Vitamin D status and sun exposure in India

Chittari V Harinarayan, Michael F Holick, Upadrasta V Prasad, Palavali S Vani, Gutha Himabindu, Chittari V Harinarayan, Michael F Holick, Upadrasta V Prasad, Palavali S Vani, Gutha Himabindu

Abstract

Background: Little if any cutaneous production of vitamin D3 occurs at latitudes above and below 35° N and 35° S during the winter months. It was postulated that those residing in tropics synthesize enough vitamin D3 year round. Several studies have documented the effect of latitude, season and time of the day on the cutaneous production of vitamin D3 in an ampoule model. Studies from India have shown high prevalence of vitamin D deficiency despite abundant sunshine.

Methods: We studied the influence of season and time of the day on synthesis of previtamin D3 in an ampoule model in Tirupati, (latitude 13.40° N and longitude 77.2° E) south India, between May 2007 to August 2008. Sealed borosilicate glass ampoules containing 50 μg of 7-DHC in 1 ml of methanol were exposed to sunlight hourly from 8 a.m. until 4 p.m. The percent conversion of 7-DHC to previtamin D3 and its photoproducts and the percent of previtamin D3 and vitamin D3 formed was estimated and related to solar zenith angle.

Results: The percent conversion of 7-DHC to previtamin D3 and its photoproducts and formation of previtamin D3 and vitamin D3 was maximal between 11 a.m. to 2 p.m. of the day during the entire year (median 11.5% and 10.2% respectively at 12.30 p.m.).

Conclusions: Therefore at this latitude exposure to sunlight between the hours of 11 a.m. and 2 p.m. will promote vitamin D production in the skin year round.

Keywords: 7-dehydrocholesterol (7-DHC); India; previtamin D3; sun exposure; vitamin D3; zenith angle.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g1.jpg
Figure 1. Influence of time of day and season on synthesis of previtamin D3 at Tirupati located at 13.4° N and 79.2° E. Figure shows the relation between zenith angles (ZA), percent conversion of 7-Dehydrocholesterol (7-DHC) to previtamin D3 and photoproducts, and the percentage of previtamin D3 and vitamin D3 (%Pre D3+D3) formed from May 2007 to August 2008. The correlations between them are shown individually for each day. The maximum (max) and minimum (min) temperature (Temp) on the day of the study is given above each day studied. August 2007 is not depicted. r, correlation coefficient; P, significance.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g2.jpg
Figure 2. Showing the mean ± SD of the zenith angles, percent conversion of 7-Dehydrocholesterol (7-DHC) to previtamin D3 and photoproducts, and the percentage of previtamin D3 and vitamin D3 against time (for the study duration). The table below gives the individual values, minimum and maximum of the variables.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g3.jpg
Figure 3. Figure depicting the percent conversion of 7-Dehydrocholesterol (7-DHC) to previtamin D3 and photoproducts, and the percentage of previtamin D3 and vitamin D3 formed from May 2007 to August 2008 along with zenith angles of various time of the day during the whole study period.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g4.jpg
Figure 4. Three-dimensional depictions of the percent conversion of 7-DHC to previtamin D3 and photoproducts and percentage of previtaminD3 and vitamin D3 along with zenith angles of various time of the day during the whole study period. Maximum temperature on the day of the study is also depicted in the same graph.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g5.jpg
Figure 5. Satellite picture of the country on the day of study at 11.30 h. First picture on the left upper panel (row 1) shows the location of study site (TIRUPATI—latitude 13.40° N and longitude 77.2° E). The date and maximum and minimum temperature on the day of study is shown in each picture. The satellite picture is downloaded from www.hinduonnnet.com under section miscellaneous—weather chart.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g6.jpg
Figure 6. Percent conversion of 7-DHC to previtamin D3 and photoproducts and formation of previtamin D3 and vitamin D3 for three similar months in consecutive years—May, June and July in 2007 and 2008.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3897581/bin/de-5-130-g7.jpg
Figure 7. (A) Graph showing the inverse correlation between the 25 (OH) D levels and latitude (r = −0.48; p < 0.0001) from various studies conducted in the country (Table 1). (B) The 25 (OH) D levels of various studies from India along with latitude and location from various studies conducted in the country (Table 1).

References

    1. Holick MF. Vitamin D requirements for the elderly. Clin Nutr. 1986;5:121–129.
    1. Holick MF. Vitamin D: a millenium perspective. J Cell Biochem. 2003;88:296–307. doi: 10.1002/jcb.10338.
    1. Chen TC. Photobiology of vitamin D. In: Holick MF, ed. Vitamin D physiology, molecular biology, and clinical applications. Clifton, NJ: Humana Press, 1998:17-37.
    1. Chen TC, Chimeh F, Lu Z, Mathieu J, Person KS, Zhang A, et al. Factors that influence the cutaneous synthesis and dietary sources of vitamin D. Arch Biochem Biophys. 2007;460:213–7. doi: 10.1016/j.abb.2006.12.017.
    1. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67:373–8. doi: 10.1210/jcem-67-2-373.
    1. Hodgkin P, Hine PM, Kay GH, Lumb GA, Stanbury SW. Vitamin-D deficiency in Asians at home and in Britain. Lancet. 1973;2:167–71. doi: 10.1016/S0140-6736(73)93004-3.
    1. Harinarayan CV, Joshi SR. Vitamin D status in India--its implications and remedial measures. J Assoc Physicians India. 2009;57:40–8.
    1. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D. Vitamin D status in Andhra Pradesh : a population based study. Indian J Med Res. 2008;127:211–8.
    1. Webb AR. Who, what, where and when-influences on cutaneous vitamin D synthesis. Prog Biophys Mol Biol. 2006;92:17–25. doi: 10.1016/j.pbiomolbio.2006.02.004.
    1. MacLaughlin JA, Anderson RR, Holick MF. Spectral character of sunlight modulates photosynthesis of previtamin D3 and its photoisomers in human skin. Science. 1982;216:1001–3. doi: 10.1126/science.6281884.
    1. The Asian Brown Cloud (ABC) The Asian Brown Cloud (ABC). UNEP and C4 (2002). The Asian brown Cloud: climate and other environmental impacts. UNEP, Nairobi. Environ Sci Pollut Res Int. 2002;9:289–95. doi: 10.1007/BF02987567.
    1. Pandve HT. The Asian brown cloud. Indian J Occup Environ Med. 2008;12:93–5. doi: 10.4103/0019-5278.43269.
    1. Winker DM, Vaughan MA, Hunt WH. The CALIPSO mission and initial results from CALIOP. In Lidar Remote Sensing for Environmental Monitoring VII. Proc SPIE. 2006;6409:1–8. doi: 10.1117/12.698003.
    1. Ramanathan V. Indian ocean experiment: An integrated analysis of the climate forcing and effects of the great Indo-Asian haze. J Geophys Res. 2007;106:28371–98. doi: 10.1029/2001JD900133.
    1. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124:869–71. doi: 10.1001/archderm.1988.01670060015008.
    1. Ladizesky M, Lu Z, Oliveri B, San Roman N, Diaz S, Holick MF, et al. Solar ultraviolet B radiation and photoproduction of vitamin D3 in central and southern areas of Argentina. J Bone Miner Res. 1995;10:545–9. doi: 10.1002/jbmr.5650100406.
    1. Lu Z, Chen TC, Holick MF. Influence of season and time of day on the synthesis of vitamin D3. In: Holick MF, Kligman AM, eds. Biological effects of light. Berlin/New York: Walter de Gruyter, 1992:57-61.
    1. Jablonski NG, Chaplin G. Colloquium paper: human skin pigmentation as an adaptation to UV radiation. Proc Natl Acad Sci U S A. 2010;107(Suppl 2):8962–8. doi: 10.1073/pnas.0914628107.
    1. Fioletov VE, McArthur LJ, Mathews TW, Marrett L. Estimated ultraviolet exposure levels for a sufficient vitamin D status in North America. J Photochem Photobiol B. 2010;100:57–66. doi: 10.1016/j.jphotobiol.2010.05.002.
    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. Weihs P, Webb AR, Hutchison SJ, Middleton GW. Measurement of diffuse U V sky radiance during broken cloud conditions. J Geophys Res. 2000;105:4945–8. doi: 10.1029/1999JD900260.
    1. Grant RH, Heisler GM. Estimation of ultraviolet B irradiation under variable cloud conditions. J Appl Meteorol. 2000;39:904–16. doi: 10.1175/1520-0450(2000)039<0904:EOUBIU>;2.
    1. Holick MF, Chen TC, Lu Z, Sauter E. Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res. 2007;22(Suppl 2):V28–33. doi: 10.1359/jbmr.07s211.
    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. Webb AR, Engelsen O. Calculated ultraviolet exposure levels for a healthy vitamin D status. Photochem Photobiol. 2006;82:1697–703.
    1. Engelsen O. Norwegian Institute for Air Research. Calculated ultraviolet exposure levels for a healthy vitamin D status. 2005; Available at: .
    1. Engelsen O, Brustad M, Aksnes L, Lund E. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochem Photobiol. 2005;81:1287–90. doi: 10.1562/2004-11-19-RN-375.
    1. Zargar AH, Ahmad S, Masoodi SR, Wani AI, Bashir MI, Laway BA, et al. Vitamin D status in apparently healthy adults in Kashmir Valley of Indian subcontinent. Postgrad Med J. 2007;83:713–6. doi: 10.1136/pgmj.2007.059113.
    1. Ramakrishnan S, Bhansali A, Bhadada SK, Sharma R, Walia R, Ravikiran M, et al. Vitamin D status and its seasonal variability in healthy young adults in an Asian Indian urban population. Endocr Pract. 2011;17:185–91. doi: 10.4158/EP10155.OR.
    1. Harinarayan CV, Gupta N, Kochupillai N. Vitamin D status in primary hyperparathyroidism in India. Clin Endocrinol (Oxf) 1995;43:351–8. doi: 10.1111/j.1365-2265.1995.tb02043.x.
    1. Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N. Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr. 2000;72:472–5.
    1. Tiwari L, Puliyel JM. Vitamin D level in slum children of Delhi. Indian Pediatr. 2004;41:1076–7.
    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. Marwaha RK, Tandon N, Reddy DR, Aggarwal R, Singh R, Sawhney RC, et al. Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr. 2005;82:477–82.
    1. Tandon N, Marwaha RK, Kalra S, Gupta N, Dudha A, Kochupillai N. Bone mineral parameters in healthy young Indian adults with optimal vitamin D availability. Natl Med J India. 2003;16:298–302.
    1. Goswami R, Kochupillai N, Gupta N, Goswami D, Singh N, Dudha A. Presence of 25(OH) D deficiency in a rural North Indian village despite abundant sunshine. J Assoc Physicians India. 2008;56:755–7.
    1. Jain V, Gupta N, Kalaivani M, Jain A, Sinha A, Agarwal R. Vitamin D deficiency in healthy breastfed term infants at 3 months & their mothers in India: seasonal variation & determinants. Indian J Med Res. 2011;133:267–73.
    1. Marwaha RK, Tandon N, Chopra S, Agarwal N, Garg MK, Sharma B, et al. Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels. Br J Nutr. 2011;106:1383–9. doi: 10.1017/S000711451100170X.
    1. Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India. 2011;59:706–9.
    1. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr. 2005;81:1060–4.
    1. Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P, Pandey A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf) 2009;70:680–4. doi: 10.1111/j.1365-2265.2008.03360.x.
    1. Balasubramanian K, Rajeswari J, Gulab, Govil YC, Agarwal AK, Kumar A, et al. Varying role of vitamin D deficiency in the etiology of rickets in young children vs. adolescents in northern India. J Trop Pediatr. 2003;49:201–6. doi: 10.1093/tropej/49.4.201.
    1. Arya V, Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int. 2004;15:56–61. doi: 10.1007/s00198-003-1491-3.
    1. Bhalala U, Desai M, Parekh P, Mokal R, Chheda B. Subclinical hypovitaminosis D among exclusively breastfed young infants. Indian Pediatr. 2007;44:897–901.
    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. Ekbote VH, Khadilkar AV, Mughal MZ, Hanumante N, Sanwalka N, Khadilkar VV, et al. Sunlight exposure and development of rickets in Indian toddlers. Indian J Pediatr. 2010;77:61–5. doi: 10.1007/s12098-009-0263-2.
    1. Harinarayan CV, Ramalakshmi T, Venkataprasad U. High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr. 2004;13:359–64.
    1. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PVLN, Sarma KVS, 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. Harinarayan CV. Prevalence of vitamin D insufficiency in postmenopausal south Indian women. Osteoporos Int. 2005;16:397–402. doi: 10.1007/s00198-004-1703-5.
    1. Harinarayan CV, Sachan A, Reddy PA, Satish KM, Prasad UV, Srivani P. Vitamin D status and bone mineral density in women of reproductive and postmenopausal age groups: a cross-sectional study from south India. J Assoc Physicians India. 2011;59:698–704.
    1. Harinarayan CV, Shalini J, Appicatlaa L, Nalini A. Vitamin D Status of Upper Socioeconomic Status Subjects of South Indians Living in High Altitude (Bengaluru) Endocr Rev. 2012;33 (03_MeetingAbstracts):Abstract No. MON-352.
    1. Paul TV, Thomas N, Seshadri MS, Oommen R, Jose A, Mahendri NV. Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin D status. Endocr Pract. 2008;14:665–71.
    1. Sanalkumar N, Nair PS, Bontha S. Vitamin D Deficiency in Middle East. Endocr Rev. 2012;33 (03_MeetingAbstracts):MON-347.
    1. Holick MF, Vitamin D. The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes. 2002;9:87–98. doi: 10.1097/00060793-200202000-00011.

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