he doesn't get much outdoor exercise, prefers movies and video games, and
won't drink milk.

Those habits contributed to a vitamin D deficiency that has helped weaken
the 18-year-old's bones and left him prone to fractures.

Doctors say it's an often overlooked problem that may affect millions of
U.S. adolescents. Often undetected and untreated, vitamin D deficiency puts
them at risk for stunted growth and debilitating osteoporosis later in
life.

There's even evidence that chronic deficiency may be linked with some
cancers, diabetes and high blood pressure, said Dr. Michael Holick, a
Boston University vitamin D specialist.

Youngsters in northern cities with less intense year-round sunlight are
especially prone to vitamin D deficiency, as are blacks and other dark-
skinned ethnic groups whose pigmented skin doesn't absorb sunlight as
easily as whites.

Ironically, so are kids who follow the advice of moms and doctors to
slather on sunscreen to avoid skin cancer, because it can block the
absorption of ultraviolet rays.

But while too much sunlight is bad, ultraviolet rays also interact with
chemicals in the skin to produce vitamin D. Holick recommends kids spend
about 10 minutes a few times a week in the sun without sunscreen.

"We get into lively debates with dermatologists because they say we should
all have sunscreen on all the time," said Dr. Catherine Gordon, a Boston
pediatric endocrinologist who has many patients with vitamin D deficiency.

Her recent research suggests as many as 20 percent of healthy children in
Boston may be vitamin D deficient.

Holick, who has done research on youngsters in Maine and elsewhere,
estimates that as many as 30 percent of adolescents nationwide may be
affected, and percentages among blacks are probably even higher.

"It's really an unrecognized epidemic," he said.

And with today's youngsters often favoring indoor activities from Web-
surfing to television, and many shunning vitamin D-fortified milk in favor
of soda, specialists say it's no wonder.

One problem is that the simple blood test that detects the deficiency is
rarely done unless a problem is suspected. Unfortunately, youngsters
suffering from it often don't have symptoms until it has advanced to the
point of causing fractures or rickets, a bone-weakening disease that
doctors think may be on the rise.

Doctors suspect that many otherwise healthy youngsters may have undetected
deficiency. Those most likely to be diagnosed often have underlying chronic
diseases requiring medication that can cause bone problems that bring them
to the attention of specialists.

That's what happened with Leon Jordan.

Currently in remission from leukemia, he had aching bones and was referred
a year ago to Dr. Craig Langman, a specialist in treating pediatric bone
problems at Children's Memorial Hospital in Chicago.

Leukemia treatment may be linked to the thinning bones, but Langman
suspected a vitamin D deficiency was contributing; a blood test confirmed
his suspicions.

Langman says about half the youngsters referred to him turn out to be
deficient in vitamin D, and in about a quarter of those cases, lifestyle
habits contribute.

Jordan said he had no idea his habits put him at risk. Now he takes vitamin
D supplements and a bone-building drug.

If the deficiency is detected early enough, before bones stop growing, such
treatments can help prevent permanent damage, Holick said.

Adolescence is a particularly vulnerable time because youngsters are
undergoing such rapid growth, said Dr. Susan Coupey, chief of adolescent
medicine at Montefiore Medical Center's children's hospital in New York.

Their bones require large amounts of calcium, and vitamin D is needed to
help the body absorb it. Thus adequate vitamin D intake is crucial from
ages 10 through 18, she said.

"It's as important as the first two years of life because the growth rate
increases," Coupey said.

According to Gordon, "If someone is vitamin D deficient, it causes the
cells that break down bone to go into overdrive.

"A mild form of vitamin D deficiency can be commonly unrecognized," she
said, "but there may be ongoing damage to their skeleton."

Gordon is among specialists leaning toward urging routine testing for the
deficiency.

In new guidelines issued earlier this year, the American Academy of
Pediatrics recommends multivitamin supplements containing 200 international
units of vitamin D for babies who are breast-fed only and for at-risk
children and adolescents. At-risk means those who don't drink at least 17
ounces daily of fortified milk, who don't get regular sunlight exposure or
who don't already take multiple vitamins with at least 200 IUs of vitamin
D.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html