Risky Populations of Vitamin D Deficiency

Posted by Dr. James Liu on

1. Infants. Human milk is the best food for these new born infants. However, vitamin D requirements cannot ordinarily be met by human milk alone. Naturally, the vitamin D content of human milk is related to the mother’s vitamin D nutritional status, so mothers who supplement with high doses of vitamin D may have correspondingly high levels of this vitamin in their milk. While the sun is a potential source of vitamin D for the mothers, but it is not a direct factor for infants. The American Academy of Pediatrics (AAP) advises keeping infants out of direct sunlight and having them wear protective clothing and sunscreen to reduce the risk of skin cancer. The AAP recommends that exclusively and partially breastfed infants be supplemented with 400 IU of vitamin D per day.

2. People with limited sun exposure. Homebound individuals, women who wear long robes and head coverings for religious reasons, and people with occupations that limit sun exposure are unlikely to obtain adequate vitamin D from sunlight. Because the extent and frequency of use of sunscreen are unknown, the significance of the role that sunscreen may play in reducing vitamin D synthesis is unclear. Ingesting adequate amount of vitamin D from foods and/or supplements will provide these individuals with sufficient amounts of this nutrient.Watch Full Movie Online Streaming Online and Download

3. People with dark skin. Greater amounts of the pigment melanin in the epidermal layer result in darker skin and reduce the skin’s ability to produce vitamin D from sunlight. Various reports consistently show lower serum 25(OH)D levels in persons identified as black compared with those identified as white. It is not clear that lower levels of 25(OH)D for persons with dark skin have significant health consequences. Those of African American ancestry, for example, have reduced rates of fracture and osteoporosis compared with Caucasians (see section below on osteoporosis). Ingesting RDA levels of vitamin D from foods and/or supplements will provide these individuals with adequate amounts of this nutrient.

4. People with fat malabsorption. As a fat-soluble vitamin, vitamin D requires some dietary fat in the gut for absorption. Individuals who have a reduced ability to absorb dietary fat might require vitamin D supplements. Fat malabsorption is associated with a variety of medical conditions including some forms of liver disease, cystic fibrosis, and Crohn’s disease.

5. People who are obese or who have undergone gastric bypass surgery. A body mass index ≥30 is associated with lower serum 25(OH)D levels compared with non-obese individuals; people who are obese may need larger than usual intakes of vitamin D to achieve 25(OH)D levels comparable to those of normal weight. Obesity does not affect skin’s capacity to synthesize vitamin D, but greater amounts of subcutaneous fat sequester more of the vitamin and alter its release into the circulation. Obese individuals who have undergone gastric bypass surgery may become vitamin D deficient over time without a sufficient intake of this nutrient from food or supplements, since part of the upper small intestine where vitamin D is absorbed is bypassed and vitamin D mobilized into the serum from fat stores may not compensate over time.

6. Older adults are at increased risk of developing vitamin D insufficiency in part because, as they age, skin cannot synthesize vitamin D as efficiently, they are likely to spend more time indoors, and they may have inadequate intakes of the vitamin. As many as 50% of older adults in the United States with hip fractures could have serum 25(OH)D levels <30 nmol/L.

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