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One in two may not have enough vitamin D

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Vitamin D does more than build strong bones, it regulates the functioning of more than 200 genes in the human body. Research shows more than half the world’s population may not get enough vitamin D. And many may have no idea.

A little girl being given a piggy back lift by her mother during a walk in the countrysideThe authors of a study published in the Journal of Pharmacology and Pharmacotherapeutics wrote vitamin D deficiency affects almost 50 percent of the population worldwide. A separate study published in the International Journal of Health Sciences labeled vitamin D deficiency as an “ignored epidemic.”

Vitamin D deficiency is a nutritional issue

Vitamin D is necessary for calcium metabolism and strong bones. Being vitamin D deficient is not considered a chronic condition. Rather it is a nutritional issue of getting enough vitamin D through diet, supplements or sunlight.

The body creates vitamin D with exposure to sunlight. Vitamin D can also be absorbed through various foods, such as milk. To receive an adequate amount of vitamin D from the sun, you would need spend between 15 and 20 minutes daily in the sunshine, with nearly half of the skin surface exposed.

When there is a vitamin D deficiency, the calcium stored in bones is used to satisfy the body’s calcium requirement.

Vitamin D deficiencies become more apparent as a person gets older, according to John Moore, DO, FAAFP, Aetna’s medical director for the Northeast Region. The body’s bones are not static, meaning they are breaking down and rebuilding all the time. “You’d think bones are solid and don’t change,” Moore said, “but the truth is microscopically, bone is always breaking down and rebuilding.”

For children, vitamin D deficiency is a common cause of bone deformities known as rickets. In adults, it can result in weaker bones.

“When calcium levels go down, certain hormone levels go up which then tells your bones to release more calcium,” Moore said. “It has a mild effect, but it does literally accelerate the break down of your bones, creating a bit of a vicious cycle.”

plant trying to growIn the U.S. differences in regional climates can increase the risk of becoming vitamin D deficient. “In the northern tier states, New England, the upper Midwest and Alaska, there tends to be a lack of vitamin D in the population,” according to Edmund Pezalla, M.D., M.P.H., vice president and national medical director of Pharmaceutical Policy and Strategy at Aetna. “Due to the colder climates, people wear more clothes so it blocks sunlight.”

A study by the International Journal of Health Sciences found that despite the amount of sunlight in the Middle East, the region has one of the highest rates of vitamin D deficiencies in the world.

Ironically, studies published in the international medical journals suggests vitamin D deficiencies are also common in the parts of the world that receive copious sunlight. For example, a study by the International Journal of Health Sciences found that despite the amount of sunlight in the Middle East, the region has one of the highest rates of vitamin D deficiencies in the world.

Dr. Sneh Khemka, M.D. and senior vice president of Aetna’s Population Health, notes that the culture and diet in India can have an impact on the rate of vitamin D deficiencies in that region.

The CDC says a person’s race and ethnicity is a significant factor in determining the likelihood of being vitamin D deficient.

“Women spend a lot of time indoors, wear restrictive clothing and socially find it unacceptable to be in the sun because dark skin denotes a lower caste,” Khemka said. “Couple that with the issue that chapatti flour decreases the absorption of vitamin D in the gut and you have high levels of vitamin D deficiency and rickets.”

Achieving the ideal level of vitamin D

A Vitamin D deficiency is detected by a blood test. For those curious about vitamin D levels, ask a physician during an annual check up. If someone is found to be vitamin D deficient, they’ll likely be prescribed supplements by a physician or could be advised to make dietary changes or spend more time in the sun. Foods rich in vitamin D: milk, cheese, eggs, yogurt, orange juice, tuna fish and salmon.

Vitamin D supplements can also be purchased over-the-counter, but both Moore and Pezalla said to be cautious. Vitamin D, as well as vitamins A, K, and E, are fat soluble. That means you don’t shed those vitamins if you get too much. (Other vitamins, such as vitamin C, are water soluble. If too much is in the body, the excess is eliminated through urination.)

Moore cautioned against taking too much vitamin D. Taking high doses of the vitamin can lead to high calcium levels in the blood, which can result in confusion, vomiting, weakness and other symptoms. Chronic high dosages can lead to more severe complications, such as kidney stones and loss of bone strength.

Moore advises not exceeding a health professional’s recommendation, which is normally no more than 100 micrograms daily for healthy adults and children 9 to 18 years old.