Vitamin D is very important to our bodies and helps us to maintain normal blood levels of calcium and phosphorous. It aids in calcium absorption, helping to form and maintain strong bones, which decreases risk for fractures and osteoporosis as we age. Recent research also suggests that Vitamin D may provide protection from many other physical and mental health conditions.
HOW TO GET IT
Vitamin D is found in some dietary sources, such as fish, eggs, fortified milk, and cod liver oil, but the primary source of vitamin D is sunlight. When exposed to ultraviolet B (UVB) rays, the D3 form of the vitamin is created in the skin.
SIGNS OF DEFICIENCY
Most people in the US do not meet the recommended levels of Vitamin D, which have been increasing every few years as more research develops. Less extreme deficiency is often undetected because the symptoms can be confused with other conditions. These symptoms may include fatigue, body aches and pains, unsteady balance, depressive symptoms or other changes in mood. Less common is extreme Vitamin D deficiency, which can lead to severe muscle and bone weakness in adults and bone deformity in children. Without enough Vitamin D, our bodies cannot absorb enough calcium needed to keep bones strong.
Aside from bone and muscle problems, Vitamin D deficiency has also been associated with brain function issues, kidney disease, respiratory concerns, diabetes, some cancers, gastrointestinal problems, autoimmune diseases, hypertension and heart disease.
SUN EXPOSURE
When thinking about sun exposure, it is important to balance Vitamin D concerns with the risks, including skin cancer, sunburn and skin poisoning. Darker skin pigments offer more protection from skin damage, but are less efficient at synthesizing vitamin D. Therefore, individuals with dark skin and people who use daily sunscreen are at greater risk for vitamin D deficiency.
People who spend most of their time indoors or covered with clothing are also at higher risk for deficiency. This may include infants, housebound elderly or disabled, anyone with a condition or using medication that requires limiting sun exposure, anyone who wears religious coverings, as well as those living north of the line from Baltimore to San Francisco. Elderly persons, in addition to having less sun exposure, may be less efficient in making Vitamin D through their skin. People with obesity and some digestive diseases may have trouble absorbing Vitamin D.
UV RAYS
The UV index is a system to tell people the strength of UV rays each day. We make the most Vitamin D in our skin when the UV index is greater than 3. During summer months and in warmer climates, enough Vitamin D can be created with 10-15 minutes of sun exposure, twice a week, on the face, hands and arms (without sunscreen). You can check your local UV index daily at http://www.epa.gov/sunwise/uvindex.html. BE CAREFUL to avoid exposure on days when the UV index is 6 or above. Exposure to the sun for extended periods of time is dangerous, so use the UV index to help you avoid unsafe sun exposure.
If your body cannot produce enough vitamin D because of insufficient sunlight exposure, you will need to obtain it from foods and/or supplements. Experts now suggest that people with risk of vitamin D deficiency should consume 1000 IU of vitamin D each day. Those who are already deficient may need higher doses to achieve an increase in the bloodstream. It’s very important to talk to your doctor about your risk for vitamin D deficiency before beginning any supplements. He /she will help you determine what your body requires. If you have children, their pediatrician may have specific recommendations regarding Vitamin D.
The threshold for safe vitamin D levels is very high, and the body will not create an unsafe amount from sun exposure. However, it is important not to take in too much through food or supplements. This can cause the intestines to absorb too much calcium, which may lead to calcium deposits in the heart and lungs, confusion and disorientation, kidney problems, nausea, vomiting, constipation, poor appetite and muscle weakness.
NUTRITION
In climates where Vitamin D cannot be sufficiently absorbed from sun exposure, the diet is often high in oily fish, which are also good for heart health. Again, it is important to balance the benefits of vitamin D with the risk of too much mercury (especially pregnant women). To learn more about which fish are low in mercury, go to: http://www.nrdc.org/health/effects/mercury/guide.asp. Some foods are fortified with vitamin D, including breakfast cereals, oil spreads (ie. Smart Balance), dairy products*, milk alternatives (soy, almond, rice) and some orange juice.
SUMMARY
If you are concerned about your Vitamin D level, here are 3 ways to increase it:
- safe and adequate sun exposure
- a diet with vitamin D rich or fortified foods
- supplements
Be sure to speak with your doctor before taking steps to address your risk of deficiency.
*All forms of milk contain the same amount of Vitamin D supplementation. Skim or fat-free milk is the best choice for heart health and contains as much Vitamin D as whole milk, which is sometimes confusingly called “Vitamin D Milk.”
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