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Social Kids – Supporting Social Development in Children

Some children are naturally social, and others struggle with finding their place in social circles.  As parents we can support even the most timid child to learn positive social skills that can last a lifetime.  Below are ten tips to support social development in children.

1. Allow Your Child to Have Influence in Your Family

Give your child a voice in your house and she will have an easier time speaking up in other situations. The best way to foster this in your family is by active listening. Give your child your full, undivided attention and weigh carefully what it is that they are saying. Even young children want to know that their feelings are important and are being heard. Children of all ages begin to recognize that they can earn certain rights and privileges if they do what is expected of them. They thrive when they have a perception of power, some ability to shape their life.

Friendship_social2. Focus on the Positive

Too often parents look at parenting as correcting undesirable behaviours, and their parenting styles dissolve into complaining, nagging and reacting. If you focus on fostering and developing the positive behaviours in your child, then the negative behaviours won’t be so overwhelming. Use positive reinforcement to encourage positive behaviours in your child. Reward positive behaviours by giving them something they value – some one-on-one time doing a favourite activity, computer and television privileges, a play date with a friend, etc. Try to avoid using sweet treats (such as candy and chocolates) as a reward – this reinforces unhealthy eating behaviours as a reward for good work – an issue that often persists into adulthood.

 3. Set a Social Example

Children who struggle with socializing are often children of poor socializers. Be sure to be a good role model for your child – talk to other parents at the park, invite friends (with or without children) over for lunch, tell your children about the fun things you like to do with your friends. This technique is known as modeling. Your child’s most influential role model is their same-sex parent. Let them observe you making friends with others and they will begin to recognize the techniques and consequences of this behaviour and begin to try the techniques themselves.

4. Engage in Your Child’s Life Outside the Home

Most parents find that the way their child behaves at home can be completely different to the way they behave at school or day care. Engage the other adults whom your child sees on a regular basis – teachers, care givers, sports coaches, and parents of other children. These people are the best resource you have for monitoring and changing your child’s behaviour outside the home.

5. Give Your Child Space to Grow

It can be tempting as a parent to be overly involved in the activities of our child. While it is important to be involved it is equally important to give your child space to try out some of their new socialization skills. Children are going to fall down, they are going to make mistakes. Children need to learn what this is like, so they can adapt when it happens and grow as people. If you are always hovering over your child, you rob them of a sense of self-mastery, a sense of accomplishment and competency.

soccer_social6. Enroll Your Child in Group Extracurricular Activities

While activities such as piano or language lessons are important in building skills and competency, enrolling your child in a group activity will allow them to meet other children their age and practice socializing in a low-risk setting. Select diverse activities (not too many at once) and allow your child to find what they enjoy doing while making friends. Examples of group activities include: soccer, swimming, baseball, dance, martial arts, reading groups, cub scouts/ girl guides, art or pottery classes, and more.

7. Host Playdates

Most people feel more confident in familiar settings. If you want to support your child in building friendships be prepared to invite friends over. Keep playdates small – start with just one child – and short – one to two hours is plenty for most children. Have suggestions for fun activities and be prepared to get the ball rolling, but then step back and watch your child play with their friend. At the end of the playdate have a conversation with your child about they fun things he did with his friend, encouraging children to share their feelings with you will make it easier for them to share their feelings with others. If possible, try to arrange regular playdates with the same children – and when they are ready they will want to go have a playdate at their friend’s house as well.

Together time_social8. Be Your Child’s Friend

Get down to your child’s level and play with them like a friend. Not only will this be fun for both you and your child, but you will learn a great deal about your child’s strengths and weaknesses. Studies have suggested that parents of the most socially successful children laugh and smile often, avoid criticizing their child during play time, are responsive to their child’s ideas and aren’t too directive.

9. Don’t Push

As much as we want our children to be happy and well liked by their peers, pushing them into making friends can easily backfire. Some children need more time and need to take more gradual steps towards building friendships. Support your children, but don’t push them. Help them develop social skills such as empathy, problem-solving, co-operation, sharing, negotiation and communication skills.

10. Be Patient!

No skill is learned overnight!  Be patient with this process and know that once your child learns positive social skills they will be able to use them for the rest of their lifetime.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Vegetarian 101 – Iron in the Vegetarian Diet

Iron is one of the most important minerals for health.  Iron is used to form hemoglobin which allows our red blood cells to carry oxygen to each and every cell in our body.  Iron deficiency is the most common nutrient deficiency worldwide with up to two billion people affected, mostly women and children, and affects omnivores and vegetarians alike.

Symptoms of Iron Deficiency

Iron deficiency generally develops slowly and symptoms often do not appear until anemia is severe, even though our cells are already suffering the consequences of inadequate iron.

Symptoms of iron deficiency are similar in all age groups and include:

iron in the vegetarian diet

  • Fatigue
  • Dizziness
  • Shortness of breath
  • Irritability
  • Pale skin
  • Sore tongue
  • Dark coloured stools
  • Frequent infections
  • Sensitivity to temperatures (cold or heat)
  • Pica (the desire to eat non-food substances – most commonly ice or dirt)

Vegetarians have no higher incidence of iron deficient anemia than the omnivore population, however there are some additional precautions vegetarians must take to ensure an adequate dietary intake of iron.

Absorption of Iron from the Diet

Green leafy vegetables are a source of vegan ironDietary sources of iron are either heme-based (from animal sources) or non-heme (vegetarian.)  Some foods (such as cereals and infant formulas) are also iron-enriched or iron-fortified – non-heme iron is used in these foods.

Although a vegetarian diet is likely to contain as much (or more) iron than an omnivorous diet, the non-heme iron in a vegetarian diet is substantially less available for absorption because of differences in the chemical form of iron and accompanying constituents that inhibit iron absorption (such as calcium, tannins and phytates).

Vegetarians need to consume approximately 80% more iron than indicated by the national Recommended Daily Intake (RDI) due to the decreased bioavailability.  Absorption of non-heme is estimated to be 10%, although more will be absorbed in cases of severe anemia.  By comparison the absorption of non-heme iron is approximately 18%.

Iron absorption can be enhanced by combining iron rich foods with a source of vitamin C, using iron cookware (especially for cooking acidic foods that solubize iron from the pan), sprouting grains and avoiding coffee, tea and red wine with meals.

Vegetarian Food Sources of Iron

Food Amount Iron (mg)
Soybeans,cooked 1 cup

8.8

Blackstrap molasses 2 Tbsp

7.2

Lentils, cooked 1 cup

6.6

Spinach, cooked 1 cup

6.4

Tofu 4 ounces

6.4

Bagel, enriched 1 medium

6.4

Chickpeas, cooked 1 cup

4.7

Tempeh 1 cup

4.5

Lima beans, cooked 1 cup

4.5

Black-eyed peas, cooked 1 cup

4.3

Swiss chard, cooked 1 cup

4.0

Kidney beans, cooked 1 cup

3.9

Black beans, cooked 1 cup

3.6

Pinto beans, cooked 1 cup

3.6

Turnip greens, cooked 1 cup

3.2

Potato 1 large

3.2

Prune juice 8 ounces

3.0

Quinoa, cooked 1 cup

2.8

Beet greens, cooked 1 cup

2.7

Tahini 2 Tbsp

2.7

Veggie hot dog, iron-fortified 1 hot dog

2.7

Peas, cooked 1 cup

2.5

Cashews 1/4 cup

2.1

Bok choy, cooked 1 cup

1.8

Bulgur, cooked 1 cup

1.7

Raisins 1/2 cup

1.6

Apricots, dried 15 halves

1.4

Veggie burger, commercial 1 patty

1.4

Watermelon 1/8 medium

1.4

Almonds 1/4 cup

1.3

Kale, cooked 1 cup

1.2

Sunflower seeds 1/4 cup

1.2

Broccoli, cooked 1 cup

1.1

Millet, cooked 1 cup

1.1

Soy yogurt 6 ounces

1.1

Tomato juice 8 ounces

1.0

Sesame seeds 2 Tbsp

1.0

Brussels sprouts, cooked 1 cup

0.9

Sources: USDA Nutrient Database for Standard Reference, Release 24, 2011

Recommended Daily Intake and Supplementation

The RDI for iron is 80% higher for vegetarians and is dependent on your age.  Children, adolescents and pregnant women have increased needs due to the rapid growth seen during these ages.  The values below are for vegetarian people only and reflect the increased need for iron in this population

Daily recommended intake of dietary iron for vegetarians

Children are at risk for iron deficiencyInfants (0-2 years): 19mg per day
Children (3-11 years): 18mg per day
Adolescent girls (12-18): 27mg
Adolescent boys (12-18): 19mg
Adult women (19-50): 32mg
Adult men (19-50): 15mg
Pregnant women: 48mg
Seniors (>50): 14mg 

Iron supplements should only be taken if blood tests have shown evidence of an iron deficiency or decrease in iron storage levels. Research suggests that a daily iron supplement is best for treating low iron, however frequency may be decreased to once or twice per week for prevention of deficiency in people with a history of low iron.

Iron supplements should be taken away from other minerals (especially calcium) since these may decrease the absorption of iron.  A source of vitamin C (500mg capsule) is also recommended to enhance absorption each time an iron supplement is taken.

Ferrous fumarate and ferrous sulfate contain the highest amount of elemental iron per mg with ferrous gluconate containing the least.  Ferrous gluconate, ferrous fumarate and ferrous citrate are well tolerated with fewer digestive side effects reported.

Constipation, darkening of the stool and digestive upset are the main side effects seen with iron supplements.  Supplements should be continued for three months beyond the resolution of iron deficiency anemia to replenish body stores of iron.

If you suspect you may have an iron deficiency, seek a blood test from your Medical Doctor or Naturopathic Doctor.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Selected References

Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. British Society of Gastroenterology. 2005

M Amit; Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 2010;15(5):303-314.

Hunt JR.  Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 2003;78(suppl):633S–9S

Stoltzfus RJ, Dreyfuss ML. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia. International Nutritional Anemia Consultative Group (INACG)

Keeping Kids Healthy

Immune support for childrenIt’s back-to-school time again!  An exciting time for parents and kids – and the viruses and bacteria that are heading back to school with them!  For many kids back-to-school means back to runny noses, sneezing, coughing, colds and flus.  And for parents it means sick kids, missed work days – and likely coughs and colds of their own!  But fear not fellow parents, below are my top ten tips for boosting your child’s immune system for back-to-school!

1.    Get a good night sleep

During sleep our immune system is busy producing immune cells that help us to fight off the bugs that lead to colds and flu.  With the change in sleep schedules at back-to-school time a lot of kids aren’t getting the sleep they need.  School-aged children and teens need around 10 hours of sleep per night – so get them to bed on time!

 2.    Teach proper hand washing

Encourage your kids to wash their hands thoroughly several times per day.  Most kids wash their hands for less than 10 seconds but it takes 20 seconds to effectively clean hands.  Avoid using antibacterial soaps – most colds are caused by viruses, not bacteria.  Regular soap is as effective at killing germs as antibacterial soap and doesn’t lead to the development of antibacterial-resistant bacteria strains.

 3.    Cover your cough properly!

As kids we were taught to cough or sneeze into our hands – but times have changed!  When you cough or sneeze into your hand you then transmit viruses and bacteria to everything you touch – door knobs, stair rails, other people.  Teach your kids to cough or sneeze into their elbow – this is known around our house as the “vampire cough” technique.  It’s one of the most effective ways to stop the spread of germs, and my kids think it’s hilarious!

 Oranges for immune health4.    Feed your immune system

Eating a diet rich in immune-boosting nutrients is one of the best ways to keep our kids (and ourselves!) healthy during back-to-school.  Orange, red, yellow and dark-green fruits and vegetables contain vitamin C, beta carotene and other antioxidants and phytonutrients necessary for proper function of our immune system.  Beans, lean meats and whole grains are a source of zinc, which is necessary for growth and immune function.

 5.    Skip the sweets

Refined sugars – found in candies, cakes, muffins, chocolates and sweetened beverages – decreases the function of your immune system for up to six hours after eating it.  That’s a whole day of school!  So skip the sugary school snacks and encourage your kids to eat fruits, vegetables and healthy snacks instead.

 6.    Take your vitamin D

If you live in Canada you need to take a vitamin D supplement through the fall and winter.  All of us – mothers, fathers, grandparents and kids need to take our vitamin D.  In Canada we don’t get enough sunlight between October and April to make vitamin D, resulting in widespread deficiency.  And since we need vitamin D to make antimicrobial peptides – our body’s natural antibiotics – it is no surprise that cold and flu season starts just as our vitamin D levels fall.  Doses are based on body weight – around 800IU for children and around 2000IU for adults.

 7.    Battle bad bugs with good ones

Probiotics are good bacteria that live in our digestive tracts but they are good for more than healthy digestion.  Research shows that probiotics improve the function of the immune system by decreasing numbers of bad bacteria, enhancing function of immune cells and strengthens the mucosal lining of our gut.  Adults and children who take probiotics take less sick days and children have fewer incidences of ear infections, strep throat and colds.

 8.    Treat a cold early

When your kids come home with the first signs of a cold or flu, don’t hesitate to start treating them before it gets worse!  There are a wide variety of herbal medicines, nutrients and supplements that are fantastic for boosting your child’s immune system at the first sign of sickness.  Elderberry, vitamin C, Echinacea, goldenseal, astragalus – and many other – options are available through your Naturopathic Doctor.

 9.    Stay hydratedsleeping kid

Drinking water and clear fluids keeps you hydrated and prevents viruses and bacteria from adhering to the lining of your nose and throat.  During back-to-school season I also suggest parents, kids and teachers drink herbal teas to enhance their immune function.  At both my clinic locations you can purchase the Immuni-Tea I formulated for my own family – a delicious blend of Echinacea, elderberry, ginger, astragalus and other herbs to enhance immune function and keep your whole family healthy!

 10. Keep your sick kids home

Stop the spread of germs and keep sick kids home.  Your child will get well faster with rest and appropriate care, rather than going to school and getting more rundown and exposed to more viruses and bacteria.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Tea for Fever in Children

 

Fever is a natural defence mechanism that our body uses to fight off viral and bacterial infections.  Increasing the body’s temperature allows our immune system to function optimally and makes it difficult for viruses and bacteria to replicate.

In an adult the level of fever generally corresponds to the severity of the illness causing it.  This is not necessarily the case in children.  In a newborn the body’s temperature control mechanisms are not yet well developed.  As a result signs other than fever (poor appetite, lethargy, irritability, nausea and vomiting) may be earlier indicators of an infection than fever.

Often the best treatment for a fever is NOT to decrease the fever (which is performing an important function in fighting off infection), but instead to optimize the fever with herbal diaphoretics.  Diaphoretics temporarily raise the body temperature, activate the immune system, encourage sweating (which then brings down body temperature), improve circulation, and minimize the symptoms of colds and influenza including sore muscles, chills, congestion, and sore throat.

Fever often leads to dehydration, which makes tea an especially effective treatment because it will not only help you to manage the fever but it will also supply much-needed hydration.

Very high fevers (generally above 103F/ 39.4oC in an adult, above 102F/ 38.8oC in a child, and above 101F/ 38.3oC in an infant) should be treated with appropriate medications (such as children’s acetaminophen or ibuprofen) to decrease fever while using tea as a supportive treatment.  Do not give aspirin to a child with a fever.  Aspirin use in children with viral infections has been linked to development of a serious liver disease known as Reye’s syndrome.

In some cases a feverish child may experience a febrile seizure.  These occur in a very small percentage of children.  They do not appear to be related to the severity of the fever or to the rate at which the temperature rose.  About 50% of children to experience one febrile seizure will go on to have another one.  If your child has a febrile seizure ensure that you have your child examine by a doctor to rule out any underlying conditions or causes.

There are several herbal teas that can be used safely in children with a fever.  These herbs can also be used by adults.  Children should be dosed according to their age.  One teaspoon every 3-4 hours for children under one year of age, 2 teaspoons every 3-4 hours for children 1-2 years of age and children over 2 years of age can have 1/4 cup every 3-4 hours.  Adults can consume one cup every 3-4 hours.

Catnip (Nepeta cataria) Chamomile (Matricaria recutita)
Elderberry (Sambucus nigra) Ginger (Zingiber officinalis)
Bayberry (Myrica cerifera) Peppermint (Mentha piperita)
Lime blossom (Tilia europa) Yarrow (Achillea millefolium)

Remember – a fever is a sign that the immune system is working.  Hydration and herbal teas are often enough to help a child (or adult!) through the symptoms of a fever.  Always monitor the fever and use medications when necessary.  When in doubt, consult a Naturopathic Doctor or Medical Doctor for help.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Iron Deficiency in Children

Iron deficiency is the most common nutrient deficiency seen in children.  In adults the causes of iron deficiency tend to be pregnancy and menses (in women) and gastrointestinal bleeding (in men).  In children iron deficiency is most often due to dietary influences.

Dietary Influences on Iron Levels

Lentils are a vegan source of iron

The effects of diet on iron levels are well-known.  Eating a diet low in iron-rich foods will result in iron deficiency in all age groups.  The chart below shows foods that are rich in iron and should be included in a health-promoting diet.  Picky toddlers and school-aged children may develop iron deficiency due to an iron-poor diet.  However, a low iron diet is only one cause of iron deficiency in children.

The most common cause of iron deficiency in younger children (0-24 months) is over-consumption of cow’s milk.  The iron in cow’s milk is much less available for absorption than human milk.  Breastfeeding for the first 12-24months or using formulas fortified with iron are the simplest solutions for iron deficiency in young children.

Due to the high demand of a child’s body for iron (necessary for growth and development) and the possibility for long-term impacts of iron deficiency (poor growth, decreased intelligence and IQ) an iron deficient child must be treated quickly and appropriately.

Other Causes of Iron Deficiency

Malabsorption (the decreased ability to absorb iron from the diet) is a potential cause of iron deficiency in all age groups.  Malabsorption is most commonly seen in people with celiac disease (an inability to tolerate gluten-containing foods – such as wheat, rye, oats, barley, kamut and spelt) or in people with H. pylori colonization in their digestive tracts.  Absorption of iron is also of concern in vegetarians because the phytates in iron-rich plant foods can decrease absorption.

Genetic conditions can also be a potential cause of low iron.  If you have a family history of iron deficiency discuss this with your Naturopathic Doctor.

Symptoms of Iron Deficiency

The symptoms of iron deficiency in adults and children are similar:

  • Fatigue
  • Dizziness
  • Pale skin
  • Sore tongue
  • Dark coloured stools
  • Pica (the desire to eat non-food substances – most commonly ice or dirt)

Food Sources of Iron

Animal Sources(meat, fish, poultry, eggs, dairy) Plant Sources(legumes, nuts, grains, vegetables, fruit)
Excellent sources (containing at least 3.5mg of iron per serving)
  • Pork, chicken or beef liver
  • Beef kidney or beef heart
  • Clams, canned
  • Oysters, canned
  • Iron-fortified breakfast cereal (1 cup)
  • Instant oatmeal
  • Soybeans, white beans
  • Firm tofu
  • Lentils
  • Chickpeas
Good sources (containing 2.1 -3.4mg of iron per serving
  • Beef
  • Shrimp
  • Sardines
  • Pasta (1 cup)
  • Kidney, navy, pinto beans
  • Baked potato with skin on
  • Cooked spinach (1/2 cup)
Fair sources (containing 0.7 – 2.0mg of iron per serving)
  • Pork, ham, chicken, turkey, lamb
  • Crab, salmon, tuna
  • Eggs (2 large)

*Meat portions are 100g/ 3oz – approximately the size of a deck of cards

  • Split peas (3/4 cup)
  • Dried fruit – raisins, figs, dates (1/4 cup)
  • Almonds, cashews, mixed nuts (1/4 cup)

Treating Iron Deficiency in Children

Iron supplements are the most common cause of accidental poisoning in children so great care must be taken in the dosing and storage of iron supplements.  Before prescribing iron supplements a blood test must be done to confirm low iron levels.  Once iron deficiency has been established your Naturopathic Doctor will prescribe an iron supplement appropriate for your child’s needs.  Dosage of iron is determined by weight and the recommended dose must not be exceeded.

Iron dosage: 2mg/ kg body weight per day

Iron supplements are best absorbed on an empty stomach, but this may cause stomach upset in some children.  If that is the case, take the iron with food.  Taking iron with vitamin C or with an acidic meal (containing lemon juice or vinegar) will increase absorption.

Supplemental iron should be taken for three months, at which time blood tests should be repeated to check iron status.  Iron supplements should be continued for 3 months beyond the point where iron levels are found to be sufficient in order to replenish iron stores.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Organics 101

 

Organic foods – once available only in farmer’s markets, health foods stores and co-operatives are now readily available in most large grocery store chains.  If you haven’t yet made the change to eating organics, it is time you did.

Changing to eating organics doesn’t have to be challenging.  Understanding the value in eating an organic diet, and knowing which foods to always buy organic is a good place to start.  So read on to learn more about Organics 101.

4 Benefits of Eating Organic

1. Higher nutritional value

Conventional farming practices have resulted in declining levels of minerals in fruits and vegetables since the 1940s.  Combined with the common practices of early (pre-ripened) harvesting, longer storage, and increased processing of food crops, and it’s not surprising that we are getting fewer nutrients from our food than we were 70 years ago.

Organic fruits and vegetables contain higher levels of minerals, vitamin C, and antioxidants.  Higher levels of lycopene have been found in organic tomatoes, polyphenols in organic potatoes, flavonols in organic apples, and resveratrol in organic red wine.  Scientific reviews have estimated that organic produce tends to contain 10-50% higher phytonutrients than conventionally grown produce.

2.  Lower pesticide residues

One in three conventionally produced food products contains a variety of pesticide residues.  Consuming pesticide residues in food has been linked by Israeli researchers to headache, tremor, fatigue, depression, anxiety, poor memory, skin rashes, convulsions, nausea, indigestion and diarrhea.

3. Better for our children

Children’s immature and developing nervous system, immune system, organs, and detoxification processes, plus their larger intake of food per kilo of body weight, combine to make them more susceptible to pesticides and toxins than adults.

A study published in Environmental Health Perspectives found that children eating primarily organic diets had significantly lower levels of organophosphorous pesticides in their system than children eating conventional diets.  Other studies indicate that chronic exposure to organophosphorous pesticides – even at low levels – may affect neurological functioning, neurodevelopment, and growth in children.

“Dose estimates suggest that consumption of organic fruits, vegetables, and juice can reduce children’s exposure levels from above to below the U.S. Environmental Protection Agency’s current guidelines, thereby shifting exposures from a range of uncertain risk to a range of negligible risk” – Cynthia L. Curl, Richard A. Fenske, and Kai Elgethun.

4. Better for our environment

Pesticide contamination of groundwater, loss of topsoil and the high energy costs of conventional farming are all minimized in organic farming practices.

Environmental Working Group’s “Dirty Dozen and Clean Fifteen”

Making the transition to eating organic can be simplified by following the guidelines provided by the Environmental Working Group’s 2010 Shopper’s Guide to Pesticides.  Available as a downloadable and printable pocket guide, their listing of foods to always consume organically (the “Dirty Dozen”) and those that are conventionally grown but have low pesticide residue (the “Clean Fifteen”) is a valuable aid as you make the change to organic eating.

The Dirty Dozen (always buy organic)

The Clean Fifteen (lowest in pesticides)

CeleryPeaches

Strawberries

Apples

Blueberries

Nectarines

Bell Peppers

Spinach

Kale

Cherries

Potatoes

Grapes (imported)

OnionsAvocado

Sweet corn

Pineapple

Mango

Sweet peas

Asparagus

Kiwi

Cabbage

Eggplant

Cantaloupe

Watermelon

Grapefruit

Sweet potato

Honeydew melon

Sources:

Environmental Health Perspectives ehponline.org, posted online Oct. 31, 2002, C.L. Curl, R.A. Fenske, and K. Elgethun, “Organophosphorus pesticide exposure of urban and suburban pre-school children with organic and conventional diets

Organic Trade Association http://www.ota.com/organic/benefits/nutrition.html

Environmental Working Group – 2010 Shopper’s Guide to Pesticides http://www.foodnews.org/sneak/EWG-shoppers-guide.pdf

Four Steps to Selecting Safe Baby Care Products

As parents we want to be sure we are making safe choices for our children.  With marketing claims like “natural”, “mild”, and “gentle” it can be hard to decide which products truly are safe for our little ones.  Every week three-quarters of children are exposed to allergens, neurotoxins, and harmful chemicals in their body care products.

By following the four steps listed you can be sure you are making the best choices for your family.

Four Steps to Selecting Safe Baby Care Products

Step One – Simplify!  Use fewer products.

Most adults use as many as ten personal care products each day.  The number we use with our children can be just as high.  Diapers, wipes, body wash, shampoo, soap, lotions, bubble baths, diaper creams and more are applied to our babies’ skin each day.  Minimize the potential for chemical exposure by eliminating products that aren’t necessary.

Suggestions: Use warm water on a washable cloth to wipe baby’s bum after diaper changes.  Use one product as a shampoo/soap/body wash.  Don’t use bubble bath with young children.

Step Two – Less is More – Use products with fewer ingredients and no fragrance.

The fewer ingredients the more natural the product”.

It’s a general rule and in many cases it is true.  The longer the ingredient list the more preservatives, dyes, emollients and other chemicals the product contains.  There are exceptions to this rule of course, some botanical products use many different plant extracts in their formulas.  But a quick glance at the length of the product label can provide valuable information.

It is also important to choose products that are free of synthetic dyes and fragrances.  Synthetic dyes and fragrances are often composed of several harmful chemicals but due to product labeling laws do not need to be listed separately.  Avoid exposing your child to these chemicals by selecting products that are fragrance and dye free.

Step Three – Read Labels… and Know What Ingredients to Look For.

More important than the length of an ingredient list, knowing what ingredients to avoid is paramount to protecting your child from exposure to potentially harmful chemicals.  The following is a brief list of ingredients to avoid:

Benzyl alcohol and isopropyl alcohol Skin irritants and potential neurotoxicity concerns
BHA Found in diaper cream.  Banned in other countries because it can cause skin depigmentation
Boric Acid and Sodium Borate Found in diaper cream.  Industry authorities caution against use on infant or damaged skin
2-Bromo-2-Nitropropane-1,3-Diol (or Bronopol) Found in baby wipes.  Allergen and irritant that can form cancer-causing contaminants
Ceteareth and PEG compounds Petrochemicals that may contain cancer-causing impurities
DMDM Hydantoin Allergen and irritant that can form cancer-causing contaminants
Dyes Some are linked to cancer and are banned outside the U.S.
Fragrance Allergens that may contain neurotoxic or hormone-disrupting chemicals
Iodopropynyl butylcarbamate Chemically similar to neurotoxic pesticides
Methylchloroisothiazolinone and methylisothiazolinone Allergens with neurotoxic concerns
Oxybenzone Found in sunscreens.  In sunlight, can produce allergy- and cancer-causing chemicals
Parabens Hormone-disrupting chemicals with potential cancer concerns
Triethanolamine Allergen and irritant that can form cancer-causing contaminants
Triclosan Linked to thyroid disruption, produces toxic byproducts in tap water

Additionally, a 2009 study found formaldehyde or 1,4-dioxane in a large percentage of tested baby products.  Both formaldehyde and 1,4-dioxane were found in 17 out of 28 tested products (61%).  Formaldehyde and 1,4-dioxane are known carcinogens; formaldehyde can also cause skin rashes in some children.  These chemicals are not listed on product labels because they are contaminants, not ingredients.

Formaldehyde contaminates personal care products when preservatives release formaldehyde over time in the container.  Common ingredients likely to cause formaldehyde contamination include: quaternium-15, DMDM hydantoin, imidazolidinyl urea and diazolidinyl urea.

1,4-dioxane is a byproduct of a chemical processing technique called ethoxylation.  Manufactures can easily remove the toxic byproduct, but are not required by law to do so.  Common ingredients likely to be contaminated with 1,4-dioxane include: PEG-100 stearate, sodium laureth sulfate, polyethylene and ceteareth-20.

Step Four – Make a List and Check It Twice.

Having a list of ingredients to avoid, and bringing it with you when selecting new baby care products is the easiest way to be sure you are making a healthy choice.

The Environmental Working Group has made this even simpler by providing parents with two phenomenal resources.  One is the Safety Guide to Children’s Personal Care Products which includes a printable pocket reference guide.

Skin Deep is also from the EWG and offers a searchable cosmetic safety database with toxicity ratings for thousands of individual products and brands.  It is an invaluable resource.  I recommend double checking any product on the Skin Deep website before purchasing it.

Making the best choices for your children doesn’t have to be difficult.  By utilizing the four steps highlighted in this article and accessing the resources offered by groups such as the Environmental Working Group, you can be confident you are using products that live up to the highest standards – your standards.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

References:

No More Toxic Tub.  March 2009.  Campaign for Safe Cosmetics.  Available at http://safecosmetics.org/downloads/NoMoreToxicTub_Mar09Report.pdf

Safety Guide to Children’s Personal Care Products. Environmental Working Group Report.  Available at http://www.cosmeticsdatabase.com/special/parentsguide/summary.php

Parent’s Buying Guide: Safety Guide to Children’s Personal Care Products.  Environmental Working Group.  Available at http://www.cosmeticsdatabase.com/special/parentsguide/index.php?bybrand=1

Ingredients to Avoid: Safety Guide to Children’s Personal Care Products. Environmental Working Group.  Available at http://www.cosmeticsdatabase.com/special/parentsguide/ingredients.php

Tea for Tots

Sharing the Joy of Tea with Kids

There are few topics that I like to talk about more than tea.  I love tea.  I love the flavour of tea, the diverse kinds of tea, the ritual of making tea and the warm, calm feeling that I get when I settle in with a cup of tea.  Tea is also one of my favourite ways of prescribing botanicals (plant based medicines) for adults and children alike.

While I would not recommend giving a child a cup of orange pekoe, chai or English breakfast tea (all of which contain caffeine!) there are an abundance of other kinds of tea that are perfect for children.

Preparing Tea for Kids

Making a cup of tea for a child is very similar to preparing it for an adult, with a couple of simple adjustments.

  • Children often prefer a weaker tea.  Adults should steep tea for between 4 and 6 minutes (depending on the type of tea and personal preference).  For children steep the tea for only 2 to 4 minutes.  If the tea is too strong, add extra water to dilute the strength (this is also a good way to quickly cool the tea!).
  • The temperature of tea to be served to a child should be considerably cooler.  I suggest serving children’s tea chilled, at room temperature or lukewarm (the same temperature used for baby bottles or formula – around 26-36oC).

Selecting Teas for Your Child

Selecting tea is part of the pleasure of drinking tea.  You can have tea that calms you, tea that wakes you up, tea that soothes a sore throat or an upset tummy, or tea that just tastes good.  You can select tea for your children in much the same way.

Teas for Health

Anxiety – studies show that more and more children are experiencing anxiety, and at younger and younger ages.  If your child has anxiety associated with school, friends, separation or for any other reason try giving them a tea to help calm their nervous system.  Teas for anxiety include chamomile, oat straw, passionflower (for children over four), and skullcap (for children over six).  Prepare a cup of tea and enjoy it together in the evening or before stressful events.

Colic – even young babies can benefit from tea!  A tea made from fennel, chamomile or peppermint can be very helpful in relieving colic in infants.  A breastfeeding mother can drink the tea (1 cup three times per day) or the tea can be diluted and given to the infant with a medicine dropper (1 diluted tsp three times per day).

Constipation – use a flaxseed tea (1 teaspoon flaxseed in 1 litre of water, simmered for 15 minutes) to cook oatmeal.  Prepare the tea and then use the tea instead of water to prepare oatmeal for your child to eat.  Or add ¼ cup of flaxseed tea to 4 ounces of juice and give it to your child once daily.  Constipation should resolve within 24-48 hours.

Coughs – depending on the type of cough there are several options for teas to soothe a coughing child.  For a cough with sore throat, marshmallow root or slippery elm tea can be very soothing.  For cough with congestion, licorice or coltsfoot tea are both effective.
(Note: Do not use for more than 3 days in a row.  Licorice should not be used in children with high blood pressure).
Peppermint tea is a mild cough suppressant and can be used in the evenings to help children with a persistent cough to get some sleep.

Sambucus nigra berriesFever – To decrease chills and increase perspiration (which will shorten the duration and intensity of the fever) try a tea with any of the following ingredients (in equal parts): lemon balm, chamomile, peppermint, licorice and elder flower.  For a child over 2 years of age ½ cup of tea can be given up to four times daily for one day.  Serve this tea as hot as your child can tolerate.
Note: Do not use licorice in a child with high blood pressure.  Fevers are commonly a sign that the body is fighting a viral or bacterial infection.  If your child’s temperature exceeds 102F (38.9oC) consider contacting a qualified healthcare provider for further guidance.

Nausea – ginger tea is very effective in decreasing nausea, vomiting, upset stomach and for soothing the digestive tract.  Giving your child tea when they are nauseous or vomiting also provides much needed hydration.  Use ½ cup of ginger tea, three times per day for the first 24 hours of nausea.  Ginger tea is also very effective for motion sickness.  Try giving your child ginger tea as needed during car trips to treat motion sickness.

Teas for Taste

There are a great variety of herbal teas available that children love.  Try fruit based herbal teas as a delicious and low calorie alternative to fruit juice.  Many of the fruit based teas are delicious served cold as an iced tea.  Some of my family’s favourites are:

Hibiscus flowers give tea a bright pink colour kids love
  • Chocolate mint rooibos – a loose tea, naturally caffeine free and deliciously sweet.  Available at www.steepedandinfused.com.
  • Passion by Tazo tea – hibiscus flower, lemongrass, mango and passion fruit combine to make a sweet, pink-hued tea.  Fantastic as an iced tea.  Available at Starbucks stores or many grocery stores.
  • Raspberry Zinger, True Blueberry and Country Peach Passion – all by Celestial Seasonings are favourites of my 2 year old son.  Simple, sweet, fruity flavours are popular with young children and adults alike.

So go ahead and try serving tea to your child.  There is no reason why a tea party need only be pretend!   You may be surprised at how much your child enjoys the flavours and rituals of tea drinking.

Disclaimer:

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Resources:

Hoffman, David.  Medical Herbalism.  2003.
Zand, Janet.  Smart Medicine for a Healthier Child 2nd Ed.  2003.

Warming Socks

In my first year of Naturopathic medical school we learned a hydrotherapy technique that was lovingly referred to as “cold, wet socks”.  Sounds appealing doesn’t it?  Despite the name, the warming socks (as I prefer to call it) treatment is cheap, simple and effective.  And not nearly as unpleasant as the name would lead you to believe.

Why do Warming Socks?

Warming socks is a technique used to treat the common cold, influenza, sore throats, sinus infections, upper respiratory tract infections, headaches, head and chest congestion.

The treatment works by stimulating the body’s natural defences.  Warming socks is a type of “heating compress” – a hydrotherapy technique that causes the body to increase blood circulation in order to heat up the cold, wet socks.

This increase in blood circulation helps to relieve congestion and stimulates greater action of the immune system so that it is better able to fight the virus or bacteria causing the illness.

This treatment can also have a sedating effect, and many people report sleeping much better during the treatment.

It is best to start the warming socks treatment on the first day of an illness and repeat it for three nights in a row.  It is most effective as part of an integrated treatment plan including rest, hydration, proper nutrition and immune-boosting botanicals or supplements.

How to do Warming Socks

Equipment

One pair of thin cotton socks

One pair of thick wool socks

Sink or bucket filled with very cold (or iced) water

Tub or bucket filled with very warm water

A warm bed

Procedure

Step 1: Get ready for bed

Step 2: Put cotton socks in a sink of very cold, or iced, water.  Soak for a minute to saturate the socks then wring them out so that they do not drip.

Step 3: Place your bare feet into a tub or bucket of very warm water.
Soak your feet as long as you want, but make sure the water stays warm and so do your feet.

Step 4: Dry your feet with a towel and put the wet cotton socks on your feet.

Step 5: Immediately pull the dry wool socks over the wet socks.  You want the wool socks to completely cover the cotton socks.

Step 6: Go to bed right away.  Make sure your feet stay warm.

In the morning your feet will be warm and dry.  Symptoms of your cold and head or chest congestion will be diminished or gone.

Repeat the warming socks treatment for three nights in a row.  It can be used on adults and children but people with chronic conditions or compromised immune systems should consult with a Naturopathic Doctor before starting the warming socks treatment.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

10 Things You Need to Know About Vitamin D

The importance of Vitamin D to health can not be underestimated.  It is the only vitamin that our body makes from exposure to sunlight.  Learn 10 important things about the “sunshine vitamin” and discover the impact Vitamin D can have on your health.

1. Vitamin D is made from sunlight

Vitamin D SunriseVitamin D is often referred to as the “sunshine vitamin” because our skin produces vitamin D from the sun’s ultraviolet light (UVB).  Our skin can make enough vitamin D in 30 minutes with just our face, hands and feet exposed.  Full body exposure for 15 minutes can produce between 10 000 – 20 000IU (international units) of vitamin D3.  However, many factors influence our body’s ability to produce vitamin D: complexion, use of sunscreen, cloud cover, smog, time of day, latitude and season.

Individuals with darker complexions make less vitamin D than fair-skinned people.  Studies estimate that half of all women of African descent living in northern latitudes are vitamin D deficient.

Sunscreen use is important for the prevention of skin cancer but it has the unfortunate effect of blocking vitamin D production by blocking UVB rays from reaching our skin.

Cloud cover can reduce UVB energy by 50%, shade reduces it by 60%.  UVB rays do not penetrate glass, so exposure to sunshine indoors does not promote vitamin D production.

2. Vitamin D deficiency is a major concern during Canadian autumns and winters

Latitude has a lot to do with vitamin D status.  Due to our northern latitude the majority of Canadians have insufficient vitamin D levels during the fall and winter months.  One study demonstrated that in Canada from November through February UVB rays aren’t strong enough for our bodies to produce enough vitamin D.

Vitamin D stores in our bodies are quickly depleted during the early autumn months leading to insufficient levels during the late autumn and winter.  Vitamin D is stored in the blood for a few weeks and in fat tissue for a few months.

The average vitamin D level in late winter for American and Canadians is approximately 15-18ng/ml – levels below 20ng/ml are considered seriously deficient.

3. Vitamin D can help prevent Influenza and the Common Cold

Pediatric Naturopathic MedicineEach year more studies are showing a relationship between low vitamin D levels and incidence of colds, influenza and other respiratory tract infections.

People with higher vitamin D levels experience fewer respiratory illnesses and when they do get sick the illness is milder and shorter.  The Public Health Agency of Canada is currently investigating the role of vitamin D in the protection against season influenza and the H1N1 (swine flu) strain.

Vitamin D levels in your blood are at their lowest point during flu season.  Your body uses vitamin D to make antimicrobial peptides – the body’s natural antibiotics.  When vitamin D is deficient you make fewer peptides and are more vulnerable to illness.

Infants and children are a population where respiratory tract infections can have serious health implications.  Infants and children with lower levels of vitamin D are more susceptible to viral infections.

Vitamin D supplementation may be used to prevent or treat influenza.  To treat influenza larger doses of vitamin D3 may be needed.  It is best to consult with a Naturopathic Doctor if you are considering taking high doses of vitamin D as it can be toxic in high doses.

4. Vitamin D may prevent Cancer

You might not know it, but the connection between vitamin D status and cancer is well established in the scientific community.  Adequate levels of vitamin D have been shown to decrease the risk of developing over 16 different types of cancer including breast, ovarian, prostate, pancreatic, colon, non-Hodgkins lymphoma and lung cancer. It is also an important part of integrative cancer treatment protocols.

A study by Dr. W. Grant, vitamin D expert, found that about 30 percent of all cancer deaths (2 million worldwide) could be prevented each year with higher levels of vitamin D.

Vitamin D can protect against cancer in several ways, including:

  • Increased self-destruction (apoptosis) of mutated cells
  • Reduced spread (metastasis) and reproduction (proliferation) of cancer cells
  • Increased differentiation of cells (cancer cells often lack differentiation)
  • Reduced growth of new blood vessels from pre-existing ones, which is a step in the transition of dormant tumors turning cancerous

Other studies have estimated that you can decrease your risk of developing cancer by more than half by optimizing vitamin D levels.

5. Vitamin D is essential for bone health

Vitamin D is necessary for healthy bonesVitamin D deficiency results in childhood rickets and in osteomalacia (under-mineralized bone) in adults.  Without sufficient vitamin D bones become thin, brittle or misshapen.

Osteoporosis is a very common disease in North America.  It is characterized by fragile bones that significantly increase the risk of fracture.  Long term vitamin D insufficiency is associated with the development of osteoporosis.  Supplementing calcium and vitamin D can help protect adults from developing osteoporosis.  Vitamin D is necessary to allow the body to absorb calcium, either from dietary or supplemental sources.  Vitamin D also lowers the risk of fractures in people with osteoporosis.

6. Vitamin D can decrease the risk of Auto-Immune diseases

Vitamin D is one hard working vitamin!  Not only can it decrease the risk of cancer, common cold, influenza and osteoporosis, but it can also decrease the risk of developing several auto-immune diseases.  Conditions such as autism, type I diabetes mellitus, schizophrenia and rheumatoid arthritis all have been correlated with low levels of vitamin D.

One auto-immune condition has been studied extensively with relation to vitamin D status.  Multiple sclerosis (MS) is a chronic auto-immune disease that occurs almost exclusively in extreme latitudes and rarely near the equator.  In MS the immune system attacks the body’s own cells as “foreign”, causes vision changes and muscle weakness.  Adequate vitamin D levels may decrease the incidence of MS.  It is also an important integrative treatment for people with MS.

7. Vitamin D is essential for children and breastfed infants

Levels of vitamin D in breast milk have been found to be lower than needed for proper growth and development in infants (breast milk contains about 25IU/litre).  Because of this finding breastfed infants are recommended to be supplemented with 400IU of vitamin D daily (formula is also supplemented with vitamin D).  Supplementing at this young age could have life-long benefits.

Older children and adolescents also benefit from vitamin D supplements.  The American Academy of Pediatrics suggests supplementing all children to ensure adequate vitamin D levels.

8. Vitamin D can help prevent Type I and Type II Diabetes

More obese adults are deficient in vitamin D than same-age adults with normal weights.   A large percentage of adults with type II diabetes are also obese.  60% of people with type II diabetes have inadequate levels of vitamin D in their blood.  If you are obese, supplementing with vitamin D may help decrease your risk of developing type II diabetes.  If you already have type II diabetes supplementing with vitamin D can help improve insulin sensitivity.

Scientific studies have also established a link between type I diabetes and vitamin D levels.  Deficient levels of vitamin D are frequently found in patients diagnosed with type I diabetes and some research supports supplementation of vitamin D to decrease the risk of type I diabetes.  Children supplemented with vitamin D were also found to be less likely to develop type I diabetes.

9. Vitamin D levels can be tested – and should be!

The only way to determine the correct dose of vitamin D for you to take is to get your blood levels tested.  There are currently 2 different vitamin D tests available.  The best one is 25-hydroxyvitamin D.  This is a better marker of overall vitamin D status than 1,25-hydroxyvitamin D.

Vitamin D levels should be tested for three reasons.

  1. Vitamin D requirements are different for everyone. Depending on your age, colour of your skin, weight, and latitude of the town you live in, you could need anywhere from 400IU to over 10 000IU per day!
  2. Vitamin D can be toxic in excessive doses. Vitamin D accumulates in fat tissues where it is stored for a few months.  Vitamin D overdose causes hypercalcemia (too much calcium in the blood), dehydration and tissue calcification.  Blood tests showing levels of greater than 200nmol/L of vitamin D are toxic.  It is very difficult to reach this level through sunlight exposure or nutritional sources of vitamin D.  Toxicity has been seen with long term supplementation of excessive levels of vitamin D.  Having your blood levels tested will ensure you are not taking excessive dosages of vitamin D.
  3. Vitamin D insufficiency is often asymptomatic. It is possible to have low levels of vitamin D in your body and not be aware of it.  The only way to know you have optimal levels of vitamin D is to test for it.

Vitamin D Levels (25-hydroxyvitamin D)

Deficient Insufficient Optimal Cancer therapy Excess
<25ng/ml <35ng/ml 50-65ng/ml 65-90ng/ml >100ng/ml
<20nmol/L <40-80nmol/L 80-120nmol/L 120-160nmol/L >200nmol/L

10. Not all Vitamin D supplements are created equal

gel cap skyThere are two types of vitamin D available; Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol).  Only Vitamin D3 should be used for supplementation.  Vitamin D2 is a synthetic form of Vitamin D and does not impact vitamin D stores in our bodies in the way Vitamin D3 does.  Vitamin D3 is the natural form, the same form our bodies create from sun exposure.

Vitamin D3 is better absorbed in a liquid form.  Several companies make liquid Vitamin D3.

Food sources of Vitamin D3 (fortified milk, fish, cod liver oil, egg yolk, mushrooms) are often insufficient to maintain optimal levels of Vitamin D3.  Especially during the winter months in Canada, supplementation is necessary.

As of 2012, the conventional RDAs (recommended daily allowances) in Canada are only:

  • 400 IU for infants and children
  • 600 IU for adolescents and adults aged 9-70
  • 800 IU for adults over 70
  • 600 IU for pregnant and breastfeeding women

These levels are completely inadequate for maintaining optimal health, especially in the autumn and winter months in Canada.  The only way to determine an adequate (and safe) dosage of Vitamin D is with a blood test.  However, general guidelines from the scientific literature suggest a dosage of:

Vitamin D3 Dosage Guidelines

35IUs of Vitamin D3 per pound of body weight

For a child weighing 40 pounds, a dosage of approximately 1400 IU would be reasonable and for a 160 pound adult the dose would be approximately 5600 IU’s.  This dosage is for a fair skinned healthy young adult.  It is a guideline only and does not suggest that all adults and children should be taking these doses.

Conclusion

Achieving adequate levels of vitamin D is important!  Reduce your risk of cancer, influenza, respiratory tract infections, diabetes, auto-immune diseases and improve your bone health and overall health with just one vitamin supplement daily.

Photo courtesy of Jamie Amodeo. www.flickr.com/jamieamodeo

Photo Credit: ellesmere FNC via Compfight cc

Resources:

Aloia JF, Ni-Ng M.  Re: epidemic influenza and vitamin D.  Epidemiol Infect.  2007 Oct;135(7):1095-6; author reply 1097-8.

Aloia JF, Patel M, Dimaano R, Li-Ng M, et al.  Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration.  Am J Clin Nutr.  2008 Jun;87(6): 1952-8.

Autier P, Gandini S.  Vitamin D Supplementation and Total Mortality: A Meta-analysis of Randomized Controlled Trials.  Arch Intern Med.  2007 Sep 10;167(16):1730-7.

Cannell JJ, Vieth R, Umhau JC, et al.  Epidemic influenza and vitamin D.  Epidemiol Infect.  2006 Dec;134(6):1129-40.

Cannell JJ, Zasloff M, Garland CF, Scragg R, Giovannucci E.  On the epidemiology of influenza.  Virol J.  2008 Feb 25;5:29.

Ginde AA, et al.  Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.  Arch Intern Med.  2009 Feb 23;169(4):384-90.

Grant WB. An estimate of premature cancer mortality in the United States due to inadequate doses of solar ultraviolet-B radiation, Cancer, 2002b;94:1867-75

Grant WB.  Geographic variation of prostate cancer mortality rates in the USA; implications for prostate cancer risk related to vitamin D; Int. J. Cancer, 2004 Sep 1;111(3):470-1

Grant WB. Lower vitamin-D production from solar ultraviolet-B irradiance may explain some differences in cancer survival rates.  J Natl Med Assoc.  2006 Mar;98(3):357-64.

Gordon CM, Feldman HA, Sinclair L, et al.  Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers.  Arch Pediatr Adolesc Med.  2008;162[6]:505-512.

Health Canada, Vitamin D and Calcium: Updated Dietary Reference Intakes: http://www.hc-sc.gc.ca/fn-an/nutrition/vitamin/vita-d-eng.php

Holick MF.  Calcium and Vitamin D.  Diagnostics and Therapeutics.  Clin Lab Med.  2000 Sep;20(3):569-90

Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006

Mar;81(3):353-73

Hypponen E, Laara E, Reunana A, Jarvelin MR, Virtanen SM.  Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study.  Lancet.  2001;358:1500-3.

Ingraham BA, Bragdon B, Nohe A.  Molecular basis of the potential of vitamin D to prevent cancer.  Curr Med Res Opin.  2008;24:139-49.

Laaksi I, et al.  An association of serum vitamin D concentrations <40nmol/L with acute respiratory tract infection in young Finnish men.  Am J Clin. Nutr.  2007 Sep;86(3):714-7.

Mayo Clinic Information Sheets: www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind”>vitaminD

Dr. Mercola website: http://articles.mercola.com/sites/articles/archive/2004/03/31/cancer-sunlight.aspx

Merlino LA, Curtis J, Mikuls TR, et al.  Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study.  Arthritis Rheum.  2004;50:72-7.

Munger KL, Levin Ll, Hollis BW, Howard NS, Ascherio A.  Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis.  JAMA.  2006 Dec 20;296(23):2832-8.

Robsahm TE, Tretli S, Dahlback A, Moan J.  Vitamin D(3) from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway).  Cancer Causes Control.  2004;15:149-58.

Wagner CL, Greer FR: American Academy of Pediatrics Section on Breastfeeding: American Academy of Pediatrics Committee on Nutrition.  Prevention of rickets and vitamin D deficiency in infants, children, and adolescents.  Pediatrics 2008;122:1142-52.

Webb AR, Kline L, Holick MF.  Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin.  J Clin Endocrinol Metabl.  1988;67:373-8.

Zella JB, DeLuca HF.  Vitamin D and autoimmune diabetes.  J Cell Biochem.  2003;88:216-22