Vitamin D Deficiency - Literature review Example

Vitamin D Deficiency There are increasing problems associated with vitamin D in the world and most specifically in the United Kingdom. Most of the problems have been associated with a deficiency of vitamin D. Hence, the lack of vitamin has been declared as a pandemic in many countries of the world. The problems arise when the body is unable to make the required amount of the vitamin. Various issues contribute to the body being unable to make or access the required amount of the vitamin. First, inaccessibility to sunlight that is the major source of vitamin D can lead to deficiency. The problem arises as the transfer of solar radiation to the skin is stopped or through interference with the penetration of UVB radiation in the skin (Holick & Chen 2008, P. 1081). Hence, the problems result to people getting very little sunlight on their skin. Evidence has been documented that indicates that most part of northern Europe can rely on the sun to meet their needs for enough vitamin D. For example, in the United Kingdom, the recommended daily intake (RDA) is 400 IU/day in adult (Macnair 2012). Achievement of the required amount of sunlight has been a challenge in the region. The problem arises because in the summer, there is limited exposure to sunlight, and this only generates about 2000 IU of the vitamin (Macnair 2012). The other challenge to getting the optimal amount of sunlight in the body is the colour of the skin. The colour of the skin plays a significant role in getting the optimum amount of the sunlight. Moreover, the colour of the skin determines the level of exposure needed in getting the optimum dose. For example, the elderly and dark-skinned individuals require more exposure to the sunlight (Macnair 2012). Melanin has been shown to be extremely efficient in absorbing of the UVB radiation and hence increased skin pigmentation has been shown to be a problem due to reduced vitamin D3 synthesis (Holick & Chen 2008). Moreover, geographical location has been shown to be a problem in accessibility of vitamin D. In the UK, majority of the country is above the latitude that allows proper exposure to sunlight. As noted by Macnair (2012), nearly half of the UK population is exposed to an insufficient level of sunlight in at least six months. As a result, there has been serious level of vitamin deficiency in the region. There has also been a change in lifestyle that further aggravates the problems. For example, most of the older people stays indoors while other uses sunscreen to avoid skin damage leading to a higher level of insufficiency in the uptake of sunlight. The other notable problem to vitamin D is lack of diets with enough level of vitamin D. In fact, fewer natural foods contain enough level of vitamin D. The main diet source for this vitamin is oily fish that has up to 400 IU per 100gm (Macnair 2012). However, only people have more than one serving a week. There is also negligible amount of vitamin in some vegetables such as wild mushrooms. A survey conducted has also indicated that dietary intake is about 80-160 IU/day (Macnair 2012). Vitamin D provides immense benefits to the human body in relation to health. The first significant role is in the prevention of fractures in the elderly population. It has been found that vitamin D supplementation in the population helps greatly in ensuring there are no fractures. The favourable results were after the individual involved took sufficient dose of the vitamin. The survey was done on 40,000 elderly people majority of which were women found that a high intake of vitamin D supplements led to a reduction in hip and non-spine fractures by 20% (Harvard School of Public Health (HSPH) 2014). Secondly, vitamin D plays a significant role in the stability of the muscles. The vitamin leads to increased muscle strength that helps in reducing falls in the older population (Battault et al. 2013). Weakness in muscles has been associated with disability and death in the older people. An analysis of multiple studies indicated that taking the correct amount of dose of vitamin D per day led to lowered rate of fall at 19% (HSPH 2014). Moreover, there has been a correlation between the level vitamin D and risk of heart diseases. For example, studies have shown that a reduced amount of vitamin in the body has a strong association with the emergence of heart disease. A follow-up study done by health professionals on 50,000 healthy men concluded that those that were deficient in vitamin D had a higher chance of getting heart attack (HSPH 2014). Other studies have also led to the conclusion that low vitamin D levels led to increased risk of heart failure, cardiac arrest, stroke, and cardiovascular death. The vitamin helps in the prevention of heart diseases in various ways. It has been found that vitamin D plays a vital role in controlling blood pressure and prevention of damage to the arteries. Vitamin D is also thought to play a role in some cancers. Researchers have noted a strong link between colon cancer and geographical location (HSPH 2014). People living in higher altitudes, such as northern Europe, depict high rates of death from colon cancer that those in lower altitudes (HSPH 2014). The association has been put forth based on exposure to solar radiation. The sunrays in the higher altitudes are usually weak and hence people have a low level of vitamin D in such areas. The outcome has led to the conclusion that lower vitamin D levels may lead to increased risk of colon cancer (Battault et al. 2013). In addition, the vitamin plays a significant role in the development of immunity in the body. The immunity is achieved as the vitamin takes up the role of regulating the immune system. The association to immunity has been documented through analysis of some of the human diseases. For example, an analysis done on multiple sclerosis (MS) indicates that it is higher in far north as compared to the equator (HSPH 2014). In the northern part, there is a chronic deficiency of the vitamin as compared to the southern parts. A study done on white males and females found that those with a high level of vitamin had reduced the chance of developing MS (HSPH 2014). Similarly, those with low level of vitamins had a higher chance of developing MS. The same correlation has been found in diseases such as Type 1 Diabetes, flu, and the common cold. There are various symptoms associated with vitamin D deficiency. Most of the symptoms are seen by considering the health of an individual involved. One f the significant sign associated with vitamin D deficiency is the bone weakness (DeBruyne, Whitney & Pinna 2007). The bones in the body become frail, and the individual involved is unable to carry out difficult task. Mostly, a decreased level of the vitamin is associated with risk of fractures in the older adults (HSPH 2014). Moreover, the elderly are also more prone to fall due to weak bones and muscles. Additionally, lack of the vitamin is associated with reduced muscle strength and size. The decrease is associated with a reduced level of vitamin in the muscle and nerve tissue. One of the conditions associated with above symptoms if Osteomalacia. The condition is commonly found on elderly that have diet low of vitamin D, poor absorption of the vitamin, and those with reduced exposure to the sunlight (DeBruyne, Whitney & Pinna 2007). Moreover, inadequate vitamin D is recognised as a risk factor in osteoporosis (DeBruyne, Whitney & Pinna 2007). This is an indication of the reduced bone density in the body. The effect arises due poor absorption of calcium in the body and hence bone remodelling is impaired. Secondly, lack of vitamin D is associated with several symptoms in small children. The most significant sign is the development of rickets. The condition in children is associated with low dietary intake of vitamin D or lack of exposure to the sunlight (DeBruyne, Whitney & Pinna 2007). The condition may also occur on babies that are exclusively fed of breast milk without any supplement. Children that have reduced the amount of vitamin exhibit delayed level of walking. Moreover, the deficiency of the vitamin is also associated with thyroid conditions in a human being. Parathyroid gland may become overactive due to low levels of vitamin D (Oleson, Seidel & Zhan 2013). Studies carried out in the past have demonstrated that vitamin D may help in averting problems associated with the glands and removal of the gland (Mayoclinic 2014). On the other hand, the decreased level of the vitamin is associated with the heart conditions. Numerous studies have associated vitamin D deficiency with the rise of heart diseases (HSPH 2014). The lower level of the vitamin has also been associated with the development of heart's failure, sudden cardiac arrest, and stroke. Additionally, the deficiency is associated with the high number of cancer cases. The most significant symptom is the development of colon cancer in regions believed to receive an inadequate level of sunlight. Hence, lower vitamin D level has been associated with increased risk of colon cancer (HSPH 2014). Moreover, the reduced level of vitamin has been associated with reduced immunity in human beings. Vitamin D level is believed to be lowest during the winter months (Cannell, Vieth, Umhau, et al. 2006). Children that have a low level of the vitamin are most likely to get respiratory infections while adults have frequent cough, cold, and upper respiratory tract infections (HSPH 2014). In addition, the reduced level of the vitamin has also been associated with various discomforts in the body. The main discomfort includes musculoskeletal pain, headache, and fatigue. In a study done in a population, it was found that 58% of individual with this discomfort had vitamin D level below the recommended level (Knutsen, Brekke, Gjelstad & Lagerlov 2010). Knutsen et al. (2010) found that the rate of headache reduced with an increased level of vitamin D. In addition, a reduced level of vitamin D is associated with some chronic diseases. One of the significant diseases is asthma. According to Korn et al. (2013), there has been a close association between subnormal vitamin D levels and asthma. Vitamin D has a favourable outcome to immunity. It is believed that the vitamin has several effects on body immune systems that might play a role in the primary prevention of the asthma (Korn et al. 2013). Various initiatives exist in which accessibility to sources of vitamin D can be improved. First, it is good to note that only a few animal foods can supply significant amount of vitamin D. Therefore, any mean that can improve accessibility to vitamin D is paramount to reduce the incidences of deficiency in the population. One of the significant sources that can improve accessibility is by the use of fortified margarine (DeBruyne, Whitney & Pinna 2007). Substitution of butter with margarine acts as a significant source of the vitamin. Secondly, improvement can also be possible using infant formulas fortified with vitamin D (Allen & Albala 2007). The focus is in ensuring that there is an adequate amount for daily intake as long as the infant consume at least 500 millilitres of formula. The fortification of milk with vitamin D is of the essence as it acts as a guarantee that children will meet their vitamin D needs (DeBruyne, Whitney & Pinna 2007). In addition, it is good to offer infants with vitamin D supplements as breast milk offer less amount of the vitamin. The practice should be adhered to especially when the infant cannot be able to take at least two glasses of milk per day and those that are not regularly exposed to the sunlight. Moreover, this should be also done on infants that are not able to take multivitamin supplements containing at least 5microgras of vitamin D (DeBruyne, Whitney & Pinna 2007). In addition, in some countries accessibility is realised through fortification of breakfast cereals (DeBruyne, Whitney & Pinna 2007). The other ways of ensuring accessibility is through adequate sun exposure. Adequate exposure plays a significant role in ensuring the rate of deficiency is reduced. One should ensure that hands, face, arms, and legs are exposed to sunlight two to three times a week (National Institute of Health 2012). A survey done by vitamin D researchers have noted that approximately 5-30 minutes of sun exposure between 10Am and 3PM at least twice a week led to sufficient vitamin D synthesis in the body parts exposed (Ostelin 2014). The exposure will make the skin produce enough of vitamin D. However; this can be a challenge to people that do not get enough of the sunlight. Therefore, to ameliorate the challenge, such people in higher altitudes can be offered supplements. On the other hand, as older people are less likely to spend time in the sunlight, they should be offered vitamin D supplements (National Institute of Health 2012). The challenges can also be overcome by provision of a healthy diet. The healthy diet should mostly be stressed on young children, dark-skinned, and older people. A balanced diet should contain plenty of calcium and vitamin D. Such diet should include oily fish, eggs, and fortified foods such as cereals (NHS 2013). It is also good to shift the focus on vitamin D deficiency in men. Although vitamin D deficiency affects all genders, there is merging statistics that proves some disparities. In some researches, it has been found to be less prevalent in men than in women. For example, research done by professor Dally noted that 42 percent of women and 27 percent of men living in the southern parts were deficient during summer (Deakin University 2012). The percentage of deficiency also varied during winter-spring with 58% of women as compared to 35 % of men (Deakin University 2012). The percentages are a clear indication that men are less likely to get deficient of the vitamin as compared to women. The difference may be linked to extra responsibilities that are taken by women. For example, women are involved in breastfeeding their young ones. This might be a contributing factor to the variation in the rate of deficiency. On the other hand, there is percentage risk of deficiency associated with a particular gender. In males, for example, it has been found that the prevalence at risk of deficiency ranged between 1%-8% percent (Looker et al. 2011). Moreover, the risk of deficiency has been found to increase with age in men until the age of 30 (Looker et al. 2011). After the age of thirty, there was decreased risk compared with age. In conclusion, it is cleared that vitamin D plays a significant role in the human body. The most significant role is in maintenance of a healthy body by ensuring the body is not prone to health condition. Among the health conditions prevented by the vitamins includes asthma, heart diseases, and colon cancer. On the other hand, the presence of vitamin in a lower amount in the body is devastating. It leads to increased health conditions such as asthma and stroke. Moreover, the children and older adults seem more vulnerable to the deficiency of the vitamin. Hence, there need to be intervention programs such as fortification of foods that can increase accessibility of the vitamin. Further, the governments should take a role of ensuring that factors leading to deficiency are addressed in primary health care set-up. The effect will be a reduction in the number of individuals with a low amount of the vitamin. References Allen, G & Albala, K 2007, The Business of Food, New York: ABC-Clio. Battault, S., Whiting, S., Peltier, S., Sadrin, S., Gerber, G & Maixent, J 2013, ‘Vitamin D metabolism, functions and needs: from science to health claims,’ European Journal of Nutrition, vol. 52, p. 429-441. Cannell JJ., Vieth R., Umhau JC & et al. 2006, ,Epidemic influenza and vitamin D.’ Epidemiology Infect, Vol.134, p.1129-40. 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Korn, S., Hubner, M., Jung, M., Blettner, M & Buhl, R 2013, ‘Severe and uncontrolled adult asthma is associated with vitamin D insufficiency and deficiency,’ Respiratory Research, vol. 14, no. 25, p. 1-8. Looker, A., Johnson, C., Lacher, D., Pfeiffer, C., Schleicher, R & Sempos, C 2011, Vitamin D status: United States, 2001-2006, retrieved 25 August 2014,< http://www.cdc.gov/nchs/data/databriefs/db59.pdf>. Macnair, P 2012, A nation in need of Vitamin D, retrieved 24 August 2014, < http://www.huffingtonpost.co.uk/dr-patricia-macnair/a-nation-in-need-of-vitamin-d_b_1243997.html>. Mayoclinic 2014, Drugs and Supplements Vitamin D, retrieved 25 August 2014, . National Institute of Health 2012, Vitamin D, retrieved 25 August 2014, < http://www.nlm.nih.gov/medlineplus/druginfo/natural/929.html>. NHS 2013, Rickets-Prevention, retrieved 25 August 2014, < http://www.nhs.uk/Conditions/Rickets/Pages/prevention.aspx>. Oleson, C., Seidel, B & Zhan, T 2013, ‘Association of vitamin D deficiency, secondary hyperparathyroidism, and heterotopic ossification in spinal cord injury,’ JRRD, vol. 50, no. 9, p. 1177-1186. Ostelin 2014, Vitamin D, retrieved 25 August 2014, . Read More