{"id":677,"date":"2021-03-24T11:12:23","date_gmt":"2021-03-24T16:12:23","guid":{"rendered":"https:\/\/test-crn-owl-wp.aspirant.com\/?page_id=677"},"modified":"2023-12-13T18:20:52","modified_gmt":"2023-12-13T18:20:52","slug":"education","status":"publish","type":"page","link":"http:\/\/a-ac-dev-app-crn-vdm-wp.azurewebsites.net\/index.php\/education\/","title":{"rendered":"Learn More"},"content":{"rendered":"

<\/div><\/div>

Learn More
\n<\/span><\/p><\/h2><\/div>

Discover what vitamin D means for you and your health status<\/span><\/h5><\/div><\/div><\/div><\/div><\/div>

How Common is Vitamin D Deficiency & Insufficiency? Who is at Risk?<\/h2><\/div>

\"\"Low vitamin D status is becoming more common worldwide. The prevalence of vitamin D deficiency (VDD) was found to be 28.9 % and vitamin D insufficiency (VDI) 41% in a subset of 26,010 US adults surveyed as part of the ongoing National Health and Nutrition Examination Survey (NHANES) 2001-2010. Those who were African American, less educated, of lower socioeconomic status, smokers, physically inactive, obese and infrequent milk consumers demonstrated a higher prevalence of VDD and VDI. <\/span>1<\/sup><\/span> Worldwide, many countries report a high prevalence of low vitamin D status. The percentage of individuals with VDD or serum 25(OH)D <30\u2009nmol\/L (or 12\u2009ng\/ml) is estimated to be 7.4% in Canada, <\/span>2<\/sup><\/span> 13% in Europe<\/span>3<\/sup><\/span> and as high as >20% of the population in India, Tunisia, Pakistan and Afghanistan. <\/span>3,4<\/sup><\/span> However, certain populations are more at risk for becoming deficient than others. <\/span>For example, individuals with chronic diseases especially of the liver, kidney and heart, anyone with diseases that lead to malabsorption such as Crohn\u2019s disease, hospitalized patients, and anyone with reduced exposure to sunlight. <\/span>5<\/sup><\/span>,6<\/sup><\/span> O<\/span>lder adults, individuals with existing conditions, obese individuals<\/span>, diabetics<\/span> and those taking certain medications are particularly at risk. Older adults, especially those that are institutionalized, are at increased risk due to decreased sun exposure, decreased ability to synthesize vitamin D in the aging skin, <\/span>7<\/sup><\/span> decreased intake and possibly a greater number of medications. Medications such as antiseizure medications, glucocorticoids, rifampin and supplements such as St. John\u2019s W<\/span>o<\/span>rt may increase the risk of vitamin D deficiency. <\/span>8<\/sup><\/span>\u00a0<\/span><\/p>\n<\/div>

<\/i><\/i><\/span>References<\/span><\/a><\/h4><\/div>
\n
    \n
  1. Liu X, Baylin A, Levy PD. Vitamin D deficiency and insufficiency among US adults: prevalence, predictors and clinical implications. British Journal of Nutrition. 2018;119(8):928-936.<\/li>\n
  2. Sarafin K, Durazo-Arvizu R, Tian L, et al. Standardizing 25-hydroxyvitamin D values from the Canadian Health Measures Survey. Am J Clin Nutr. 2015;102(5):1044-1050.<\/li>\n
  3. Cashman KD, Dowling KG, \u0160krab\u00e1kov\u00e1 Z, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016;103(4):1033-1044.<\/li>\n
  4. Cashman KD. Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing. Calcified tissue international. 2020;106(1):14-29.<\/li>\n
  5. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. European journal of clinical nutrition. 2020;74(11):1498-1513.<\/li>\n
  6. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985;76(4):1536-1538.<\/li>\n
  7. Mandal AKJ, Baktash V, Hosack T, Missouris CG. Vitamin D status and COVID-19 in older adults. Aging clinical and experimental research. 2020;32(11):2425-2426.<\/li>\n
  8. Wacker M, Holick MF. Vitamin D – effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5(1):111-148.<\/li>\n<\/ol>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

    What is Vitamin D?<\/h2><\/div>

    \"\"Vitamin D is<\/span> a fat soluble vitamin<\/span> that humans get from <\/span>the <\/span>diet, sunlight and supplements<\/span>. It is<\/span> not a single compound but is a family of similar compounds with slightly different side chains. <\/span>There are two major forms of vitamin D: vitamin D2 and D3. V<\/span>itamin D2 or ergocalcifero<\/span>l<\/span> is the most common form and <\/span>an important dietary source<\/span> that<\/span> is synthesized by<\/span> plan<\/span>t<\/span>s and <\/span>also used to fortify foods like milk, orange juice and cereals<\/span>. Most mammals can convert <\/span>vitamin<\/span> D2 to <\/span>vitamin <\/span>D3. Vitamin D3, <\/span>also called <\/span>cholecalciferol<\/span>,<\/span> is<\/span> the form that can be made <\/span>by<\/span> the <\/span>human <\/span>body <\/span>from cholesterol<\/span> and is naturally found in cod liver oil<\/span>, <\/span>oily fish<\/span>, and is often found in dietary supplements<\/span>. D3 is the active part of 1,25-dihydroxycholecalciferol <\/span>(1,25(OH)<\/span>2<\/span>D), <\/span>which is responsible for the biological functions of vitamin D<\/span>. <\/span>1<\/sup><\/span>\u00a0<\/span><\/p>\n

    With no supplementation, a<\/span>bout 80% <\/span>of vitamin D3 <\/span>is synthesized in the skin<\/span> and 20% is obtained from the diet<\/span>. <\/span>With regular sun exposure, a healthy diet, and healthy kidneys, many<\/span> people can make the vitamin D they need<\/span>.<\/span> However, most people are not regularly exposed to the sun<\/span> and diets vary<\/span>. <\/span>The absorption of <\/span>Vitamin D from <\/span>food sources <\/span>is<\/span> dependent upon the presence of long chain fats and bile salts. <\/span>Dietary <\/span>vitamin D first go<\/span>es<\/span> to the liver<\/span> then the<\/span> kidney<\/span> converts it to its active form and<\/span> distributes the active form throughout the body<\/span>. Because it is synthesized and released from , the kidneys, and the fact that there are vitamin D receptors in many tissues<\/span> makes vitamin D a \u201chormone-like\u201d vitamin<\/span>. <\/span>1<\/sup><\/span>\u00a0<\/span><\/p>\n

    Vitamin D is delivered throughout the body on vitamin D binding protein and must bond with a vitamin <\/span>D<\/span> receptor<\/span> (VDR)<\/span> to enact its biological effects. These receptors are located throughout the body<\/span> and explain why vitamin D is important for so many functions in the body<\/span>. <\/span>2<\/sup><\/span> For example, <\/span>VDR <\/span>has been found <\/span>in cells of the intestinal epithelium, renal tubules, parathyroid gland cells, skin (keratinocytes), mammary epithelium, pancreas (beta islet cells), pituitary gland, skeleton (osteoblasts and chondrocytes), immune system (monocytes, macrophages, and T-lymphocytes), and germ tissues. The tissues with the highest VDR content are intestine, kidney, parathyroid gland, and bone, all of which are associated with maintenance of calcium homeostasis. <\/span>3<\/sup><\/span>\u00a0<\/span><\/p>\n

    \u00a0<\/span><\/p>\n<\/div>

    <\/i><\/i><\/span>References<\/span><\/a><\/h4><\/div>
    \n
      \n
    1. Hewlings SJ, Medeiros DM. Nutrition: Real People, Real Choices. Pearson Prentice Hall; 2009.<\/li>\n
    2. Sassi F, Tamone C, D\u2019Amelio P. Vitamin D: nutrient, hormone, and immunomodulator. Nutrients. 2018;10(11):1656.<\/li>\n
    3. Wang Y, Zhu J, DeLuca HF. Where is the vitamin D receptor? Arch Biochem Biophys. 2012 Jul 1;523(1):123-33. doi: 10.1016\/j.abb.2012.04.001. Epub 2012 Apr 6. PMID: 22503810.<\/li>\n<\/ol>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

      Why is Vitamin D Important?<\/h2><\/div>

      \"\"Vitamin D was first known for its role in bone development and maintenance. It plays a key role in the metabolism of calcium and phosphorus, two important minerals for bone integrity<\/span>. <\/span>Vitamin D stimulates the cells of the small intestine to produce <\/span>a <\/span>calcium binding protein called calbindin, which increases calcium absorption. When blood calcium levels decline, vitamin D stimulates the production of calbindin to increase calcium absorption from food. In addition, when blood levels of calcium fall, vitamin D stimulates the kidneys to conserve calcium by decreasing urinary excretion. <\/span>Vitamin D has many other important functions. <\/span>It plays a key role in maintaining <\/span>immune health, <\/span>oral health<\/span>, <\/span>muscle health and strength, for regulating gene transcription and promoting protein synthesis<\/span>. <\/span>1<\/sup><\/span> These functions have received more research attention in recent years due to the findings that vitamin D receptors (VDR) and the vitamin D activating enzyme 1-<\/span>\u03b1<\/span>-hydroxylase (CYP27B1) are found in many cells outside the bone and kidney including the muscles, the intestine and some immune cells. This suggests the <\/span>biologically <\/span>active form of vitamin D<\/span>, <\/span>1,25(OH)<\/span>2<\/span>D<\/span>,<\/span> can influence immun<\/span>ity and health<\/span> in <\/span>multiple <\/span>ways<\/span>. <\/span>1-3<\/sup><\/span>\u00a0<\/span><\/p>\n<\/div>

      <\/i><\/i><\/span>References<\/span><\/a><\/h4><\/div>
      \n
        \n
      1. Wacker M, Holick MF. Vitamin D – effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5(1):111-148.<\/li>\n
      2. Sassi F, Tamone C, D\u2019Amelio P. Vitamin D: nutrient, hormone, and immunomodulator. Nutrients. 2018;10(11):1656.<\/li>\n
      3. Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients. 2013;5(7):2502-2521.<\/li>\n<\/ol>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

        Vitamin D and Bone Health<\/h2><\/div>

        \"\"<\/p>\n

        While calcium is often associated with bone health, it is important to remember that vitamin D is also essential for healthy bones. In fact, the U.S. Food and Drug Administration (FDA) has authorized health claims that describe the relationship between vitamin D, calcium and osteoporosis risk [1]. For example, the FDA authorized health claim recognizes that adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis in later life [1]. Around the world, vitamin D is recognized for bone health and other non-U.S. government authorities, like Health Canada and the European Food Safety Authority (EFSA), also have authorized health claims,[1] including:<\/p>\n<\/div>