Vitamin D and Bone Health: An Expert Point of View

Written by Heather Widtfeldt, PT. Interview with Dr. Donna Nimec, MD.

Vitamin D is a vitamin that helps the body absorb and use calcium. Vitamin D is necessary for strong bones. 

The Journal of American Medical Association reports that most children get vitamin D from three sources:

• Sunlight
• Fortified milk and juice
• Foods containing naturally occurring vitamin D

Sunlight helps the body make vitamin D. Most milk and many juices have vitamin D added.

Cod liver oil, egg yolks and fatty fish contain vitamin D.

Children with certain conditions are at high risk of low vitamin D levels and low bone mineral density. In a 2020 article from Annals of Pediatric Endocrinology & Metabolism, it is reported that “pediatric neurological disorders constitute a major secondary cause of osteoporosis in children.”

We asked our trusted physician, Donna Nimec, MD, of Spaulding’s Pediatric Rehabilitation Medicine Division, about vitamin D and how to support bone health if your child is at risk of bone mineral loss. Here are the important takeaways from the discussion with Dr. Nimec:

• Discuss the importance of vitamin D with your rehabilitation team and if your child is at risk for low vitamin D levels. Your physician may order a laboratory test to determine if your child’s vitamin D level is low.
• At the recommendation of your physician, consider adding a vitamin D supplement or a combination of calcium/vitamin D to make sure your child is getting enough of these vitamins and minerals.
• Recognize the influence of diet on vitamin D levels. Children on ketogenic diets are at risk for lower bone mineral density. Include vitamin D-rich foods into your child’s diet regularly.
• Encourage your child to play outside. Vitamin D is naturally produced in the skin from exposure to sunlight. 
• Discuss with your physician the impact of certain medications such as antiepileptic drugs and glucocorticoids on vitamin D levels and bone health. Your doctor may choose to perform routine monitoring such as laboratory work, x-rays, or a DXA scan to help manage any risk.
• There are other important considerations with bone health. Daily weight-bearing in the legs through standing or exercise helps to support strong bones. If your child is challenged by standing or maintaining standing, discuss with your rehabilitation team how to best support strong bones.

Citations

Moreno MA, Furtner F, Rivara FP. Vitamin D and Bone Health. Arch Pediatr Adolesc Med. 2012;166(7):684. doi:10.1001/archpediatrics.2012.1066

Ko A, Kong J, Samadov F, et al. Bone health in pediatric patients with neurological disorders. Ann Pediatr Endocrinol Metab. 2020;25(1):15-23. doi:10.6065/apem.2020.25.1.15

For more information about our pediatric therapy and physiatry services, please contact one of our Pediatric Outpatient sites.