THE D VITAMIN

Vitamin D

One reads, regularly, about this or that vitamin that becomes the flavour of the month, with the press enthusiastically punting the selected letter as a panacea for every health need.

However, humans need a balanced mix of all the vitamins and minerals for optimum health. Recent studies, however, have shown that South Africans, like the Americans, are severely lacking (over 70% of the population) in Vit D.

Vit D is actually a fat soluble hormone (not really a vitamin, as this category requires us daily to ingest the range because the body is unable to manufacture or store vitamins).

D is found in two major forms, Vit D2 and Vit D3, the former found in certain foods, while the latter is synthesized in our skin when it is exposed to UVB light from the sun. Vit D synthesis starts in the skin and then the liver and kidneys process it into its final active form, known as calcitriol. This, the body can store until it is used and depleted.

D is found in few foods, such as oily fish, like salmon, mackerel, sardines, and tuna, and it appears in the yolk of eggs. Vit D is essential for a range of bodily functions. It promotes calcium absorption in the gut and helps the normal mineralization of bone for bone growth. Without it, bones become thin, brittle or misshapen and muscles weaken. It prevents rickets in children and, together with calcium, helps protect older adults from osteoporosis and degeneration of the nervous system. It also has roles in the neuromuscular and immune systems and reduces inflammation. Recent tests have shown that athletes in the northern hemisphere, who train indoors or have little exposure to the sun, perform at a lower level than those with sufficient Vit D, and there is also strong evidence that Vit D helps prevent the incidence of colon cancer and, possibly, breast cancer, as well as helping in the treatment of both types of diabetes.

The irony, in a country like ours, blessed with ample sunlight, is that the population suffers from D deficiencies. While it is sensible to limit exposure of the skin to too much of the sun’s rays or through the ridiculous use of tanning machines that create artificial UV radiation (skin cancer is a major hazard in both), researchers suggest that between five and 30 minutes of sun exposure to the face, arms, legs and body, at least 3 times a week, without sunscreen, before 10.00am and after 15.00pm, will lead to sufficient Vit D synthesis. It is said that the skin can produce approx. 10,000 International Units of Vit D in response to 20-30 mins. of summer sun exposure, which is 50 times more than the U.S, government’s recommendation of 200-400 I.U’s a day!

However, the old Recommended Daily Allowance (RDA) of D is considered to be hopelessly outdated and open to new considerations. For example, the Canadian Cancer Society recommends 1000 I.U’s daily (note that one egg contains only 20 I.U’s and one serving of canned tuna contains only 200 I.U’s) and research shows that adults seem able to tolerate levels of 2000 I.U’s a day without contraindications.

Our needs vary, according to each stage of life, and especially for those over 50, the skin is shown to be less able to synthesize D as efficiently and the kidneys less able to convert D to its active hormone form (hence, the need for supplementation). In March, 2007, a group of Vit D and nutrition researchers published a controversial and provocative editorial that noted that supplemental intakes of +-1700 I.U. a day were needed to raise Vit D concentrations to the level they believed was adequate for optimal human health.

The jury is still out on just how much D we need. It seems clear, however, that we need more than we synthesize at present. The blood test for D is known as the Calcidiol Test (the 25-hyrdoxyvitamin D test), with optimal Vit D blood levels at 50ng/mL (125 nmol/L), according to the Vitamin Council, USA, and it might be prudent to ask your MD about being tested. Whatever the case, a little more exposure to the fresh air and abundant sunlight freely available to all, should do us all the world of good!

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