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Kids & Vitamin D: New recommendation: Double the dose

Rating

4 Star

Kids & Vitamin D: New recommendation: Double the dose

Our Review Summary

The American College of Pediatrics announced new guildelines doubling the amount of vitamin D recommended for infants, children and adolescents. The new guidelines state that all children should receive 400 IU* per day of vitamin D beginning from the first few days of life to prevent and treat rickets. These guidelines are based on a review of recent scientific studies and evidence showing that 400 IU of vitamin D per day is safe for pediatric poulations. This amount of vitamin D may also play a role in reducing the risk of osteoporosis in adulthood and preventing infections, autoimmune diseases, cancer, and diabetes.

The interview segment could have been far more informative and helpful for viewers. This is one case where a news release – from the American College of Pediatrics – is actually more helpful than the news segment – www.aap.org/pressroom/nce/nce08vitamind.htm.

The addition of a nutrition expert would have been helfpul, as would a comment on supplementation cost and at least a cursory discussion of the evidence supporting this increase in dose and the health-related benefits to be expected in children. An additional area that merits exploration (and an expert might have covered) is that the supplementation should be specifically with vitamin D, not necessarily a multivitamin, as there is less evidence to support this in all children.

For the reader’s reference, rickets continue to be reported in the U.S. in infants and children. Sunlight is the best source of vitamin D but it is difficult to determine the safe amount of sunlight exposure needed to to synthesize vitamin D in the skin. Most children (and adults) do not get enough vitamin D in their diet and supplements are often needed.

*400 IU is the amount of vitamin D provided by 1 quart of fortified milk.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not provide the cost of vitamin D supplements. It would have been helpful to mention the amount of vitamin D provided in vitamin supplements that children might already be taking. Most consumers are aware of the costs of other sources: milk, fortified cereal, and fish, thus, these did not need to be mentioned.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Applicable

Neither the news release issued by the American Academy of Pediatrics nor the scientific paper on which the new guidelines were based provided absolute or relative reduction of the risk of rickets that would result from the new vitamin D recommendation. This is understandable due to ethical considerations that would preclude this type of study from being done. As a result, this information was not available for this story. The story did mention potential benefits of vitamin D in reducing the risk other diseases, such as cancer and diabetes, and, it also could have also mentioned the potential for reducing the risk of developing osteoporosis in adulthood, as noted by the American Academy of Pediatrics.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story correctly states potential harms of excess vitamin D are very rare.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

In their press release announcing new guidelines that double the recommended amount of vitamin D (www.aap.org/pressroom/nce/nce08vitamind.htm) the American College of Pediatrics indicates that this change is a result of reviewing new clinical trials. The College guidelines did not provide other detailed scientific information which could have informed this story. The story was consistent with this approach and referenced ‘new research’. However, they could have provided other relevant facts related to vitamin D deficiency and rickets to add context. In addition, the doctor interviewed for the story incorrectly defines osteomalacia. For reference, osteomalacia is a softening of the bones due to vitamin D deficiency, not ‘a weakness of the muscles of the bones’. (Muscle weakness can be a symptom of osteomalcia.)

Does the story commit disease-mongering?

Satisfactory

The story presents new health information about vitamin D that would be of general interest. It does not commercialize or ‘over-sell’ the topic. It would have been even better to include a comment indicating that the potential benefit of vitamin D in fighting diabetes, heart disease, and cancer is based upon research that has been in adults.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story did indicate the source of the information but left out other important facts. The physician interviewed does not appear to be an expert on childhood nutrition. Instead he is known for helping celebrities lose weight and is the author of diet books including Extreme Fat Smash Diet (St. Martin’s Press). Conflict of interest of the funding source was not mentioned, nor was independent corroboration or medical opinion presented.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story does indicate common food sources and vitamin D supplements are options for obtaining vitamin D. (See Availability of Treatment comments.)

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story does correctly indicate that most children (and adults of all ages) do not get enough vitamin D through diet alone and will need to take supplements to met daily requirements. To illustrate this point, the story provides an example that children would have to drink 1 quart of milk each day to get the recommended amount of vitamin D, 400 IU per day. It does provide examples of good dietary sources of vitamin D: fortified cereal, milk, and oily fish. On the other hand, this story only makes brief mention of sunlight and fails to explain that sunlight is the best source of vitamin D. (Also see Harms of Treatment comments.)

Does the story establish the true novelty of the approach?

Satisfactory

This story properly indicates that the news being reported is an update of a previous guideline issued in 2003.

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure if the segment relied solely or largely on a news release. It interviewed only one guest and we don’t know why he was chosen. (See Sources below.)

Total Score: 5 of 8 Satisfactory

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