(1) Rickets: Vitamin D deficiency leads to rickets, which is usually observed in young children between the age of six months and two years. There is reduced calcification of growing bones. The disease is characterized by growth failure, bone deformity, muscular hypotonia, tetany and convulsions due to hypo-calcemia. There is an elevated concentration of alkaline phosphates in the serum. The bony deformities include curved legs, deformed pelvis, pigeon chest, Harrison's sulcus, rickety rosary, kyphoscoliosis, etc. The milestones of development such as walking and teething are delayed.
(2) Osteomalcia: In adults, vitamin D deficiency may result in osteomalacia, which occurs mainly in women, especially during pregnancy and lactation when requirements of vitamin D are increased.
Both rickets and osteomalacia are frequently reported in India, although they do not appear to be a problem of public health importance. In the world as a whole, their prevalence has declined as a result of changes in social customs (e.g., purdah system), and the expansion of mother and children health services leading to better care and feeding of infants and children (3). In the developing countries today, rickets as a menace to child health is overshadowed by the prevalence of protein energy malnutrition.
Prevention: Preventive measures include
(a) Educating parents to expose their children regularly to sunshine; (b) Periodic dosing (prophylaxis) of young children with vitamin D; and vitamin D fortification of foods, especially milk. Some industrialized countries still carry out the last measure. Periodic dosing and education appear to be the most practical approaches in developing countries.
Fraser urges caution concerning oral supplementation, because orally administered vitamin D appears to bypass the protective mechanism the prevent excessive 25 (OH) D 3 formation. The margin of safety with oral vitamin D between the nutrient requirement and toxic intake is narrow. The signs of vitamin d toxicity are usually related to hypercalcemia, like thirst, anorexia, polyuria and the risk of metastic calcification.
Vitamin D Deficiency And Cancer
Vitamin D is also added to milk and to some brands of orange juice, soymilk and cereals. At this time vitamin D is not added to other milk products like cheese, yogurt and butter. Vitamin D is free and the secret of the Hormone has been intentionally kept hidden from the public so vitamins can be sold in place of free sunlight.
The sun lotion industry has tried to make everyone paranoid of the suns rays so that they can sell their poison. Vitamin D is synthesized in the skin upon exposure to ultraviolet B (UVB) radiation. However, this synthesis is affected by latitude, season, time of day, age, sunscreen use, and skin pigmentation (IOM, 1997).
Vitamin D is included in most multivitamins, usually in strengths from 50 IU to 1,000 IU as softgels, capsules, tablets, and liquids. Recommendations are: 5 micrograms (200 IU or International Units) daily for all individuals (males, female, pregnant/lactating women) under the age of 50 years-old. Vitamin D is not abundant in our usual food choices, so we get most of the vitamin from sun exposure and multivitamins. The problem is that the sun is not a reliable source for everyone.
Vitamin D is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts [4-6 ].
Vitamin D is a generic term and indicates a molecule of the general structure shown for rings A, B, C, and D with differing side chain structures. The A, B, C, and D ring structure is derived from the cyclopentanoperhydrophenanthrene ring structure for steroids.
Vitamin D is available in fortified foods (where vitamin D has been added) such as milk, cereals, or margarine. There is also a new vitamin D fortified orange juice available (fortified with the same amount of vitamin D as used in milk). Vitamin D is a vitamin that helps your body use calcium. Calcium is a mineral that gives strength to your bones and teeth.
Calcium-binding protein increases the rate of mucosal uptake of calcium. Since membrane permeability to calcium is enhanced by vitamin D, a corresponding increased uptake of phosphorus will occur to maintain electrical neutrality. Calcium is needed for muscle contraction, blood vessel contraction and expansion, secretion of hormones and enzymes, and message transmission through the nervous system.
Fortified foods are the major dietary sources of vitamin D. Prior to the fortification of milk products in the 1930s, rickets (a bone disease seen in children) was a major public health problem in the United States. Fortified foods are a major source of vitamin D. Breakfast cereals, pastries, breads, crackers, cereal grain bars and other foods may be fortified with 10% to 15% of the recommended daily value for vitamin D.
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