TBT: The ABCs of Achieving a Balance in Vitamin Consumption

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When kids seem to want to subsist on chicken fingers, French fries, and pizza alone, you have to wonder whether they’re getting all the vitamins they need. Vitamin deficiencies can cause serious health problems, but how worried should parents be about their children clinically lacking vitamins? Back in 2013, beijingkids spoke to Dr. Maher Eldadah, M.D., a pediatrician at Beijing United Family Hospital, and Dr. Basim Ansari, a family medicine practitioner at the then Puhua International Hospital in Shuangjing (Ed’s note: Beijing Puhua International Hospital is now located at 12 Tiantan Dongli, near the Temple of Heaven), for clarity on vitamins, what a lack of them can mean, and the best way to ensure optimal nutrition.

Vitamin Deficiencies – Should You Worry?

The good news is, “it’s hard to imagine someone developing a vitamin deficiency unless they have very strange eating habits,” says Dr. Eldadah. “As long as your child is eating a regular, healthy diet, vitamin deficiencies are not common.” That goes for parents, too.

“Vitamin deficiencies are uncommon in general populations,” agrees Dr. Ansari. But women and children can become deficient in certain vitamins in certain cases, he continues, so tests to rule out a vitamin deficiency are sometimes recommended. Unfortunately, there is no single test to determine all vitamin deficiencies, so each one must be tested separately.

Vitamin D is found in dairy products like milk, yogurt, and cheese

Vitamin D

Vitamin D has received a lot of attention recently, especially since some studies found low levels of vitamin D in hospitalized COVID-19 patients. Found in fortified dairy products like milk, cheese, and yogurt, as well as naturally in egg yolks and fatty fish like sardines and tuna, vitamin D is synthesized when the skin is exposed to the sun. Deficiencies in vitamin D arise especially when children are kept away from the sun or live in regions that get little sunlight, such as Scandinavia.

While using sunscreen is important, it’s good for kids to get a few minutes of unprotected sun exposure so that they can naturally synthesize vitamin D. While heavy pollution can make it seem like Beijing doesn’t see much sun, Dr. Eldadah thinks that families can still get plenty of rays through the pollution. Dr. Ansari recommends getting sunlight on days when there is less smog to avoid exposure to pollutants.

“Vitamin D is essential for absorbing calcium and phosphorus, which you need for healthy bone growth and development,” says Dr. Eldadah. “If you don’t get enough vitamin D, you don’t have enough calcium and phosphorous, so you don’t have enough calcium to build your bones.” This is why a vitamin D  deficiency can lead not only to soft and brittle bones but also in severe cases to rickets – though this is nowadays uncommon, reassures Dr. Ansari.

Vitamin D deficiency can manifest itself in confusing ways, including late teething in young children, irritability, poor growth, and muscle cramps. It’s hard to diagnose a vitamin D deficiency based solely on symptoms unless there are, for example, obvious fractures. The only way to know for sure is to do a vitamin D blood test or an X-ray to check for abnormal bone growth.

Infants who are breastfed exclusively will need vitamin D supplements of about 400 international units (ius) per day, according to Dr. Eldadah, especially if the child is regularly bundled in layers of clothing or religiously kept out of the sun. However, supplements may not be necessary if the baby’s diet includes a fortified formula. If your child doesn’t drink fortified milk as they get older, consult your doctor about supplementing with vitamin D.

Vitamin A

As the old saying goes, eating carrots helps keeps your eyes healthy — and it’s true. Your retinas rely on vitamin A; without adequate levels, you may start experiencing vision problems like night blindness. However, vitamin A deficiencies are only common in impoverished nations where children regularly suffer from malnourishment. Nevertheless, your child should eat plenty of yellow and orange produce, such as carrots, yams, and squash, as well as eggs and cheese.

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Vitamins B6 and B12

The B vitamin complex is essential for nervous and musculoskeletal health, as well as the heart and skin. All eight B vitamins work together, so a deficiency in any of them can cause severe nerve damage. Your body only needs small amounts of vitamin B, says Dr. Eldadah. As long as your child is eating a balanced diet, vitamin B supplements are not necessary. The only exception is for vegetarians or vegans, who may want to consider taking vitamin B tablets. Dr. Ansari recommends 0.1 to 1.5 mg of vitamin B6 and 0.5 to 2.5mg of vitamin B12 per day. Vitamin B can be found in meats, fish, nuts, beans, eggs, and milk.

Eating a healthy, balanced diet is the best way to get the vitamins we need

Too Much of a Good Thing

It is possible to get too many vitamins, and it’s more common than people think, says Dr. Eldadah. “If you take too many vitamins, you’ll reach vitamin toxicity,” he explains. “The body is a smart machine; if you give it too much of anything, it gets rid of it. If you take a multivitamin [with a recommended intake of] one or two tablets a day and you take four or five tablets every day for weeks, you’re probably overdosing.”

Symptoms of toxicity differ for each vitamin but may include weakness, irritability, fatigue, mood swings, hair loss, tingling sensations, numbness, and skin problems. These symptoms are vague, so diagnosing vitamin toxicity can be difficult and problems may continue to worsen. If you or your children take a daily multivitamin, stick with the recommended dosage. “A lot of people think they will be vitamin-deficient if they don’t take supplements, but you have to be very poor and have a diet [completely devoid of nutrition] to develop deficiencies,” says Dr. Eldadah.

Taking Multivitamins Correctly

Children should only take multivitamins if they are extremely picky about food, cautions Dr. Eldadah. If parents are concerned about their child’s diet, then taking a multivitamin may not be a bad idea. Chewable or gummy multi-vitamins are child-friendly, but parents should keep these out of reach from kids, who may think the vitamins are candy. Eating too many can lead to acute vitamin toxicity, which can manifest in symptoms such as vomiting and diarrhea.

There is no single trusted brand name for vitamins, says Dr. Ansari. Every country has different preferred brands, so make sure that the packaging contains dosage guidelines and a recommended daily allowance (RDA). Buy vitamins from trusted sources and brands such as Centrum (善存 in Chinese), which has an official store on Taobao. When buying on Taobao or Jingdong, especially imported brands, follow the general rule that if the price looks too good to be true, it probably is. Local pharmacies also sell multivitamins — ask for 多维生素片 duō wéishēngsù piàn. You can also order from international health store iherb.com (which ships to China) or ask your family doctor which brands or retailers they suggest.

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Photos: Pexels, Pixabay, Unsplash 

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