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Introduction to Vitamin D Deficiency

The main role of vitamin D is to ensure our bones remain healthy.1

Vitamin D is essential for musculoskeletal health as it promotes calcium absorption from the bowel, enables mineralisation of newly formed osteoid tissue in bone and plays an important role in muscle function.1

Sources of vitamin D

The major source of vitamin D is from skin exposure to sunlight. When our skin is exposed to sunlight, ultraviolet B radiation penetrates the viable epidermis and dermis and is absorbed by 7-dehydrocholesterol, which is converted to vitamin D3.2,3

Figure 1 highlights this process.

However, several factors impact the cutaneous production of vitamin D3, here are some examples: 4

  • Time of day
  • Season
  • Ageing
  • Sunscreen use
  • Skin pigmentation
  • Latitude

Dietary sources are relatively insignificant compared with the synthesis in the skin from exposure to sunlight or ultra- violet rays. This is because there are not many rich food sources of vitamin D. It can be found in reasonable amounts in oily fish (e.g. salmon, sardines) and cod liver oil. Eggs, meat and milk contain small amounts. In the UK, margarine, infant formula milk, and some breakfast cereals and dairy products such as yoghurts have added vitamin D.5,6

Vitamin D deficiency and insufficiency

Vitamin D deficiency is common, with over 50% of Europe considered to be lacking in this essential nutrient.2

A UK survey in 2007 showed that nearly half the adult population in the UK may have insufficient levels of vitamin D and up to 16% have a severe deficiency during winter and spring.7

Average:

  • References

    1. Royal Osteoporosis Society: Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management. Available at: https://strwebprdmedia.blob.core.windows. net/media/ef2ideu2/ros-vitamin-d-and-bone-health-in-adults-february-2020.pdf/ Last accessed: November 2023.

    2. Holick, MF. Vitamin D: a D-Lightful solution for health. J Investig Med. 2011;59 (6):872-880.

    3. Holick, MF. Vitamin D: a D-Lightful health perspective. Nutrition Reviews. 2008;66(Suppl.2):S182-S194.

    4. Holick, MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(suppl):1678S-88S.

    5. British Dietetic Association. Food Fact Sheet. Available at https://www.bda.uk.com/resource/vitamin-d.html/ Last accessed: June 2023.

    6. Bentley, J. Vitamin D deficiency: identifying gaps in the evidence base. Nursing Standard. 2013;27(46):35-41.

    7. Hypponen E, Power C. Hypovitaminosis D in British adults aged 45 yr: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007;85(3):860-868.

    KKI/UK/STX/0024 November 2023