400 IU of vitamin D a day,” he said. “After the age of 1, they should be up to 1,000 IU per day, and teenagers should definitely be on 2,000 IU a day.”

Holick would prefer to see the safe upper limit of vitamin D raised. “What I would recommend is that in the first year of life, it should be raised to 5,000 IU per day and for children over the age of 1 and all adults, 10,000 IU a day,” he said.

More information

For more information on vitamin D, visit the Nemours Foundation.
SOURCES: Jonathan Mansbach, M.D., assistant professor of pediatrics, Harvard Medical School and Children’s Hospital Boston; Samantha Heller, R.D., C.D.N., registered dietitian, clinical nutritionist, exercise physiologist, Fairfield, Conn.; Michael F. Holick, Ph.D., M.D., professor of medicine, physiology and biophysics,director, Vitamin D, Skin and Bone Research Laboratory, Boston University School of Medicine; November 2009, PediatricsSimilar Posts:

• Smog Tougher on the Obese
• Rising obesity will cost U.S. health care $344 billion a year

These calculations are based on the projection that in 10 years 43% of Americans adults may be obese, which is roughly 30 or more pounds over a healthy weight, if obesity continues to rise at the current rate. Extra weight increases the risk of diabetes, heart disease and many types of cancer.

This report comes as the country struggles to find ways to curb medical costs and Congress debates health care legislation.

“Obesity is going to be a leading driver in rising health-care costs,” says Kenneth Thorpe, chairman of the department of health policy and management at Emory University in Atlanta. Thorpe did this special analysis on obesity for America’s Health Rankings, the 20th annual assessment of the nation’s health on a state-by-state basis.

“There is a tsunami of chronic preventable disease about to be unleashed into our medical-care system which is increasingly unaffordable,” says Reed Tuckson of United Health Foundation, sponsor of the report with the American Public Health Association and Partnership for Prevention.

Using weight data, Census statistics and medical expenditure information, Thorpe found:

•An obese person will have an average of $8,315 in medical bills a year in 2018 compared with $5,855 for an adult at a healthy weight. That’s a difference of $2,460.

•If the percentage of obese adults doesn’t change but stays at the current rate of 34%, then excess weight will cost the nation about $198 billion by 2018.

•If the obesity rate continues to rise until 2018, then Colorado may be the only state with less than 30% of residents who are obese.

•More than 50% of the population in several states could be obese by 2018: Oklahoma, Mississippi, Maryland, Kentucky, Ohio and South Dakota.

The report adds to the growing body of evidence of obesity’s impact on medical costs. A study released in July showed that obese Americans cost the country about $147 billion in weight-related medical bills in 2008, double what it was a decade ago. It now accounts for about 9.1% of medical spending.

Overall, the United States spends about $1.8 trillion a year in medical costs associated with chronic diseases such as diabetes, heart disease and cancer, and all three are linked to smoking and obesity, the nation’s two largest risk factors, according to the America’s Health Rankings report.

Smoking is still the No. 1 preventable cause of death in the country, accounting for about 440,000 deaths annually, the report says.

About one in five Americans smoke. More than 3 million people quit smoking this past year. The percentage of people who smoke varies by state, from 9.3% in Utah to more than 25% in Kentucky, Indiana and West Virginia, the study says.

“This report is an urgent call to take much more aggressive action to deal with key disease risk factors such as obesity and smoking,” Tuckson says.

Health economist Eric Finkelstein, co-author of The Fattening of America, says medical costs won’t go down unless Americans make a serious effort “to slim down by improving their diet and exercise patterns.”

For the full report, go to www.americashealthrankings.orgSimilar Posts:

• Smog Tougher on the Obese
• 6 Million U.S. Kids Lack Enough Vitamin D
• Check out New Year, New You Transformation Challenge | eFitness for Life

By Steven Reinberg
HealthDay Reporter

(HealthDay News) — Air pollution appears to hit the obese hardest, causing significant increases in blood pressure, a new study finds.

Air pollution has been linked to a variety of health problems including asthma, heart disease and diabetes, but this is the first time obesity has been taken into account, researchers say.

“For those who are obese, exposure to air pollution further exacerbated systolic blood pressure and pulse pressure,” said lead researcher Srimathi Kannan, an assistant professor at the School of Public Health and Health Sciences of the University of Massachusetts at Amherst.

“When you are looking at environmental exposures and medical outcomes, you have to consider obesity,” Kannan said.

The report is published in the Oct. 16 online edition of the Journal of Epidemiology and Community Health.

For the study, Kannan and colleagues collected data on air pollution and health as part of the Healthy Environments Partnership study. The study looked at these factors in 919 households in areas of Detroit that included rich and poor neighborhoods and a mix of racial and ethnic groups.

Among the 348 people who had their blood tested and their weight, blood pressure, height and waist circumference measured, over half were obese and 57 percent had waist circumferences that put them at risk for diabetes and heart disease.

Among all those tested, 68 percent had high blood pressure or were on the edge of developing high blood pressure and 36 percent had high cholesterol, the researchers found.

Average levels of particulate matter air pollution were 15 micrograms per cubic meter in three of the places measured, but in one area the levels were 20 percent higher.

People who lived in the area with the greatest amount of air pollution had higher pulse pressure than those in other areas, the researchers found. Pulse pressure is the difference between the systolic and diastolic blood pressure, the top and bottom numbers in a reading.

In addition, people living in the smoggiest areas also had higher systolic blood pressure, and it didn’t matter whether they were obese or of normal weight. However, the effect was greater among the obese, Kannan’s team noted.

The researchers believe that individuals and society need to address the combined health threat of obesity and air pollution.

“Continued vigilance regarding regulation of emissions sources in communities of color and low-income communities is critical, combined with efforts to address obesity, in order to reduce well-established disparities in cardiovascular health,” the researchers concluded.

Michael Jerrett, an associate professor of environmental health sciences at the School of Public Health of the University of California at Berkeley, said the study “is linking into the broader debates about underlying causes of death in our society.”

For people who already have high blood pressure, diabetes or who are obese, air pollution may make these conditions worse, Jerrett said.

“You end up with this vicious cycle where someone becomes obese due to lifestyle and other factors, which actually becomes worsened by the air pollution,” he said.

Jerrett noted that air pollution is only one environmental factor that contributes to worsening health. In addition, the poor are often exposed to more air pollution because of the neighborhoods they live in, he added.

“What comes along with the social deprivation is a cascade of other lifestyle and occupational factors that may also make the person more susceptible to air pollution’s effects,” he said.

Those factors can include poor nutrition, stress, traffic and industrial noise, Jerrett explained. “These can be heightening their sensitivity to air pollution,” he said. “So many of these susceptibility factors cluster together in the same neighborhood, in the same person.”

More information

For more information on obesity, visit the U.S. National Library of Medicine.
SOURCES: Srimathi Kannan, Ph.D., assistant professor, School of Public Health and Health Sciences, University of Massachusetts, Amherst; Michael Jerrett, Ph.D., associate professor, environmental health sciences, School of Public Health, University of California, Berkeley; Oct. 16, 2009, Journal of Epidemiology and Community Health, onlineSimilar Posts:

• Rising obesity will cost U.S. health care $344 billion a year
• 6 Million U.S. Kids Lack Enough Vitamin D

Similar Posts:

• Rising obesity will cost U.S. health care $344 billion a year
• 6 Million U.S. Kids Lack Enough Vitamin D