Should we worry about Vitamin D?

For most of us, it is hard to not notice the recent hype about the rampancy of vitamin D insufficiency or deficiency among Indians. Some may have already found that they are deficient and probably quite badly so. So what has happened in the recent past for this sudden increase in numbers? Are these numbers right? Should we worry? What about children?

The fact is it is true! Apparently, Vitamin D deficiency is the most under diagnosed and under treated deficiency in the world! An article published in a scientific journal this February talks about widespread prevalence of vitamin D deficiency (70-100%) in the general population across socioeconomic strata, age and gender in our country. The paper states that even seeming healthy adults and adolescents seem to be deficient. So what is fuelling this? Vitamin D can be produced in the body if there is adequate exposure to sunlight; to be more precise the UV ‘B’ rays of the sun. It is produced in the skin and then turned into the “active forms” in two steps by the liver and kidney. Sunlight alone can do the job, but the other way the body can get vitamin D is through diet. But unfortunately foods that are good sources are not something which we eat regularly; for example- eggs, beef liver, fatty fish like salmon, mackerel and tuna. Another option is cod liver oil capsules. For vegetarians it is a bigger challenge! Also very few milk and dairy products are

enriched with vitamin D unlike countries in the west. So sunshine is the best bet to get vitamin D, but what has happened as lack of abundant sunshine is not the problem!

Change in lifestyle- kids are spending more time indoors, increased screen time,

and adults in the family are spending more time in air conditioned cars, offices

and gyms –hence not much exposure to sunlight.

Sports/Play not taken seriously – sports or free play is the first to be sacrificed

for academic pursuits or tuitions. Physical education class which in most schools

is only twice a week is borrowed for finishing the academic year’s portions

especially in higher classes.

Social Stigma -added to the above is the cultural /social stigma attached to dark

skin. There is excessive use of sunblock and you also come across teen girls

going to the extent of covering exposed limbs to avoid sunlight thereby

completely avoiding positive effects of sunshine.

Not enough Calcium – vitamin D and calcium work together for maintaining

good bone health. In most instances the calcium intake is insufficient and

children/adult do not meet the required servings (five) of milk and milk products

daily.

Obesity – another downside of being obese is vitamin D insufficiency, as it gets

deposited in the fat stores and is not available for use by the body.

Not found in a variety of foods -as mentioned above dietary sources are fairly

limited unlike other vitamins, hence it is challenging to get this vitamin through

diet.

Cost – even if the doctor requests this test, cost could be one reason why there

could be some procrastination – tests for vitamin D costs around 1500/-

So what should we do? Outdoor and healthy lifestyle – if your family spends enough time outdoor

playing or in other activities (minimum 20-30 minutes) everyday, consume

sufficient dairy products, are in good health – not falling sick often, children do

not look fragile, growing up well (right height/weight for their age) then you can

relax.

Talk to your doctor – some doctors catering to the higher income group do

request for vitamin D testing. It is still a bit controversial for doctors to order

this test as the symptoms are hidden, can be missed easily in a routine clinical

exam. Unless the patient is articulate about his condition or the doctor is a

family physician and is aware of the lifestyle of the patient, this test may not be

prescribed. So when you visit your general physician do have a discussion on

the possibility of having vitamin D insufficiency and see if a blood test is

required.

Blood test levels –there is still debate in the scientific world on the levels

required for optimal health. In general, levels below 30 nmol/L (12 ng/mL) are

too low for bone or overall health, and levels above 125 nmol/L (50 ng/mL) are

probably too high. Levels of 50 nmol/L or above (20 ng/mL or above) are

sufficient for most people.

Right meat – if you family does eat meat do try including fatty fish and eggs

More is not necessarily good – If any family member is found

insufficient/deficient – follow the doctor’s instruction for the course strictly.

Vitamin D is a fat soluble vitamin and excess of this vitamin cannot be disposed

by the body and can result in toxicity

Sunshine – encourage outdoor activities for the family –gardening, walks,

running, swimming, evening play – do not use sun block unless you or your

child are spending hours out in the sun. People with darker tone take a longer

time to make this vitamin!

There is emerging evidence indicating poor vitamin D status could affect health beyond just bone health – diabetes, cancer, blood pressure etc. But for now ensuring our children have the right bone density and as adults we don’t fall prey to osteoporosis – it is time we paid attention to the sunshine vitamin!

Bio: Meera Srinivasan is on the ParentEdge Editorial Panel. She has a background in Nutrition and Food Technology and comes with more than 15

years of experience in the food industry. As an involved parent of a 12-year old girl, she is passionate about increasing awareness on nutrition and health among children and parents.

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