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...... Vitamin D: What is it? Vitamin D, calciferol, is a fat-soluble vitamin. It is found in food, but also can be made in your body after exposure to ultraviolet rays from the sun. The major biological function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. It promotes bone mineralization in concert with a number of other vitamins, minerals, and hormones. Without vitamin D, bones can become thin, brittle, soft, or misshapen. Vitamin D prevents rickets in children and osteomalacia in adults, which are skeletal diseases that result in defects that weaken bones. What are the sources of vitamin D? Food sources : Fortified foods are the major dietary sources of vitamin D. Prior to the fortification of milk products, rickets (a bone disease seen in children) was a major public health problem. One cup of vitamin D fortified milk supplies about one-fourth of the estimated daily need for this vitamin for adults. Although milk is fortified with vitamin D, dairy products made from milk such as cheese, yogurt, and ice cream are generally not fortified with vitamin D. Exposure to sunlight Exposure to sunlight is an important source of vitamin D. Ultraviolet (UV) rays from sunlight trigger vitamin D synthesis in the skin. Season, latitude, time of day, cloud cover, smog, and sunscreens affect UV ray exposure. It is especially important for individuals with limited sun exposure to include good sources of vitamin D in their diet. When can vitamin D deficiency occur? A deficiency of vitamin D can occur when there is limited exposure to sunlight, when dietary intake of vitamin D is inadequate, when the kidney cannot convert vitamin D to its active form, or when someone cannot adequately absorb vitamin D from the gastrointestinal tract. In children, vitamin D deficiency causes rickets, which results in skeletal deformities. In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones. Females who cover their body for religious/environmental reasons, and individuals working in occupations that prevent exposure to sunlight are at risk of a vitamin D deficiency. If these individuals are unable to meet their daily dietary need for vitamin D, they may need a supplement of vitamin D. Individuals who have reduced ability to absorb dietary fat (fat malabsorption) may need extra vitamin D because it is a fat soluble vitamin. Vitamin D and osteoporosis Osteoporosis is a disease characterized by fragile bones. It results in increased risk of bone fractures. Having normal storage levels of vitamin D in your body helps keep bones strong and may help prevent osteoporosis in elderly, non-ambulatory individuals, in post-menopausal women, and in individuals on chronic steroid therapy. Normal bone is constantly being remodeled (broken down and rebuilt). During menopause, the balance between these two systems is upset, resulting in more bone being broken down than rebuilt. Estrogen replacement, which limits symptoms of menopause, can help slow down the development of osteoporosis by stimulating the activity of cells that rebuild bone. Vitamin D Deficiency: Prolonged deficiency of vitamin D results in changes in the bones of children and adults, and possible hearing loss with aging. In addition, rickets (in children) and osteomalacia (in adults) where bones are malformed and weak from poor calcium and phosphorus deposition. Osteoporosis is another adult disease that results from a poor dietary vitamin D and calcium intake. Hearing loss from vitamin D deficiency may progress as the adult ages due to increased porosity of the cochlea bone in the inner ear. Vitamin D supplementation usually repairs conditions caused by poor dietary intake. Prolonged exposure to sunlight does not cause vitamin D toxicity. The best known activity of vitamin D is its role in maintaining bone. It functions by increasing the uptake of calcium from the intestine through interaction with the parathyroid glands in controlling bone resorption and serum calcium levels. The skeleton is the body's reservoir of calcium and provides calcium through resorption of mineral when serum levels of this essential element drop. Vitamin D also increases reabsorption of phosphate by the kidney tubule, and may directly affect the osteoblast, the cell which forms bone. The diet is very low in vitamin D, unless you're consuming fish liver. Fortified foods, primarily dairy, are our major sources and may be produced by irradiation or by addition of synthetic forms of the vitamin. Supplementation with fish liver oils or extracts of these oils in capsules are important sources, especially for children or seniors living at higher latitudes and particularly during fall and winter. A reduced incidence of hip fractures has been shown for seniors using calcium and vitamin D supplements.

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