Seven in ten children in the United States are not getting enough vitamin D, according to the National Health and Nutrition Examination Survey (NHANES, 2001-2004).

Vitamin D, 25-Hydroxyvitamin D, is a fat-soluble vitamin that promotes calcium absorption, fortifying bones and teeth, and maintaining the level of calcium and phosphorus in the blood.

Vitamin D deficiency can result in conditions such as rickets in children (usually <11 ng/mL), and osteomalacia and osteoporosis in adults (typically levels <25 ng/mL). Low levels of vitamin D also increase the risk of bone and heart disease, and are also associated with higher blood pressure and lower calcium and HDL cholesterol levels in later life.

Based on the information obtained from the survey, researchers found that, of more than 6,000 of children followed, nine percent (equal about 7.6 million) were vitamin D deficient, and a greater number were found to be getting an insufficient amount—61%, representing 50.8 million U.S. children. Only 4% received the recommended daily amount of vitamin D.

Children classified as “insufficient” had 15-29 ng/mL, while those who were classified as “deficient” had levels of 15 ng/mLor less. Normal range, according to the National Institute of Health, is 30-74 ng/mL.

The study is the largest of its kind to date, gaining nationwide rather than just regional data. "We expected the prevalence of vitamin D deficiency would be high,” says lead author Juhi Kumar, M.D., M.P.H., of the Children's Hospital at Montefiore Medical Center, “but the magnitude of the problem nationwide was shocking."

Vitamin D deficiency is more common for female children, those that are older, obese, drink less than one glass of milk week, and those who spend four hours or greater on the computer or watching television per day. African-American and Mexican-American children also had a greater risk.“It’s very hard to get enough vitamin D from dietary sources alone,” says Dr. Michal Melamed of the Albert Einstein College of Medicine in Bronx, New York.

Melamed, co-leader of the study, attributes part of this problem to lifestyle, recommending parents send their children outdoors. One source of vitamin D is UV-B sunlight, which converts cholesterol in the skin into vitamin D. She also recommends ditching the sunscreen for a while: “Just 15 to 20 minutes a day should be enough…don't put sunscreen on them until they've been out in the sun for 10 minutes, so they get the good stuff but not sun damage.” Individuals with darker skin and those who live in northern regions with less sun exposure should spend more time outdoors.

The American Academy of Pediatrics recommends that children and teens get at least 400 IU per day, double the previous recommendation of 200IU per day. Good sources of vitamin D include fish, milk, eggs, cod liver oil, and fortified foods. Vitamin D levels can also be increased with the use of supplements.

The study's abstract is available online, and will be published in September's issue of Pediatrics.

 The air quality in and around your home may have negative effects on your child’s intelligence, according to a study by Columbia University Center for Children’s Environmental Health (CCCEH).

The study, released a week ago by the National Institute of Environmental Health Sciences (NIEHS), found that children exposed to chemical pollutants called polycyclic aromatic hydrocarbons found in the air, water, and soil scored lower on IQ tests than children with lower exposure.

Polycyclic aromatic hydrocarbons, or PAHs, are chemical pollutants that can be found in the air, water, and soil. PAHs are typically released from the burning of fossil fuels (coal, diesel, oil, gas, etc.), tobacco and other natural substances. Auto emissions are a major source of PAHs in the United States, especially in heavily trafficked urban areas.

Doctor Frederica Perera, lead author and professor of Environmental Health Sciences at Columbia University Mailman School of Public Health, compares the exposure to such pollutants to low-level lead exposure. “These findings are of concern because these decreases in IQ could be educationally meaningful in terms of school performance,” she says. “IQ is an important predictor of future academic performance.”

A child’s developing fetal and nervous system is more vulnerable than an adult’s, and PAHs have been associated with higher cancer risk, asthma, allergies, low birth weight, and a reduced head circumference. Reduced head circumference, according to CCCEH, is connected with lower cognitive functioning and academic performance. In this study, the first of its kind, researchers hoped to study the relationship of in utero PAH exposure on a child’s intelligence.
 
Participants were non-smoking black and Dominican-American women, aged 18-35, residing in Washington Heights, Harlem and South Bronx, N.Y.—areas with higher pollutant exposure. During pregnancy participants regularly completed questionnaires and were asked to wear monitors that measured PAH levels.

Researchers followed the children, measuring IQ levels at age three and again at age five using the Wechsler Preschool and Primary Scale of the Intelligence. Of the 249 children, 140 had higher than the average 2.26 n/m3 level of exposure. The mean score for all children was 98.72, with a mean score of 96.6 for children whose exposure was classified as “high” and 101.6 for children with lower exposure. Scores differed by 4.67 on the verbal and 4.31 points on the full-scale test.

Researchers will continue to follow children to age 11 to learn more about the effects of PAHs on intelligence and child development. “It should serve as a warning bell to us all,” says Linda Birnbaum, Ph.D., director of NIEHS. “We need to do more to prevent environmental exposures from harming our children.”

Want more information about health during pregnancy? Visit Healia's Pregnancy Community or take the Healia Pregnancy Quiz!

The largest study ever conducted on U.S. children’s health begins enrolling participants this week in parts of New York and North Carolina. The National Institutes of Health (NIH) announced today that the long-planned National Children’s Study will begin recruiting volunteers to take part in its comprehensive study of how genes and the environment interact to affect children’s health. The study will track the health and development of more than 100,000 children from before birth until they turn 21.

The ambitious study was originally ordered by Congress in 2000, but budget issues and logistical planning delayed the NIH from beginning the study until now. Researchers want to investigate how environmental factors encountered in early life can “tip the scales” for genetically vulnerable individuals leading to disorders such as autism, asthma, and cerebral palsy, and perhaps even to diseases of adulthood like Parkinson’s disease and schizophrenia. Because of the large number of individuals enrolled, the study also has the capability to assess uncommon disorders, as well as how exposures to different environmental conditions and genetic factors may interact.

Enrollment in the study begins this week at two very different sites: the urban, industrial New York City borough of Queens, and the sparsely populated, rural area of Duplin County, N.C. In April, scientists will begin recruiting in five more locations in California, Pennsylvania, Utah, South Dakota and Minnesota.

The first locations will serve as pilot sites for the study's initial setup, with nationwide enrollment set for summer 2010. Eventually, the study will expand to include a total of 105 locations throughout the country to ensure that the data collected reflect a scientifically representative sample of the nation's diverse population.

Scientists are seeking women who are trying to get pregnant or who are already in the in the early stages of pregnancy. Study participants will be required to provide a series of samples, both biological – including urine, blood, hair, and genital swabs – and environmental – including samples of dust, water, and air from inside their homes. Pregnant moms will participate in monthly phone calls and be required to keep records of medical events, diet, and activity. After birth, their babies' health will be tracked through periodic exams and checks of their home environment in the first year of life and beyond.

However, if you live in one of the enrollment areas, the NIH urges you NOT to contact them in an attempt to become a study participant. In order to maintain scientific validity, participants must come from within narrowly defined geographic locations. Researchers are calling homes as well as enlisting the help of local prenatal care providers to recruit participants.

A listing of the exact locations of the first seven sites to enroll is available on the National Children’s Study Web site at http://www.nationalchildrensstudy.gov/about/overview/Pages/Study-Centers-Awarded-12-18-08.pdf.

For more information about health issues for children, join the Healia Health Community for child health. For more information about childhood asthma, check out the Healia Health Guide on Asthma.

 

Below is a list of the top 15 healthiest countries in the world as ranked by Forbes magazine. To arrive at their rank, research staff at Forbes examined statistics such as pollution; the percentage of a country's population with access to improved drinking water and sanitation; infant mortality rates; the rate of prevalence of tuberculosis; the density of physicians per 1,000 people; undernourishment rates; and healthy life expectancy for men. Forbes eliminated from the analysis the countries that did not have statistics in every measure (including some that would likely have made the top 15 such as Ireland, Belgium, and Norway.

The 15 healthiest countries in the world are:

1. Iceland
   This small Scandinavian island in the North Atlantic is the healthiest country in the world due to its long healthy life expectancies, low pollution levels, high density of physicians per capita, and low TB and infant mortality rates.
2. Sweden
   The largest of the Scandinavian countries – both in area and population – Sweden has some of the cleanest air in the world. Its infant mortality rate and TB prevalence are some of the lowest in the world. But the physician density, while relatively high, is not enough to knock Iceland from the top spot.
3. Finland
   Rounding out the top three is yet another Scandinavian country. Finland shares the clean air, low TB prevalence, and low infant mortality rate of its regional brethren ahead of it on the list, but comes up just a little short on those measures to crack the top two.
4. Germany
   The German health care system, one of the best in the world, provides one of the highest physician densities on the list and Germany’s clean air solidifies its position in the top five.
5. Switzerland
   Switzerland has the second-highest health spending per capita of all the countries considered and has one of the world’s highest physician densities and longest healthy life expectancies. However, its air pollution levels are higher than the others in the top five.
6. Australia
   Australia has an excellent health care system that requires insurance companies to charge policyholders the same premiums regardless of their status or past. The country also has some of the world’s cleanest air, but its relatively high TB prevalence keeps it out of the top five.
7. Denmark
   While this forth Scandinavian country to make the list has some of the highest income taxes to help pay for the country’s universal health care coverage, the Danish health care system isn’t very efficient, perhaps due in part to its having one of the lowest physician densities on the list. The country does have one of the highest healthy life expectancies on the list.
8. Canada
   Canadians enjoy one of the world's longest life expectancies despite having the lowest physician density on the list. Our neighbor to the north also has one of the lowest TB rates, but gets marked down for its relatively high infant mortality rate.
9. Austria
   Austria has a relatively high physician density and a low infant mortality rate, but its poor air quality and high TB prevalence prevent it form climbing any higher on the list.
10. Netherlands
    This highly urbanized, densely populated nation suffers from pollution in the water, air, and soil, but its low TB rate and average healthy life expectancy keep in the top ten.
11. United States
    The U.S.far outspends any other country on health care, but 15% of the population still lacks health insurance. However the U.S does have the lowest infant mortality rate in the world, the second-highest healthy life expectancy, and a low TB rate.
12. Israel
    Israel has one of the highest levels of air pollution on the list, but its physician density is the highest in the world and life expectancy is average for the countries on the list.
13. Czech Republic
    The Czech Republic has one of the list’s lowest healthy life expectancies as well and relatively poor sanitation and high TB prevalence. However, the country now boasts one of the world’s lowest infant mortality rates.
14. Spain
    A high physician density, healthy life expectancy, and low infant mortality rate make Spain a pretty healthy place to live, but a high tuberculosis rate and air pollution temper this somewhat.
15. France
    France’s excellent health care system, clean air and high density of physicians per capita landed it on the list, while poor wastewater treatment and a high tuberculosis rate kept France from climbing any higher.

_{Source: Forbes Special Report: World's Healthiest Countries, Allison Van Dusen and Ana Patricia Ferrey, April 08, 2008.
Photo: keeshu, MorgueFIle license}

The following is a list of the healthiest cities in America as ranked by Sperling's BestPlaces and Centrum. The Centrum Healthiest Cities Study is a comprehensive "health report card" of U.S. cities based on the key factors that can contribute to overall well-being.

To compile the list, Sperling’s and Centrum culled data on 50 U.S. cities from both public and private sources and assessed each city against 50 select measures in five major categories: Physical Activity, Health Status, Nutrition, Lifestyle Pursuits, and Mental Wellness.

The top 10 healthiest U.S. cities are:

1. San Jose, CA
   This northern California city gets high marks for mental wellness, low rates of cigarette smoking, and high fruit and vegetable consumption.
2. Washington, DC
   Citizens of the nation’s capital have great overall mental and emotional health, along with good rates of dental care and low average body mass index (BMI).
3. San Francisco, CA
   These Bay Area residents have low average BMI and get lots of physical activity, and the city has the most physicians per capita.
4. Seattle-Bellevue-Everett, WA
   Despite the rain, Northwesterners in the Seattle have the highest physical activity and vigorous exercise of any city and also make the healthiest lifestyle choices.
5. Salt Lake City-Ogden, UT
   Residents of this home to the Mormon Tabernacle have high rates of mental wellness and physical activity.
6. Oakland, CA
   The third Bay Area city to make the list, Oakland boasts high overall health status, good dental care, and low smoking rates.
7. Sacramento, CA
   This inland city in northern California has the lowest rate of asthma and also scores highly on exercise rate and intensity.
8. Orange County, CA
   The smallest (by area) county in California, this southern enclave has high rates of physical activity and also score well in mental wellness and rates of restful sleep.
9. Denver, CO
   Residents of this mile-high city in the Rockies have low BMIs and a high level of physical activity.
10. Austin-San Marcos, TX
    Home the University of Texas, this region scores high in physical activity and has one of the highest numbers of gyms and heath clubs per capita.

For more information on living healthy, join the Healia Health Community for Excercise and Fitness or the Healia Health Community on Diet and Nutrition.

_{Source: Sperling’s Best Places. More information about the methods and resources used can be found here: http://www.bestplaces.net/docs/studies/healthy_methodology.aspx}

_{Photo: roarofthefour, Flicr, Creative Commons}

A report released by the Centers for Disease Control and Prevention (CDC) this week finds that car and other transportation-related accidents are the leading cause of death for children and teens in the U.S. About 8,000 child and teen deaths each year in the U.S. involve a motor vehicle occupant, pedestrian, or cyclist, with the highest fatality rates being among occupants of motor vehicles.

To prepare the report, the CDC examined data collected between 2000 and 2006 on emergency room visits and fatalities in children and teens from birth to age nineteen. According to the report, an estimated 9.2 million children visit emergency departments each year for unintentional injuries. Falls caused the most non-fatal injuries (about 2.8 million each year) and were associated with over half of the nonfatal injuries involving children less than one year. Drowning and poisoning were also leading causes of non-fatal injuries among children less than four years old

The report also notes that between 2000 and 2005, unintentional injuries resulted in 73,052 deaths among children and teens, with transportation-related deaths leading the way. Such deaths were highest among children 15 to 19 years of age. Overall, males were almost twice as likely to die from unintentional injuries as females.

The release of the CDC’s report coincided with the World Health Organization′s (WHO) and the United Nations Children′s Fund′s (UNICEF) launch of the 2008 World Report on Child Injury Prevention. The global report found that car crashes, drowning, and other accidents kill 830,000 children worldwide each year. Road crashes are the leading cause of accidental death worldwide, killing 260,000 children each year and injuring 10 million, with drowning, burns, falls, and accidental poisoning rounding out the top five.

Around 95 percent of the worldwide accidental deaths occurred in the developing world, mostly in Africa, and in richer nations deaths from accidents disproportionately affect the poor.

For information about the preventing child injuries and death, see the CDC’s “Protect the Ones You Love” initiative at www.cdc.gov/safechild. The Healia Health Community on Child Health is a great place to discuss the measures you take to keep your kids safe and get ideas from other parents.

 

_{Sources: UPI, CDC}

_{Photo: Old Man Lee, Flickr, Creative Commons}

Researchers from Johns Hopkins University have published an article warning consumers to limit consumption of energy drinks that contain high levels of caffeine. The researchers reported that some energy drinks can contain many times the amount of caffeine as a regular cola drink. As a result, they recommend energy drinks carry a warning label that shows their caffeine content and includes information about possible health risks.

Because caffeinated energy drinks are marketed as supplements and not as regular soft drinks, they are not required to display their caffeine content and are not subject to the Food and Drug Administration's regulations regarding caffeine content in beverages.

Excessive caffeine consumption may result in fast heart rates (tachycardia), nausea and vomiting, difficulty sleeping, increased urination, anxiety, tremors, and depression.

Given that many high energy drinks are being marketed to children and young people, it’s important to be aware of how much caffeine your children are consuming. In addition, because caffeine acts as an appetite suppressant, children may not be getting proper nutrition.

Join Healia’s Diet and Nutrition Community to learn more about this and other nutrition issues.