To put it simply, vitamin D is a hormone that assist the body to absorb phosphorus and calcium for bone development and neuromuscular function. The body makes its own vitamin D through a process that involves the skin, liver, and kidneys in that sequence. Total vitamin D pool in the body consists of the internally produced vitamin D and that taken with food and supplements.

Shortage of vitamin D can lead to osteopenia, precipitates and exacerbates osteoporosis, increased muscle weakness which worsens the risk of falls and fractures. Common causes of vitamin D deficiency are low exposure to sunlight, decreased skin synthesis, poor intestinal absorption and inadequate diet. There is a high prevalence of vitamin D deficiency in apparently healthy individuals. Osteoporosis is the commonly known condition associated with lack of vitamin D. Osteoporosis is associated with bone mass reduction and changes in bone turnover and structure leading to a decreased resistance to low energy trauma. Osteoporosis is often known as a silent illness because many people do not know that they have it until its too late.

It is estimated that more than 75 million people in Europe, US and Japan have osteoporosis. In Europe more than 1.1 million fractures associated with osteoporosis occur every year. It is predicted that by 2050 osteoporosis related hip fractures could increase 204% in women and 310% in males just because of population aging. Falls due to neuromuscular dysfunction causes many hospital admissions, death and health expenditure. Vitamin D supplementation reduces the number of fractures and directly improves neuromuscular function thus help in prevention of falls and subsequent fractures. The simplest way to correct vitamin D deficiency is through adequate nutrition and supplements.

Vitamin D can be acquired from foods such as egg yolks, butter, cod liver oil, and cold-water fish such as Salmon. Milk and margarine with added vitamin D still seems to be the important source of this vitamin in some countries. For many people the most common and a simple source of vitamin D is through supplements. These supplements are commonly available in two forms D2 and D3. D3 is believed to have the most potent properties and is the preferred form. Adequate daily intake is 200IU of vitamin D from infancy to 50 years of age, 400IU for 51-70 years and 600IU for those aged above 70.

Vitamin D and sun exposure:

Black people mostly have a low levels of vitamin D compared to people from other races, this is due to the fact that skin pigmentation decreases vitamin D production. Despite low vitamin production levels black people rarely have less osteoporotic fracture rates compared to other groups possibly because of better absorption rates of both vitamin D and calcium. The prevalence of low vitamin D is also common with people especially women wearing clothes that prevent sunlight exposure, especially within the Muslin communities. Moreover, osteoporosis prevalence is increased in postmenopausal women who wear the traditional concealing clothes that cover arms, head and legs, due to inadequate sun exposure combined with hormonal changes.

Vitamin D and Obesity:

Obesity is usually associated with reduced levels of vitamin D, it is postulated that this is due to two factors, which are limited mobility and increased storage of vitamin D in fat tissue. Sometimes obesity can be a consequence of low vitamin D levels. Vitamin D production after sun exposure in obese people is not impaired but it is not adequately transferred from skin to the liver and becomes trapped in skin fat.

Vitamin D and other conditions:

There are conditions that interfere with vitamin D absorption such, Chron's disease, Down's syndrome, heparin use, warfarin, some anti-epileptic drugs, and some anti-tuberculosis drugs. Unspecified bone or muscle pain is most commonly due to deficiency of Vitamin D, these complaints are common in the elderly and during Winter. People with Type 2 diabetes usually have low bone turnover but their osteoporotic rate is not different from the general population.

In conclusion!

Researchers postulate that longterm treatment with vitamin D in the aged decrease fracture incidents by improving both the quality of bone formed and nerve and muscular control of movement, thus reducing the trend towards suataining falls.

Vitamin D insufficiency is along term condition that becomes manifest mostly in the elderly and postmenopausal women. The condition itself begins earlier on in life. This implies therefore that people should not wait until later in life to take corrective measures of this condition, earlier treatment can have long term benefits. The beauty of the vitamin D insufficiency treatment is in the fact that it can easily be managed.

The simplest cost-effective ways of ensuring adequate vitamin D levels lie on the following measures:

1. Physical activity increases bone strength thus providing protection from minor injuries that lead to fractures

2. Adequate exposure to sunlight, it is said that 10 to 15 minutes of exposure a day is adequate to provide sufficient vitamin D (taking into consideration seasonal variations).

3. Diet rich with vitamin D.

4. The easiest is taking supplements with vitamin D.

Adequate vitamin D levels, supplements of calcioum and other minerals, and exercise help decrease the risk of falls and fractures and also reduction in tooth loss. Postmenopausal women should take their a combination of an antiresporptive drug with vitamin D supplements.