Vitamin D Deficiency

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Vitamin D deficiency, also called Vitamin D hypo-vitaminosis, coupled with an unbalanced diet cause medical problems in approximately 2/3 of people living in the United States. 

While statistics from reputable sources differ somewhat, all are in agreement that most Americans are deficient in Vitamin D.

According to the Centers for Disease Control and Prevention (CDC), more than half of the general population is deficient in Vitamin D, regardless of their age. 

Approximately 70% of elderly Americans and 90% of Americans of color lack normal levels of Vitamin D.

According to the Merck Manual,  which is used by medical students and professionals, "Almost no one consumes enough vitamin D from foods to prevent vitamin D deficiency when exposure to sunlight is inadequate." 

Why Is Our Vitamin D Deficiency So Pronounced? 

There are several reasons:

Nutrient-Deficient Foods:  Our foods are highly processed, (usually with high amounts of sodium and preservatives).  These fast, convenient foods come at the expense of our body becoming nutrient-deficient in the many vital nutrients it so desperately needs. 

Many mothers must work to help support the household.  Convenient, fast-food is a time-saver, but, sadly, Americans, as a nation, are overweight and our health is being sacrificed in the name of convenience and the lack of fresh food preparation time. 

Cooked food actually takes much longer than preparing most fresh, raw food.  Fresh fruit and vegetables as snacks for children and adults is much better for the body than fruit-roll-ups and potato chips.   

Digital World & Less Sunlight: The same technological revolution which has brought information to us through our computer screens and keyboards, has come at the price of the fact that very few people receive 15 full minutes of sun on their body every day of the 365 days in the year.

In the not so distant days of yesteryear, children walked to and from school and played outside until dinner was ready. 

Today, digital games, portable notebook computers and "smart" telephones with cameras, internet and texting capabilities, and digital games have replaced an enormous amount of this everyday, healthy, outdoor activity.

A large proportion of past generations worked in the fields.  In so doing, they got plenty of sunshine and lots of exercise.  Today, most careers are based indoors. 

Summertime weekend outdoor activities help to close the gap on our Vitamin D requirements, but 2 days out of the week for less than 6 months during the year only adds up to about 50 days out of 365 (13.7%) of sunshine on our skin each year.  This is not enough.

Sunlight:  Like all other things, moderation is necessary.  Too much sunlight will cause our skin to burn.  Too little sunlight and Vitamin D deficiency occurs. 

Due to the fact that a sunscreen with as little as an SPF of 8 can hold out 98% of the UVB (Ultra-Violet B) rays, it is nearly impossible to make adequate amounts of Vitamin D if you wear sunscreen. 

A moderate balance of getting enough of the "sunshine vitamin" would be that instead of putting sunscreen lotion on your skin before going outside,... you go outside, get your 15 minutes of sunlight and then rub on the sunscreen.   

UVB Index In Your Area of the Country:  Humans, animals and plants all need sunlight.  If we receive too much sunlight, its radiation can damage not only our skin, but even our DNA. 

If we receive too little sunlight, humans do not manufacture adequate levels of Vitamin D and a Vitamin D deficiency occurs.  In a similar vein, plants need sunlight to grow via photosynthesis. 

UVB rays cannot pass through car windows, home windows or help you "catch a few rays" while sitting in your office because modern glass technology is made to block out most UVB light. 

The higher the UVB (ultra-violet B band wavelength) index where you live, the less time it takes before skin damage occurs.  You can locate your current annual UV index report for your city at the E.P.A. website, http://www.epa.gov/sunwise/uvindex.html or on the Weather Channel online. 

Salt/Sodium:  There is sodium in nearly every single food in our grocery stores and many Americans drink carbonated beverages (soft drinks) with nearly every fast food meal. 

As most people are aware, sugar is hard on our immune system, but, if we, as a nation, focused on reducing our salt intake, our bodies would be able to hold onto more of the magnesium, calcium, potassium and phosphorus that salt osmotically removes from our bodies. 

This high sodium intake is paid for with decreased calcium and magnesium, both of which are needed, along with vitamin D for strong, healthy bones. 

Vitamin D deficiency contributes not only to increased bone and muscle pain, as well as joint stiffness, but it is a major contributor to osteoporosis.  "Osteo" means bone.  "Porosis" means a condition in which the bone becomes more porous (fragile and weakened).   

Vitamin D Deficient Diets:

Milk allergy, lactose intolerance, and strict vegetarianism are associated with Vitamin D deficient diets.  Most foods with Vitamin D are fish-based, although lesser amounts are found in other foods such as liver, milk and egg yolks.

Are Some People At Higher Risk for Vitamin D Deficiency Than Others? 

African Americans:  African Americans have a 90% chance of having a Vitamin D deficiency as compared to those of Northern European descent.  This is because people of color (Hispanics, Asians and African Americans) have higher levels of melanin in their skin. 

The more melanin in the skin, the darker the complexion.  Melanin is a pigment in the skin that works to hold out harmful UVB rays. 

Freckles are concentrations of melanin which rise to the surface when exposed to sunlight.  Darker skinned people have more melanin.  Increased amounts of melanin in the skin hold out a larger proportion of UVB rays.

In the United States, The National Institute of Medicine says that due to the fortification of milk with Vitamin D, rickets is now a rare disease.  Nevertheless, in a 2003 report from Memphis, 21 cases of rickets were reported among infants, 20 of which were African American.

Elderly:  Studies show that people over the age of 60 only produce 25% of the amount of vitamin D from ultraviolet (sun) rays as people do who are under 30. 

Many elderly people reside in long term care facilities or even in their own homes and many tend to be more sedentary than when they were younger.  As a result, they do not get as much sunlight as they need. 

As people age, the skin is unable to synthesize vitamin D as efficiently as when they were younger.  The kidney, too, is not as efficient in converting vitamin D to its active hormone form.  This can lead to increased risk of hip fractures and broken bones.

People With Fat Malabsorption:  Vitamin D is a fat soluble hormone, therefore some dietary fat in the intestine is necessary for it to be absorbed by the body.  People who have a decreased ability to absorb fat from their diet may require Vitamin D in the form of supplements. 

There are a number of medical conditions associated with fat malabsorption, some of which are Crohn's disease, cystic fibrosis and some forms of liver disease. 

People Who Are Obese:  Obesity (people who have a BMI of ≥30) doesn't change the skin's ability to synthesize Vitamin D, but greater amounts of subcutaneous (below the skin) fat causes the body to diminish its release into the blood stream. 

Unfortunately, the Vitamin D remains in these larger (deeper) areas of body fat and cannot be readily used by the body. 

Gastric Bypass:  People who have had gastric bypass surgery may become Vitamin D deficient, even if they receive adequate intake from foods or if they take supplements, because part of the upper small intestine is removed during this surgery and this is where Vitamin D is absorbed by the body. 

If you have had gastric bypass, talk to your doctor before beginning Vitamin D supplementation.

Not Enough Sunshine

People who are unlikely to obtain adequate Vitamin D from sunlight due to limited sun exposure:

• Homebound:  People who are homebound and for whom it is difficult to ambulate, unassisted outside their home.
   
• Geographic Latitude:  People who live in northern latitudes, above the 35th parallel (north or south of the equator).   In the United States, the 35th parallel runs through the states of Los Angeles, California, mid Arizona, mid New Mexico, mid Oklahoma, mid Arkansas, lower Tennessee and Columbia, North Carolina.  People living north of the 35th parallel have greater risk for Vitamin D deficiency. 
   
• Number of Sunshine Days:  People who live, in Flint, Michigan, for instance, have 40 to 50% fewer "sunshine" days for their bodies to produce Vitamin D than people who live along the Gulf Coast (Louisiana, Florida panhandle).
   
• Clothing:  Women who, for religious reasons, wear head coverings, long clothing and long robes.
   
• Career:  People with occupations which prevent sun exposure.