Vitamin D insufficiency is a major public health issue

The International Osteoporosis Foundation (IOF) has launched an interactive global map based on a review of literature published between 1990 and 2011, which confirms that more than one third of all the populations studied in the developing and industrialized world show insufficient levels of vitamin D.

The map (1) and an accompanying publication (2) show that vitamin D deficiency affects both the developing and industrialized world, with deficient statuses detected in more than one third of the populations studied. It is estimated that 50–70% of the European adult population have insufficient levels of vitamin D (mean
25(OH)D values below 50 nmol/L). In US adults, vitamin D deficiency estimates range from 20% (non-Hispanic whites) to 70% (non-Hispanic blacks).The main source of vitamin D is sunlight, but even in sunny countries such as India, vitamin D levels are generally low and remain below the recommended amounts. Rates of vitamin D deficiency are higher amongst women than men. Older people are particularly at risk of vitamin D deficiency, particularly older women, who are an at-risk group for osteoporosis, and those living indoors in institutionalized care.

Osteoporosis is a serious chronic disease which affects hundreds of millions of people worldwide. Vitamin D improves bone mineral density, which lowers the risk of fracture, while also improving muscle strength, balance and leg function, which lowers the risk of falling and sustaining a fracture in the first place. As a consequence, vitamin D insufficiency has been linked to a higher risk of osteoporotic fractures. Studies show that adequate vitamin D levels can reduce the risk of falls and fractures by around 30% (3). In Germany, research has indicated that regular supplementation of vitamin D can help achieve healthcare cost savings of between €585-778 million in one country alone (4).

The IOF is urging people at risk of osteoporosis, and generally all seniors aged 60 or over, to ensure they have an optimal intake of vitamin D. For these high-risk groups, the IOF recommends a daily supplementa-tion of 800­-1000 IU in order to prevent falls and fractures. With the launch of these maps, the IOF is calling on health professionals to take note of the level of vitamin D deficiency within their own countries and is urging them to take simple and inexpensive steps to correct it. This could ultimately improve, and even save, many lives.

Experts have noted that the body’s natural ability to produce vitamin D from sunlight decreases with age, making it very difficult to achieve sufficient vitamin D levels through the diet alone, especially in the elderly. Vitamin D supplementation therefore offers an effective, inexpensive, and safe public health alternative that can make a significant difference to people’s health and quality of life, possibly reducing falls and hip frac-tures by up to 30%.

1.  http://www.iofbonehealth.org/facts-and-statistics/vitamin-d-studies-map
   
   
2. Wahl D. A. et al. A Global Representation of Vitamin D status in healthy populations. Archives of Osteoporosis. Published online August 2012.
   
   
3. Bischoff-Ferrari H. A. et al. A pooled analysis of vitamin D dose requirements for fracture prevention. New England Journal of Medicine. 2012; 367(1):40–49.
   
   
4. Grant W. B. et al. Estimated benefit of increased vitamin D status in reducing the economic burden of disease in Western Europe. Prog Biophys Mol Biol. 2009; 99(2-3):104–113.