Although the general awareness about Vitamin D is on the rise, there are many questions that come to mind- How is Vitamin D linked to sunshine, how much sunlight do we need, why is it important to get adequate Vitamin D for good health and what foods are recommended? People are also curious about just how common is Vitamin D deficiency, what are the early warning symptoms, and how their doctor may diagnose and treat it.
The skin produces 90% of the body's vitamin D needs, under Ultraviolet-B radiation from sunlight. Hence, inadequate sunlight exposure or insufficient absorption of UV-B rays by the skin lead to deficiency. In India, inadequate exposure to sunlight results from indoor lifestyle in urban areas and wearing head coverings. Besides, our darker skin contains more melanin pigment , which reduces the skin's ability to make vitamin D. In addition, air pollution contributes by reducing the amount of solar UV-B that reach the earth’s surface, apart from deterring people from being outdoors. An Indian study confirmed that inhabitants of polluted areas are at higher risk of deficiency.
Fair-skinned individuals require 20 minutes of exposure to direct sunlight three to four times a week in order to enable the skin to make adequate vitamin D, whereas those with darker skin (more melanin pigments) require 30 to 40 minute exposure three to four times a week. It is recommended to expose 18% of the body, that is arms without long sleeves and face without sunscreen. The ideal exposure time is between 11 am and 2 pm.
However, in order to make Vitamin D from sunlight, well-functioning liver and kidneys are essential. If the function of these organs is compromised, as happens with aging, additional Vitamin D supplements may be needed under a doctors supervision
Vitamin D is primarily essential for strong bones, because it helps the body use dietary Calcium. But increasingly, research is revealing its importance in protecting against a host of health problems, including Diabetes, hypertension and even multiple sclerosis and some cancers.
Notably, dietary sources and vitamin D fortified foods make only a small contribution to body requirements. Very few foods in nature contain vitamin D. The flesh of fatty fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Some mushrooms provide vitamin D2 in variable amounts. Packaged foods such as milk, ready-to-eat breakfast cereals, orange juice, yogurt and margarine are being increasingly fortified with added vitamin D,
A study showed a high prevalence of 70% (male 64%, females 76%) amongst 25-35 year-olds, with urban populations being more affected than rural. Vitamin D is a great leveller, and deficiency is seen across all age groups, genders and socio-economic classes.
Vitamin D deficiency may often go unrecognized, and many who see their doctor for aches, pains and fatigue, end up being misdiagnosed as fibromyalgia. In actual fact vitamin D deficiency retards calcium incorporation into the skeletal collagen matrix, resulting in aching bones. Chronic pain And muscle weakness may actually be very subtle, especially in the beginning. Remarkably, symptoms are being relieved when Vitamin D is given as doctors are beginning to take notice.
Vitamin D receptors are found all over the body, including the immune cells. Consequently, Vitamin D deficiency leads to lower immunity and a higher susceptibility to flu. High blood pressure and depression are also linked to Vitamin D deficiency, and maintaining normal to optimal levels of Vitamin D is becoming part of the treatment regimens for these common medical conditions.
Doctors would make the Diagnosis is made by a Blood test, with values below 20 ng/ml being considered deficient, 20-30 ng/ml insufficient and 50-70 ng/ml optimal. In individuals who are diagnosed with Vitamin D deficiency, doctors would aim at optimising the values, which can be most reliably achieved by low cost supplements, given in doses titrated by blood levels, plus adequate exposure to the midday sun.
Increase in Vitamin - D deficiency among young adults.
(Published in Economic Times - by Invite, on 27 December 2016)
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