Vitamin D – Do we really need it ?

YES!

Our body needs vitamin D to stabilize the bones. As our bones are in a constant balance between construction and reduction, we need that vital vitamin throughout our whole live. Having said this, it is of particular importance in periods of intense growth. Bones can be imagined best as a kind of base substance made out of gummy. When calcium is incorporated into this ground masse with the help of vitamin D, the stable bone is created as we know it.

The quality of the bone structure and its density is defined in the childhood and adolescence. If we manage to store enough calcium during this important time and build a stable bone structure, we will benefit for life from it. Children suffering from a chronic vitamin D deficiency will suffer from rachitic or soft bones, which can permanently deform the bones.

For adults living a sedentary live, bone resorption often outweighs and from the age of 40+ the dreaded osteoporosis can be often observed. The name says it all: the dense, shock-resistant bone (Os) is getting perforated and porous. Calcium is being deprived and the bone is losing its strength. This condition can also lead to unexpected fractures.

Why am I going far afield ?

We need vitamin D without feeling any immediate consequence if it is in insufficient quantity. The effect of vitamin D deficiency in youth becomes apparent much later in life. But then it is too late to catch up on the lost bone density.

Our body produces a precursor of vitamin D. With the help of sunlight, this precursor is converted into the actual vitamin D in our skin. So this is where the dilemma begins: It raises the question of sun protection or sunbathing? As so often, it makes sense to take a middle course: regular stay in the sun in the morning and in the afternoon; sun protection, that also means staying in the shade over lunchtime (11-15h). In Winter, sunbathing is difficult. In order to bridge this “lack of sunshine”, our body puts on a supply of vitamin D. As our lives increasingly take place in closed rooms and we protect our skin from the sun, in Switzerland currently a vitamin D addition of 400 IU during the first 3 years of life is recommended.

Dark-skinned children living in Switzerland deserve special attention when it comes to vitamin D. For hundreds of years, our skin has adapted to our habitat. It has become brighter, more permeable to the UVB rays of the sun to ensure sufficient vitamin D supply. Dark-skinned children have naturally better sun protection integrated in their skin. At the same time, they need up to 30x more sun than a fair-skinned child to produce the same amount of vitamin D. It has been only a few years where this point has been recognized in our latitudes. The guidelines vary widely from one country to another.

My recommendation:

Sunbathing is useful and important. It should be ensured that it does not cause sunburn (severe redness of the skin). Start to play outdoors and sunbathe early in the year, stay in the shade at lunchtime. This way, we manage to get along without or with only minimal sunscreen and the skin can slowly get used to the stronger sun. The natural sun protection (pigment) is built up and at the same time vitamin D can develop in the skin.

For people with pigmented skin living in Central Europe: occasional vitamin D determination at the doctor, to compensate for a potential deficit, is recommended.

Regula Ziegler
Pediatrician in Zurich
I have worked as a pediatrician for 25 years. Children have always had a great importance in my life. For 6 years I worked in my own dispensary. Then, as a mother of three girls , I became a part-time doctor. This was a very rich professional and personal experience. In  family life, the beauty of having children was often accompanied by a certain exhaustion of us parents.When I was looking for some balance in my life, I discovered yoga. My daily routine has become an energetic fabric of family life, working as paediatrician and instructing yoga. I feel very privileged to be able to combine what I like most and call it “work”. 

 

 

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