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Doctors see vitamin D 'epidemic'

Say deficiencies putting teens at risk of disease

CHICAGO -- In some ways, Leon Jordan is a pretty typical teenager. He does not exercise outdoors much, prefers movies and video games, and will not drink milk. Those habits contributed to a vitamin D deficiency that has weakened 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 adolescents in the United States. Often undetected and untreated, a vitamin D deficiency puts them at risk for stunted growth and osteoporosis.

And there is evidence that chronic deficiency may be linked to some cancers, diabetes, and high blood pressure, said Dr. Michael Holick, a vitamin D specialist at Boston University.

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 does not absorb sunlight as easily as whites.

Ironically, so are youngsters who follow the advice of mothers and doctors on applying sunscreen to avoid skin cancer, as 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 that children spend about 10 minutes in the sun without sunscreen a few times per week.

Holick, who has conducted research on youngsters in Maine and elsewhere, estimates that as many as 30 percent of adolescents nationwide may be affected and that the percentage among blacks is probably 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 is no wonder a problem exists.

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

Doctors suspect that many otherwise healthy children and teens may have an undetected deficiency. Those most likely to be diagnosed often have underlying chronic diseases requiring medication that can cause bone problems.

That is what happened with 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.

His leukemia treatment may have thinned his bones, but Langman suspected vitamin D deficiency was contributing to the problem. A blood test confirmed his suspicions. Jordan said he currently takes vitamin D supplements and a bone-building drug.

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