The sunshine vitamin
DR ARPANA NEOPANE
PROMINENT among the essential fat soluble vitamins that our body requires is vitamin D, necessary in order to maintain healthy bones and muscles. Bone strength largely depends on the balance of calcium, phosphorous, and other tissues in our bones, and vitamin D facilitates the absorption of calcium from food, and prevents loss of the same from urine. Apart from making bones strong and tensile, vitamin D is also necessary for muscle growth and power. It is synthesised in the skin from cholesterol with the help of sunlight— ultraviolet B-rays, to be specific. Lack of exposure to sunlight therefore leads to significant deficiency of vitamin D—in spite of consuming food containing it—thereby causing various problems. Many studies have shown a recent increase in the incidence of vitamin D deficiency among people. In a study done by the American Endocrine Society, for instance, this vitamin deficiency was found to be common in all age groups, although the risk was higher for the elderly, obese individuals, exclusively breastfed infants and those who enjoy limited sun exposure. Although deficiency has very clear consequences like low blood levels and softening of bone, even insufficiency itself can lead to several issues like the stiffening of arteries, hypertension, insulin resistance, diabetes, cancer, as well as autoimmune diseases. Vitamin D deficiencies may present in a number of forms. Severe deficiency in children leads to rickets, a condition characterised by the softening, loosening and deformity of bones in early childhood. In adults, severe deficiency leads to a condition called osteomalacia, marked by soft bones, spontaneous fractures, and severe bone and muscle pain, along with demineralisation of the bone—called osteopenia and osteoporosis. But because presentation of symptoms are rather vague, requiring a high index of suspicion, the insufficiency of this vitamin is not usually clinically evident. Features include pain in limb muscles, body ache, easy fatigability and depression. As the bone is soft, the slightest of weights or impact could lead to fractures, and similarly, overuse of muscles, however slight, may also lead to severe pain and restricted movement. Inevitably, the patient is reduced to a person who is always in pain, and because such factors do not show up during the usual examination processes, these cases are sometimes deemed psychiatric. The only way the condition can be confirmed is if the vitamin level in one’s blood is checked specifically. So why are more people becoming vitamin D deficient of late? One could blame the indoor culture and modern lifestyle, for one. Although a lot of people can be found expounding the bad effects of sunlight, and pressing the use of sunscreen, we must remember that some amount of sunlight is necessary so our bodies can synthesise the vitamin. Experts recommend that an exposure of about 30-45 minutes in length, especially of the face and hands, preferably between 9 and 10 am for several days of week, is ideal. It was for this very reason that ancient Greek athletes trained naked in the mornings, something that although cannot be recommended today, was actually very beneficial. Darkskinned people need longer exposure, of course, because the additional melanin in their skin can act as a sunscreen. So how much vitamin D do we need daily? The European Union’s Scientific Committee on Food lists 2,000 IU per day as the safety cut-off, as dœs the US Food and Nutrition Board. But the latest science suggests most adults should be taking more. At present, the daily recommended dose for non-deficient persons is 200-400 IU. Food rich in vitamin D comprise of meat, eggs, mushroom, fish oil, fortified foods and dairy products. Buff liver is one of the best sources of vitamin D. Since the deficiency of vitamin D leads to many eventual health issues, we need to acknowledge its importance in our diet, and the need for some regular amount of sun exposure. Of course, going overboard has its own downsides; too much vitamin D can lead to a condition known as hypervitaminosis D, wherein patients suffer nausea, vomiting, weakness, and diarrhœa. It is thus important to monitor one’s blood level regularly to see what kind of dose one requires at any given point in time so one can always maintain a healthy balance.
PROMINENT among the essential fat soluble vitamins that our body requires is vitamin D, necessary in order to maintain healthy bones and muscles. Bone strength largely depends on the balance of calcium, phosphorous, and other tissues in our bones, and vitamin D facilitates the absorption of calcium from food, and prevents loss of the same from urine. Apart from making bones strong and tensile, vitamin D is also necessary for muscle growth and power. It is synthesised in the skin from cholesterol with the help of sunlight— ultraviolet B-rays, to be specific. Lack of exposure to sunlight therefore leads to significant deficiency of vitamin D—in spite of consuming food containing it—thereby causing various problems. Many studies have shown a recent increase in the incidence of vitamin D deficiency among people. In a study done by the American Endocrine Society, for instance, this vitamin deficiency was found to be common in all age groups, although the risk was higher for the elderly, obese individuals, exclusively breastfed infants and those who enjoy limited sun exposure. Although deficiency has very clear consequences like low blood levels and softening of bone, even insufficiency itself can lead to several issues like the stiffening of arteries, hypertension, insulin resistance, diabetes, cancer, as well as autoimmune diseases. Vitamin D deficiencies may present in a number of forms. Severe deficiency in children leads to rickets, a condition characterised by the softening, loosening and deformity of bones in early childhood. In adults, severe deficiency leads to a condition called osteomalacia, marked by soft bones, spontaneous fractures, and severe bone and muscle pain, along with demineralisation of the bone—called osteopenia and osteoporosis. But because presentation of symptoms are rather vague, requiring a high index of suspicion, the insufficiency of this vitamin is not usually clinically evident. Features include pain in limb muscles, body ache, easy fatigability and depression. As the bone is soft, the slightest of weights or impact could lead to fractures, and similarly, overuse of muscles, however slight, may also lead to severe pain and restricted movement. Inevitably, the patient is reduced to a person who is always in pain, and because such factors do not show up during the usual examination processes, these cases are sometimes deemed psychiatric. The only way the condition can be confirmed is if the vitamin level in one’s blood is checked specifically. So why are more people becoming vitamin D deficient of late? One could blame the indoor culture and modern lifestyle, for one. Although a lot of people can be found expounding the bad effects of sunlight, and pressing the use of sunscreen, we must remember that some amount of sunlight is necessary so our bodies can synthesise the vitamin. Experts recommend that an exposure of about 30-45 minutes in length, especially of the face and hands, preferably between 9 and 10 am for several days of week, is ideal. It was for this very reason that ancient Greek athletes trained naked in the mornings, something that although cannot be recommended today, was actually very beneficial. Darkskinned people need longer exposure, of course, because the additional melanin in their skin can act as a sunscreen. So how much vitamin D do we need daily? The European Union’s Scientific Committee on Food lists 2,000 IU per day as the safety cut-off, as dœs the US Food and Nutrition Board. But the latest science suggests most adults should be taking more. At present, the daily recommended dose for non-deficient persons is 200-400 IU. Food rich in vitamin D comprise of meat, eggs, mushroom, fish oil, fortified foods and dairy products. Buff liver is one of the best sources of vitamin D. Since the deficiency of vitamin D leads to many eventual health issues, we need to acknowledge its importance in our diet, and the need for some regular amount of sun exposure. Of course, going overboard has its own downsides; too much vitamin D can lead to a condition known as hypervitaminosis D, wherein patients suffer nausea, vomiting, weakness, and diarrhœa. It is thus important to monitor one’s blood level regularly to see what kind of dose one requires at any given point in time so one can always maintain a healthy balance.
Dr Neopane
is a Senior Consultant Physician
at Norvic International Hospital vitamin
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