Even a dietitian can find it challenging to get enough Vitamin D

Since moving to North Idaho, I have been putting off getting my Vitamin D levels checked. Ignoring all of the recommendations from my dietitian friends who have warned me about Coeur d'Alenes's lack of sunshine in winter months, I believed that with my "practically perfect" diet and outdoor activity I was immune to a Vitamin D deficiency - WRONG! My recent blood test came back well below the recommended range.

Vitamin D intake recommendations have been under review and finally last week the Institute of Medicine (IOM), which sets recommended daily levels for nutrients, came out with their new recommendations.

The new Dietary Reference Intake values for Vitamin D and calcium are based on evidence supporting the roles of these nutrients in bone health but not in other health conditions. The panel concluded that most Americans do get enough vitamin D - not necessarily from dietary sources, but with the help of sunlight. Although not as high as dietitians and physicians hoped for, the new IOM guidance does represent an increase from levels set in 1997.

New Recommendations:

Children and adults under age 71 need 600 IUs of vitamin D daily.

Adults over 71 need 800 IUs per day

The IOM committee set the upper limit for vitamin D at 4,000 IUs a day for those who are ages 9 and older. A multivitamin contains around 400 IU. Excessive vitamin D can damage the kidneys and heart, and too much calcium from supplements has been linked to kidney stones.

Our bodies need Vitamin D to absorb calcium. People who do not get enough vitamin D throughout life have an increased risk of having thin and brittle bones (osteoporosis) in their later years.

Thin and brittle bones break easily. This is why it is important for you to get enough Vitamin D as a child and as an adult. We get Vitamin D from food, but also from sunshine. So how much should we get?

Here is a list of good sources of Vitamin D, so you can see that it is challenging to get enough from diet.

* Eggs. 1 egg yolk contains 20 IU of Vitamin D.

* Liver. A 3.5oz serving of beef liver has about 15 IU of Vitamin D.

* Oily fish like tuna, mackerel, and salmon contains 200-360 IU of Vitamin D.

* Foods with added (fortified) vitamin D, including milk and other dairy products, orange juice, and breakfast cereals contain 40-100 IU of Vitamin D.

Now do the math. If you had 3 glasses of milk (300 IU), you still fall 300 IU short.

Sunshine. Because your body uses sunshine to make Vitamin D, spending time in the sun without sunscreen can help give you the Vitamin D you need. But the amount of Vitamin D you get is influenced by season, latitude and time of day. People in the north get less, especially during the gray winter months.

Vitamin D has been a hot topic in recent years because research has linked lower levels of the nutrient to certain cancers, diabetes, and bone and immune system problems. The IOM panel concluded that more scientific research is needed to investigate the potential health benefits of larger amounts of Vitamin D.

For now, be sure to get your levels checked at your next annual physical, because if you are like me, a supplement may be in order.