The deficiency of Vitamin D is quite common across the country. In 2013, it was estimated that approximately 40 per cent of the Indian population suffered from Vitamin D deficiency. Currently, it has risen to as much as 77 per cent, in both rural and urban areas. This deficiency is particularly prevalent in adults of the 18-30 years age group. Women belonging to the lower social demographic are also more prone to Vitamin D deficiency.
The primary source of Vitamin D is exposure to the sun. However, there are many factors that prevent the majority of the population to get sufficient sun exposure. Modernisation has meant that most people spend the bulk of their time indoors. Moreover, some of the cultural practices like wearing a burqa limit exposure to the sun. The application of sunscreens and increased skin pigmentation limits the production of Vitamin D by the skin. A high level of air pollution is also a contributing factor as it prevents UVB ray transmission.
Dietary habits are also responsible for the vast vitamin D deficiency. Poor dietary habits contribute to a lower intake of Vitamin D as well as calcium. Furthermore, most food rich in Vitamin D is derived from animal sources.
Considering the fact that a majority of people in India follow a vegetarian diet, people usually don’t get sufficient Vitamin D from dietary sources. Even the food products that are widely consumed across the country such as dairy products do not have sufficient proportions of Vitamin D. Fibre-rich food products contain phosphates and phytates, which play a role in depleting Vitamin D stores.
Medical factors like underlying conditions or certain medications can also cause Vitamin D deficiency. Certain health conditions like celiac disease, cystic fibrosis, inflammatory bowel disease, chronic liver disease and gastric bypass can cause malabsorption of Vitamin D. Medications like Carbamazepine, Clotrimazole, Nifedipine etc., can cause activate Vitamin D degeneration. Vitamin D deficiency is also commonly seen in women with multiple pregnancies and successive pregnancies in a short time span.
Some adverse health effects:
• Unexplained pain and weakness in muscles and bones
• Depression and cognitive impairment
• Rickets in children due to reduced bone mineralisation
• Reduced absorption of calcium from diet and increased bone loss in adults
• Higher risk of infections like influenza, tuberculosis
• Higher risk of deranged lipid profile, hypertension, stroke and heart failure
• Increased risk of breast, lung, prostate, colon, pancreas and ovarian cancer
• Increased insulin resistance and type 2 diabetes mellitus
• With existing medical conditions, it can increase morbidity in Systemic Lupus Erythematosus and worsen Rheumatoid arthritis.
• Loss of pregnancy
Common sources:
The primary source ultraviolet B (UVB) rays. Around 50-90 per cent of Vitamin D is absorbed by the skin through sunlight and the rest comes from dietary sources. Around 20 minutes of daily exposure to the sun with around 40 per cent of skin being exposed to sunlight can help prevent Vitamin D deficiency. The ideal time to get sunlight is 11 am to 3 pm. Skin’s synthesis of Vitamin D is also affected by factors like pollution, ageing skin, ozone layer, melanin pigmentation and latitude.