Vitamin D Deficiency

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Vitamin D
VitaminDplaysanimportantroleinhelpingthebodytoabsorbcalciumthroughthesmall intestine.Ourbodiesneedcalciumtohelpthemdevelopandmaintainhealthybones,musclesand teeth. ThebulkofourvitaminDisproducedbythebodywhenUVradiationinsunlighthitsourskinand reactswithacholesterol-likesubstanceintheskin.TherearealsoverysmallamountsofvitaminD insomefoodsanddrinks.However,thisisusuallynotenoughtomaintainthelevelsourbodies need. MostpeoplegetenoughvitaminDthroughexposuretosunlightduringnormalday-to-dayoutdoor activities.However,somepeoplehaveverylowlevelsofdailysunexposure,whichcanleadto vitaminDdeficiency.Thisincludespeoplewhocovertheirskinforculturalorreligiousreasonsand peoplewhospendmostoftheirtimeindoors.Peoplewithdarkskinmayneedmoresunexposure timethanpeoplewithfairskintoproduceanadequateamountofvitaminD. Toomuchsunexposurecanincreasetheriskofskincancer.Itisimportanttofindasensible balancebetweensunexposureandprotection. Vitamin D deficiency IfyoudontgetenoughvitaminD,yourbodywillnotabsorbasmuchcalciumasitneedsandthe mineralisationofboneswillbeaffected.LackofvitaminDandcalciumcanincreasetheriskof developingarangeofmusculoskeletalconditions,including: Ricketsinchildrenwithgrowingbonesaconditionwithsoft,weakenedanddeformed bonesinchildrenoftenwithpoormuscledevelopment Neonatalhypocalcaemianotenoughcalciumintheblood,inbabiesexposedtolowlevels ofvitaminDduringpregnancy Thinningofthebonesinadultscausingbonyweaknessandincreasedriskoffractures(a conditionknownasOsteomalacia) Muscleweakness,achesandpainsincreasingtheriskoffalls,fracturesandbalance problems,especiallyinolderadults.

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Osteomalaciaisadifferentconditionfromthemorecommonlyknowncondition,osteoporosis.Both conditionsresultinbonethinningandweaknessaswellasagreaterriskofbonefractures, especiallyinolderpeople. High-risk groups PeopleatincreasedriskofvitaminDdeficiencyinclude: BabiesborntowomenwithavitaminDdeficiency Childrenandadultswithlittlesunlightexposure Peoplewhocovermostoftheirbodyforreligiousorculturalreasons Peopleunabletoregularlygetoutoftheirhouse Peoplewithnaturallyverydarkskin Peopleinresidentialcare Frailolderpeople Shiftworkers Peoplewithsomemedicalconditionssuchascertainboweldiseases.

Somestudiessuggestthatabouteightoutof10peopleinthesehigh-riskgroupshavesome degreeofvitaminDdeficiency.Ifyouareinoneofthesegroups,youshouldconsultyourdoctor foradviceonwhetheryouneedtotakeavitaminDsupplement. UV and vitamin D

VitaminD

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ThebestsourceofvitaminDisultraviolet(UV)radiationfromthesun.Asensiblebalanceofsun exposureandsunprotectioncanprotectagainstvitaminDdeficiencywithoutputtingyouatriskof skincancer. UVradiationlevelsvarydependingonlocation,timeofyear,timeofday,cloudcoverageandthe environment.WheneverUVradiationlevelsreach3andabove,mostpeopleneedtousesun protection.WhenUVlevelsarebelow3,mostpeopledonotrequiresunprotectionunlesstheyare inhigh-altitude(alpine)regionsornearhighlyreflectivesurfacessuchassnoworwater. TochecktheUVlevelsfortheday,gototheSunSmartUVAlert.ThereisaSunSmartUVAlertfor over300citiesacrossAustralia.Youcanfindthemintheweathersectionofyourdailynewspaper orvisitSunSmartUVAlertwebsite. Recommended sunlight exposure Somesunexposureonyourarms,face,handsorsimilarsurfaceareaisimportanttoreduceyour riskofvitaminDdeficiency.Recommendedsunlightexposureforpeoplewithfairskinincludes: September to AprilafewminutesofsunlightexposureeithersideofpeakUVtimes. Alwaysprotectyourskinfromthesunwithclothing,shadeand/orsunscreenbetween 10amand3pm.Reapplysunscreeneverytwohours. May to Augusttwotothreehoursofsunlightexposureovertheweek.Takeadvantage ofsunnyperiods.Sunprotectionisnotnecessaryduringthewintermonthsinthesouthern areasofAustralia,unlessyouareathighaltitudesornearreflectivesurfaceslikesnowor water.

Peoplewithverydarkskinmayneedthreetofourtimesmoreexposuretimethanpeoplewithfair skintoachievesufficientlevelsofvitaminD.Thisisbecausethepigmentsindarkskinreducethe effectsofUVradiationintheproductionofvitaminD. Be SunSmart Remembertoslip,slop,slap,seekandslidewhenevertheUVIndexisforecasttoreach3or above: Sliponclothingtocovertheskin. SloponSPF30+water-resistantsunscreen,reappliedeverytwohours. Slaponabroad-brimmedhattoprotecttheface,earsandneck. Seekshadewhereveryoucan. Slideonsunglassestoprotectagainsteyedamagechooseapairthatcarriesthe AustralianStandardAS1067tagorsticker.

Solariumshavebeenlinkedtocausingskincancerandarenot recommendedasawaytotreat vitaminDdeficiency. Some people need extra sun protection Somepeoplemayneedtolimittheirsunlightexposureorusesunscreenoutsidetherecommended hours.Talktoyourdoctorbeforeincreasingyourlevelofsunexposure,especiallyifyou: Areregularlyoutdoorsforprolongedperiodsoftime Haveveryfairorsunsensitiveskinthatburnseasily Haveahistoryofskincancer Havehadanorgantransplantoraretakingmedicationsthatincreaseyourriskofskin cancer.

Babiesandyoungchildrenalsoneedextraprotectionduetotheirsensitiveskin.AustraliashighUV radiationlevelsmeanthatmostchildrengetmorethanenoughVitaminD,evenwhenoutdoorsfor veryshortperiodswithsmallamountsofskinexposed. Diet and exercise ForthemajorityofAustralians,itisalmostimpossibletogetenoughvitaminDfromdietalone. However,youcanmakesureyourbodyhasthecalciumitneedsbypayingattentiontowhatyou eatandmakingsureyougetenoughphysicalactivity.Consumecalcium-richfoodsinyourdietand exercisemoderatelyeachdaytomaintainhealthybones. MakesureyouincludefoodsinyourdietthatcontainvitaminDsuchas:

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MilkthatcontainsaddedvitaminD(checkthelabel) SoydrinksthatcontainaddedvitaminD(checkthelabel) Margarine Eggs Liver Fishsuchastuna,salmon,sardines,herringandmackerel.

See your doctor SeeyourdoctorifyouthinkyoumaybeatriskofvitaminDdeficiency.Asimplebloodtestcan assessyourrisk.Ifyouareatrisk,makesureyouhaveregularmedicalcheck-ups.Thedoctormay recommendthatyoutakevitaminDsupplements.Ifso,takethesupplementsstrictlyasdirected. Where to get help Yourdoctor MaternalandChildHealthnurse AnAccreditedPractisingDietitian,contacttheDietitiansAssociationofAustralia Nurse-on-CallTel.1300606024forexperthealthinformationandadvice24hours,7 days SunSmart

Things to remember MostofourvitaminDcomesfromsunlighthittingtheskin. SomepeopleareatincreasedriskofvitaminDdeficiency:forexample,peoplewith naturallyverydarkskin,peoplewhocovertheirskinforculturalorreligiousreasons, peoplewhospendmostoralloftheirtimeindoorsandpeoplewithverylowexposureto sunlightforanyotherreason. VitaminDdeficiencyincreasestheriskofvariousmusculoskeletalconditionsincluding rickets(soft,weakenedbones)inchildrenandosteomalacia(weak,fragilebones)inolder adults.

This page has been produced in consultation with, and approved by:

DHS-OfficeoftheChiefHealthOfficer

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

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