General Health

Preventing the ignored endemic of Vitamin D deficiency

With the increase in medical awareness, Vitamin D is attracting a lot of social media and commercial advertisements and the general population’s attention. Earlier it was only known for its bone health benefits, but emerging science reveals a non-skeletal benefit for several other health outcomes. Slowly with a renewed interest in the nutrient vitamin D, it is getting established that it is a micronutrient that is needed for optimal health throughout the whole life.

Well-known vitamin D deficiency, rickets has been conquered with advanced medical facilities. As per scientific reports, this is just the tip of the iceberg with the massive vitamin D deficiency epidemic. Most of the time symptoms of Vitamin D remain unknown and mistaken for stress and exertion. It remains undiagnosed for years and becomes chronic and detrimental as osteoporosis, fractures, depression, autoimmune diseases and lifestyle diseases.

Vitamin D deficiency is a widely prevalent condition among patients in both symptomatic and asymptomatic spectrum. With the lack of routine testing, there exists an unknown population deficient in Vitamin D leading to an unexplained loss of quality of work and increased susceptibility to various other diseases.

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The prevalence of vitamin D deficiency is 70%–100% amongst the general population in India. Despite such a high prevalence, it remains largely undiagnosed and untreated. It is the need of this generation to acquire appropriate awareness about VDD and proactively prevent its associated complications.

What are the functions of Vitamin D? 

It is also known as the “sunshine vitamin” and is very unique among all other vitamins because it can be obtained through sun exposure in addition to food intake. Active vitamin D functions as a hormone, and its main biologic function is to maintain serum calcium and phosphorus concentrations within the normal range by enhancing the efficiency of the small intestine to absorb these minerals from the diet. When dietary calcium intake is inadequate to satisfy the body’s calcium requirement, Vitamin D, along with parathyroid hormone (PTH), mobilizes calcium stores from the bone. In the kidney, Vitamin D increases calcium reabsorption and regulates the functions of over 200 genes and is essential for growth and development.

Vitamin D status depends on the production of vitamin D3 in the skin under the influence of radiation from the sun and vitamin D intake through diet or vitamin D supplements. Usually, 50 to 90% of vitamin D is produced by sunshine exposure to the skin and the remainder comes from the diet. The natural diet, most humans consume, contains little vitamin D. Traditionally the human vitamin D system begins in the skin, not in the mouth

Vitamin D comprises a group of fat-soluble compounds that are essential for maintaining the mineral balance in the body. The vitamin D synthesized is called ‘cholecalciferol’ (vitamin D3). There are two forms of vitamin D. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol).

A sufficient intake of vitamin D (calciferol) is important as it helps the body to –

  • Maintain healthy blood levels of calcium and phosphorus
  • Absorbs calcium and makes it available to bones
  • Build and maintain healthy bones, teeth, and bone mineral density
  • Control cell division and specialization
  • Assists manage diabetes, hypertension, and lung diseases
  • Provides healthy immunity
  • Helps the body work efficiently
  • Improves muscle function and strength
  • Prevents detrimental effects of falls and fractures and allows speedy recovery
  • Avert dry skin and skin diseases
  • Necessary for overall optimal health because of its role in the metabolic function of the pancreas, brain, liver, heart, thyroid, kidney, blood clotting and almost all other organs as its receptor is found in almost all cells of the body

What is Vitamin D deficiency?

It is characterized by inadequate mineralization or by demineralization of the skeleton. Among children, vitamin D deficiency is a common cause of bone deformities known as rickets. In adults lead to a mineralization defect in the skeleton, causing osteomalacia, and induces secondary hyperparathyroidism with consequent bone loss, muscle weakness, falls, fractures and osteoporosis.

Chronic Vitamin D deficiency in adults is associated with vague skeletal ache and pain. Vitamin D3 deficiency can develop into obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neurodegenerative diseases including Alzheimer’s disease.

Also contributes to the development of cancers, especially breast, prostate, and colon cancers. Current research indicates vitamin D deficiency plays a role in causing seventeen varieties of different cancers as well as heart disease, stroke, autoimmune diseases, birth defects, and periodontal disease.

Symptoms of Vitamin D deficiency

Unfortunately, symptoms of vitamin D deficiency are vague and sometimes remain asymptomatic. It can be difficult to ascertain the difference between vitamin D deficiency and signs of poor nutrition, stress and a sedentary lifestyle. Hypovitaminosis D is one of the common causes of several non-specific musculoskeletal pain.

  • Fatigue, headache, skin rashes, loss of energy and chronic pain
  • Peeling of nails and skin rashes
  • Muscle pain, neck pain, aching bones, and frequent fractures
  • Lower back discomfort, sprain or jerk while lifting heavy items
  • Moodiness, depression and feeling low
  • Acid reflux and improper digestion and bowel movement
  • Insomnia, sleep apnea and other sleeping disorder
  • Frequent infections, seasonal flues, colds, and other immune system-related diseases
  • Excessive perspiration

Causes of Vitamin D deficiency 

Vitamin D deficiency is widespread throughout the lifecycle right from childhood to the elderly.

Children

  • Breastfeeding without vitamin D supplementation
  • Inadequate sun exposure

Adults

  • Less sun exposure
  • Ageing is associated with lower absorption of vitamin D
  • Increased demand and insufficient intake of vitamin D during pregnancy and lactation
  • Malabsorption syndrome
  • Drugs that activate steroids
  • Obesity and overweight conditions
  • Kidney diseases
  • Thyroid hormone imbalance and linked diseases
  • Granulomatous disorders and some lymphomas
  • Excessive usage of sunscreen and sunblock creams

What are the lifestyle and dietary steps to prevent Vitamin D deficiency?

A healthy disciplined lifestyle can help prevent the slow progression of vitamin D and associated calcium deficiency. Though the body can produce Vitamin D naturally through sunlight, it still has to rely on external sources to fulfil the requirement.

Healthy tips 

  • Include a balanced diet and Vitamin D food sources like oil-rich fish, eggs, and dairy products
  • Also, look for Vitamin D fortified cereals and spreads, but use under experts’ advice
  • Make sure to spend 20 mins under the sun ( Before noon) daily
  • Add 30 minutes of physical activity to the daily schedule
  • Stop excessive use of sunblocking sunscreens and creams and allow sunrays to initiate Vitamin D production
  • Check Vitamin D regularly while going for annual health check-ups especially post 30
  • In case of deficiency, consult an expert and start supplementation immediately
  • Reduce weight in case of obesity and maintain optimum weight
  • Drink adequate water and healthy fluids throughout the day
  • Never ignore symptoms and consult the doctor without delay

Foods to be avoided

  • Reduce intake of fried fatty foods, salt, sugar and other sugary products and foods that are enriched with saturated fats
  • Limit high intake of caffeine as it interferes with the absorption of vitamin D
  • Restrict alcohol consumption and cigarette smoking

Conclusion 

Vitamin D deficiency (VDD) is a global health problem but India is one of the worst affected nations in terms of the (VDD) pandemic. The deficiency is well known among all age groups. It is very crucial to educate the masses about the unknown symptoms and benefits of Vitamin D. Dedicated exponential continuous efforts are required to improve the consciousness regarding this ‘SILENT DISEASE’ with an endemic incidence and life-threatening outcomes.

References 

www.nutri-facts.org

⦁ N Engl J Med 2007;357:266-81

⦁ British Nutrition Foundation Nutrition Bulletin, 39, 322–350

⦁ International Journal of Health Sciences, Qassim University, Vol. 4, No.1, (January 2010/Muharram 1431H)

⦁ Pediatrics and Neonatology (2019) 60, 237e244

⦁ J Nutr Health Food Eng. 2017;6(3):86. DOI: 10.15406/jnhfe.2017.06.00202

⦁ Indian Journal of Orthopaedics (2020) 54 (Suppl 1):  S183–S187

Author

Aparna Das Parmar

Aparna Parmar has over 8.5 years of rich experience in the field of nutrition and healthcare and is currently a corporate nutritionist.

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