Vitamin D deficiency a worry in India

In developed countries, vitamin D is added to foods through fortification. To get minimum required levels of vitamin D in the diet, a person needs to drink at least 10 glasses of vitamin D fortified milk every day. Ideally, a diet that includes dairy, fish and egg yolk coupled with adequate exposure to sunlight should prevent vitamin D deficiency.

According to current recommendations, to prevent vitamin D deficiency, one should spend 15 to 20 minutes in the sunshine every day, with 40 per cent of the skin surface exposed between 11 am and 3 pm. These radiations cannot penetrate glass, therefore, the body does not generate vitamin D while sitting in a car or indoors. People with dark skin pigmentation may need 20-30 times more exposure than fair-skinned people. Sunscreens, commonly advised for prevention of skin cancers, can seriously impair absorption of vitamin D. Even weak sunscreens, with a sun protection factor of 8, reduce the body's ability to generate vitamin D by

95 per cent. Obesity also impairs vitamin D utilisation in the body. Obese people need twice the amount of vitamin D as healthy people.

It is impossible to generate too much vitamin D from sunlight exposure as the body self-regulates its needs. Most experts agree that the minimum daily intake of vitamin D should be at least 800-1,000 IU per day to maintain a healthy concentration of 25 (OH) D in the blood. In India, there are no policies for fortification of vitamin D, getting enough of this vitamin poses a challenge. If adequate sunshine exposure is not possible, supplements must be taken strictly under medical supervision. Chronic vitamin D deficiency requires supplementation and sunlight exposure to rebuild bones and nervous system.

Long-term strategies to address this deficiency should include public education, national health policies for screening and prevention through food fortification, and treatment with vitamin D supplementation.

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