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Monday, September 1, 2014
There is a notable increase in the scientific and popular press regarding the role of vitamin D in health and wellness. Experts have noted widespread vitamin D deficiency, linking the deficiency to serious physical and mental health conditions, potentially compromising health and safety. For example, osteomalacia, resulting from Vitamin D deficiency, causes weak muscles and bones, increasing the risk for falls and, perhaps, even fractures.
Selected Health Conditions Associated With Vitamin D Deficiency. Cardiovascular disease (hypertension, MI), diabetes (impaired insulin/glucose tolerance) and depression pose increased riskto overall health, wellness, mortality Long-term osteoporosis (increased bone fracture risk) Weak bones and muscles (fall risk)
Sources of Vitamin D: Sunshine, Food and Supplements. We understand that the best source of Vitamin D is sunlight. Only a few natural foods contain Vitamin D, some foods are fortified, and it is also available as a supplement, however; experts disagree on the recommended dosage.
Vitamin D, nicknamed the "sunshine" vitamin because the nutrient needs the sun?s UVB rays to penetrate the skin to physically activate it. But natural aging changes in the skin results in less production of Vitamin D and using sunblock to help prevent burns and for skin cancer protection results in even fewer opportunities for older adults to naturally produce Vitamin D. In addition, those living in areas with less sunshine overall or who do not routinely have exposure to 15-20 minutes of sunshine experience a lower level of Vitamin D.
Dietary Intake of Vitamin D. Because so few foods contain Vitamin D, it is a challenge to obtain the recommended daily value (DV) set by the Food and Drug Administration (FDA). The foods that provide at least 20% of the daily DV for Vitamin D are salmon, tuna, mackerel and fish [cod] liver oil (>300-100%) DV.9 However, professionals working with older adults understand that as a result of poor dietary habits often due to illness, financial constraints, or other factors, it may be challenging for some older adults to meet the daily DV requirements through diet alone.
Supplemental Vitamin D. Vitamin D supplements are gaining widespread popularity among nutrition and aging experts who are currently recommending much higher doses than the current standard daily intake for older adults (400-600 IUs.) There is some evidence suggesting that taking supplemental Vitamin D, at the upper level recommended (2000 IU/day) by the Institute of Medicine could result in enhanced health protection for older adults against Vitamin D deficiency and insufficiency, reducing risks for developing or exacerbating certain life threatening or debilitating conditions.10 However, there is great disagreement among experts and scientists about whether Vitamin D is the "magic bullet" or panacea for what ails us. In addition, there is inconsistent data on what comprises the ideal dosage for specific age groups.
Despite the disagreement about specifics, there is cautious optimism about the health benefits of supplemental Vitamin D and the experts seek the definitive scientific evidence to support preventive and protective dosages. During the summer of 2010, the Institute of Medicine is expected to report their latest dosage recommendations. In the meantime, we encourage advising older adults to be cautious about Vitamin D supplementation and counsel them to consult their primary health provider for recommendations regarding their specific Vitamin D needs. Always, better safe than sorry!
Last Reviewed: Oct 11, 2010
Bonnie J Brehm, PhD, RD
Professor of Nursing
College of Nursing
University of Cincinnati