Vitamin D Deficiency - August 2009

What do you know about…

Vitamin D Deficiency?

Recently, the American Academy of Dermatology issued an updated position statement on vitamin D and its importance for optimal health.  Vitamin D is produced by the body when skin is exposed to sunlight.  It is also naturally present in some foods.  Without sufficient vitamin D, bones can become thin, brittle, or misshapen.  Together with calcium, vitamin D also helps protect older adults from osteoporosis.  Importantly, low levels of vitamin D are associated with high blood pressure, high blood sugar and metabolic syndrome in teenagers.  Recent studies have also shown that low levels of Vitamin D are associated with higher risk of heart attack and stroke, even after controlling for factors known to be associated with coronary artery disease.

According to the Academy, nutritional sources of vitamin D (see Table) and dietary supplements are recommended over unprotected exposure to the sun, since ultraviolet (UV) radiation is a known risk factor for the development of skin cancer.  Individuals who regularly use sunscreen or wear sun protective clothing may be at risk for vitamin D deficiency.  Higher doses of vitamin D may be necessary for these individuals and for other with known risk factors for vitamin D insufficiency, such as those with dark skin, the elderly, photosensitive individuals, people with limited sun exposure, obese individuals or those with fat malabsorption.  The Academy encourages those with concerns about vitamin D to discuss options with their physician.

Vitamin D is available in two forms, D₂ and D₃.  Most supplements are in D_3, but both forms effectively raise vitamin D levels.   

What does CPC recommend?

The vitamin D position statement supports safe ways to get this important vitamin – through a healthy diet of foods naturally rich in vitamin D, vitamin D-fortified foods, and vitamin D supplements.  The updated recommendation for individuals who use daily sun protection acknowledges that while protecting the skin from the damaging rays of the sun is important, so is maintaining adequate vitamin D levels.  Concern about vitamin D should not lead people to forego sun protection, but rather prompt a conversation with their physician about how to ensure adequate and safe vitamin D intake while guarding against skin cancer.

Resources for this article are:

1.  http://www.aad.org/media/background/news/Releases/American_Academy_of_Dermatology_Issues_Updated_Pos/

2.  http://ods.od.nih.gov/factsheets/vitamind.asp

3. Aug. 3, 2009 online edition of Pediatrics

4.  25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men: A Prospective Study. Edward Giovannucci, Yan Liu, Bruce W. Hollis, and Eric B. Rimm Arch Intern Med. 2008;168(11):1174-1180.

5.  http://www.vitamindhealth.org/