An alarmingly large number of Indian women suffer from Vitamin D deficiency. An essential nutrient for strong bones, vitamin D is often called the 'sunshine vitamin' because it is produced when the human body is exposed to ultraviolet rays from sunlight. It is also present in very few foods.
According to a four-year survey of 5,65,726 women undertaken by the diagnostics chain SRL Diagnostics between 2013 and 2016, around 75-80 percent of women across India had inadequate vitamin D levels in their blood. This was even more severe in southern India, where the percentage was found to be as high as 81 percent.
"Vitamin D has to undergo a series of complex biochemical reactions once absorbed (either by sun or ingesting supplements) before it is actually put to use by the human body," says Dr Shantala Vadeyar, Group Medicinal Director, Fetal and Maternal Medicine, CloudNine group of hospitals, Mumbai, adding that women do tend to suffer from vitamin D deficiency more than men, though not by a large margin. "This is because they have a lower bone density than their male peers and lose bone mass more quickly as they age," she said. "For young women, a deficiency of vitamin D can lead to weak bones, tooth decay and kidney stones, whereas in menopausal women it often results in bone ailments such as osteoporosis."
"For young women, a vitamin D deficiency can lead to weak bones, tooth decay and kidney stones, whereas in menopausal women it often results in bone ailments such as osteoporosis."
Vitamin D deficiency is most likely to be found in people who spend most of their time indoors. According to a recent study, at least 70 percent Indians suffer from illnesses that result from low levels of vitamin D. A lot of people don't even appear to know about it, as the symptoms of this deficiency are vague and indistinct, and affect different parts of the body mentally and physically.
Here are some things every Indian woman should know about vitamin D.
1. Indian women tend to have vitamin D deficiency primarily due to social reasons.
Vitamin D usually occurs due to a lack of adequate exposure to sunlight. Indian women are more prone to the deficiency as they tend to be indoors most of the time.
"There is no physiological reason behind vitamin D deficiency being more common in women than in men," Dr Deepa Dave, head of operations at SRL Diagnostics said. "But we see it more commonly in women in India because of certain social and cultural taboos that dictate lifestyle patterns such as clothing and diet." For instance, girls traditionally receive less nutrition than boys, which limits their vitamin D dietary options. Indian women also tend to spend most of their time indoors, and have their body and faces covered with a veil, preventing adequate sun exposure. Dr Dave says that urban women who apply sunscreen are also at risk of deficiency.
2. Your risk of vitamin D deficiency increases if you have dark skin.
Dr. Shelly Singh, Senior Consultant Gynecologist, Primus Super Speciality Hospital, Delhi, says that Indian women with dark skin are at a greater risk of vitamin D deficiency as the skin pigment melanin can reduce the skin's ability to produce vitamin D.
"We see vitamin D deficiency more commonly in women in India because of certain social and cultural taboos that dictate lifestyle patterns such as clothing and diet."
3. It can lead to weak bones.
Bone ailments are a very common result of vitamin D deficiency. "It is calcium that makes your bones strong, but the mineral cannot be absorbed properly without the help of vitamin D," says Dr Marwah. In the absence of adequate calcium absorption, the body depletes the calcium reserves found in its bone's framework, which weakens the bones." If vitamin D deficiency has persisted for a long period, it can cause osteoperosis, back pain and even bone fractures.
4. It causes fatigue and muscle pain.
If you are constantly feeling fatigued, don't pass it off as a temporary sign of weakness. "Frequent joint pains, exhaustion, drowsiness and muscle pains are common symptoms of vitamin D deficiency, but people tend to not register these on a daily basis," Dr Vadeyar said. "The long-term effects of vitamin D deficiency like osteoporosis, muscle pain, fatigue, obesity, cardiac diseases etc have further psychological implications," Dr Samir Parikh, Director, Department of Mental Health and Behavioural Sciences, Fortis Healthcare, New Delhi, said.
5. Pregnant women are especially prone to vitamin D deficiency.
There can be some calcium loss during pregnancy through fetal demands and increased urinary calcium excretion, which increases with advancing pregnancy. Repeated, unplanned, and un-spaced pregnancies in dietary deficient women have been found to aggravate vitamin D deficiency in the mother and the fetus. This in turn can lead to pre-eclempsia or high blood pressure during pregnancy.
6. It can affect your unborn child.
If you suffer from vitamin D deficiency during pregnancy, chances are you'll pass it on to your child. Doctors say that it is very important that pregnant and nursing women, and babies maintain optimum levels of vitamin D. "Since the breast milk contains a very low level of vitamin D it can lead to a deficiency of vitamin D in babies as well," Dr Singh said. "In such cases, new born babies should be bottle fed with milk which is fortified by vitamin D." She also says that vitamin D deficiency can lead to problems such as low birth weight, hypocalcemia (low calcium level), rickets of soft bones, type 1 diabetes, childhood asthma and also some immune disorders in babies.
If you suffer from vitamin D deficiency during pregnancy, chances are you'll pass it on to your child.
7. It ups your risk of type 2 diabetes.
"Studies have shown that people who have low levels of this pro-hormone in their blood are at an increased risk of developing Type 2 diabetes," reveals Lekha Vyas, a nutritionist from the CloudNine Group of Hospitals, Mumbai. Link it to the increased rate of diabetes and diabetes-induced illnesses among Indians (the International Diabetes Federation reports that in 2015, India had 69.1 million cases of diabetes, making it one of the top three countries with a high diabetic population), and you might find yourself scrambling to run outside to soak up some sun.
8. It is being linked to cardiac diseases.
Recently (and more increasingly) vitamin D deficiency is being listed as a (new) reason for high blood pressure, although it is not the only and primary cause for cardiac-related problems. "A drop in the pro-hormone's levels causes abnormalities in sodium and potassium levels, which affects the kidneys, and then leads to a thickening in the left ventricle," Dr Nilesh Gautam, senior interventional cardiologist at Asian Heart Institute, Mumbai, said. "We have observed younger individuals (particularly women), especially those who work night shifts and lead sedentary lifestyles diagnosed with blood pressure problems more frequently than others, and they more often than not have low levels of vitamin D."
9. It could give you the blues.
Some studies have linked vitamin D deficiency to depression, mood swings and irregular sleep. "Of late, low levels of vitamin D have been increasingly associated with cognitive deficits, seasonal affective disorder, and depression," Dr Parikh said.
10. It is possible to prevent vitamin D deficiency.
a) Diet: Eat a diet rich in whole foods. Nutrient-dense, fatty fish like mackerel and sardines are great sources of vitamin D. You can also opt for egg yolks, fortified organic milk and other dairy products, and some grains and organ meats like liver. "There is less chance of vitamin D deficiency if the woman is non vegetarian," Dr Singh said.
b) Sun exposure: If possible, allow unprotected sun exposure in the golden hours between 10 am and 3 pm. You need to spend 15-20 minutes sitting in the sun for the body to be able to produce vitamin D.
You need to spend 15-20 minutes in the sun for the body to be able to produce vitamin D.
c) If you think you may be suffering from vitamin D deficiency, ask your doctor about getting a 25-hydroxy vitamin D blood test. The optimum level of vitamin D in blood is 30-60 ng/ml.
Your doctor will discuss adding a vitamin D supplement to your diet or even prescribe vitamin D injections if it is too low. If it is a borderline case, you can even correct the deficiency through adequate sun exposure and a rich diet. If you don't get out in the sun every day for 15-30 minutes in the morning or afternoon, consider supplementing it with a vitamin D dose of 1,000–2,000 IU (International Units) per day. Under situations of minimal exposure to sunlight, a specific recommendation of a daily supplement of 400 IU (10 μg) is retained for the Indian population. As per WHO, suggested recommendations for vitamin D include 1,000 IU/day, 5,000 IU/week or a single dose of 200,000 IU or more.