Vitamin D status and sun exposure in southeast Asia

Hataikarn Nimitphong, Michael F Holick, Hataikarn Nimitphong, Michael F Holick

Abstract

Vitamin D deficiency is more common in South Asia and Southeast Asia than is appreciated. Most studies defined 25-hydroxyvitamin D levels [25(OH)D] levels of less than 50 nmol/L (20 ng/mL) as vitamin D deficiency. With this cut-off level, the prevalence of vitamin D deficiency was about 70% or higher in South Asia and varied from 6-70% in Southeast Asia. The determinants for the variation of vitamin D status are skin pigmentation, aging, the sun protection behaviors such as application of a sunscreen, religious, lifestyle and nutritional differences. Advanced age is a known risk factor for vitamin D deficiency. Interestingly, elderly in countries such as Korea and Thailand, had higher 25(OH)D levels when compared with young people. This widespread vitamin D deficiency problem especially in the young generation is an urgent health issue that needs to be remedied.

Keywords: 25-hydroxyvitamin D; Southeast Asia; sun exposure; vitamin D deficiency; vitamin D3.

References

    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81. doi: 10.1056/NEJMra070553.
    1. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. IOF Committee of Scientific Advisors (CSA) Nutrition Working Group Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20:1807–20. doi: 10.1007/s00198-009-0954-6.
    1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy of Sciences 2011.
    1. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Endocrine Society Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–30. doi: 10.1210/jc.2011-0385.
    1. Babu US, Calvo MS. Modern India and the vitamin D dilemma: evidence for the need of a national food fortification program. Mol Nutr Food Res. 2010;54:1134–47.
    1. Puri S, Marwaha RK, Agarwal N, Tandon N, Agarwal R, Grewal K, et al. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle. Br J Nutr. 2008;99:876–82. doi: 10.1017/S0007114507831758.
    1. Shivane VK, Sarathi V, Bandgar T, Menon P, Shah NS. High prevalence of hypovitaminosis D in young healthy adults from the western part of India. Postgrad Med J. 2011;87:514–8. doi: 10.1136/pgmj.2010.113092.
    1. Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H, et al. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care. 2009;32:1278–83. doi: 10.2337/dc09-0209.
    1. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, et al. Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab. 2011;96:643–51. doi: 10.1210/jc.2010-2133.
    1. Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health. 2011;11:853. doi: 10.1186/1471-2458-11-853.
    1. Robien K, Butler LM, Wang R, Beckman KB, Walek D, Koh WP, et al. Genetic and environmental predictors of serum 25-hydroxyvitamin D concentrations among middle-aged and elderly Chinese in Singapore. Br J Nutr. 2012 In press.
    1. Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79:362–71.
    1. Matsuoka LY, Ide L, Wortsman J, MacLaughlin JA, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab. 1987;64:1165–8. doi: 10.1210/jcem-64-6-1165.
    1. Hyppönen E, Power C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007;85:860–8.
    1. MacLaughlin J, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest. 1985;76:1536–8. doi: 10.1172/JCI112134.
    1. Holick MF, Matsuoka LY, Wortsman J. Age, vitamin D, and solar ultraviolet. Lancet. 1989;2:1104–5. doi: 10.1016/S0140-6736(89)91124-0.
    1. Moy FM. Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia. J Photochem Photobiol B. 2011;104:444–8. doi: 10.1016/j.jphotobiol.2011.05.002.
    1. Kung AW, Lee KK. Knowledge of vitamin D and perceptions and attitudes toward sunlight among Chinese middle-aged and elderly women: a population survey in Hong Kong. BMC Public Health. 2006;6:226. doi: 10.1186/1471-2458-6-226.
    1. Webb AR, Engelsen O. Calculated ultraviolet exposure levels for a healthy vitamin D status. Photochem Photobiol. 2006;82:1697–703.
    1. Setiati S. Vitamin D status among Indonesian elderly women living in institutionalized care units. Acta Med Indones. 2008;40:78–83.
    1. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PV, Sarma KV, et al. High prevalence of low dietary calcium, high phytate consumption, and vitamin D deficiency in healthy south Indians. Am J Clin Nutr. 2007;85:1062–7.
    1. Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child. 2002;87:111–3. doi: 10.1136/adc.87.2.111.
    1. Nakamura K. Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis. J Bone Miner Metab. 2006;24:1–6. doi: 10.1007/s00774-005-0637-0.
    1. Holick MF. McCollum Award Lecture, 1994: vitamin D--new horizons for the 21st century. Am J Clin Nutr. 1994;60:619–30.
    1. Jayaratne N, Russell A, van der Pols JC. Sun protection and vitamin D status in an Australian subtropical community. Prev Med. 2012;55:146–50. doi: 10.1016/j.ypmed.2012.05.011.
    1. Chen W, Clements M, Rahman B, Zhang S, Qiao Y, Armstrong BK. Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China. Cancer Causes Control. 2010;21:1701–9. doi: 10.1007/s10552-010-9599-1.
    1. Juzeniene A, Ma LW, Kwitniewski M, Polev GA, Lagunova Z, Dahlback A, et al. The seasonality of pandemic and non-pandemic influenzas: the roles of solar radiation and vitamin D. Int J Infect Dis. 2010;14:e1099–105. doi: 10.1016/j.ijid.2010.09.002.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit