U.S. Faces Epidemic of Vitamin D Deficiency

According to a recent report published in the Archives of Internal Medicine, a vitamin D deficiency epidemic has hit the United States and current recommendations for vitamin D supplements are inadequate. According to the National Health and Nutrition Examination Survey vitamin D deficiency has tripled since 1994. The analysis included serum specimens from 13,369 people ages 12-60 between 2001-2004 and compared them to 18,883 specimens obtained between 1998-1994.

Authors' observations:

• Vitamin D supplementation should consist of at least 1000 IU, especially during the winter months for those living in northern latitudes (i.e. above Atlanta, Georgia)
• Current recommendations for Vitamin D supplementation (200-600 IU/d) are too low
• It is unknown what the optimal serum level is for vitamin D - most likely above 40 ng/ml
• The average vitamin D level of people ages 12-60 was 24 ng/mL
  
• Vitamin D deficiency in the African American population is the highest at 29%
• Several factors contribute to vitamin D deficiency including decreased time outdoors, obesity and the use of sunblock. (SPF 15 decreases vitamin D synthesis by 99%)

What I tell my patients:

• Vitamin D deficiency contributes to osteoporosis, depression, diabetes, many forms of cancer, cardiovascular disease, multiple sclerosis, etc.
• 25-hydroxy vitamin D levels should be checked annually (optimally between November and April when levels are likely to be lowest)
• Those most at risk for vitamin D deficiency: elderly, people of color, people who are unable to get sun exposure, and those who routinely cover their heads when walking outside
  
• You need 20 minutes of sun exposure without sunblock 3 times per week for adequate vitamin D synthesis. Care should be taken to avoid sunburn.
• Thirty minutes of sun exposure in a bathing suits results in the formation of 20,000 IU of vitamin D
  
• Our food supply does not contain adequate amounts of vitamin D supplementation - not even dairy products
  
• Everybody, with very few exceptions, should be on vitamin D supplementation 1000 IU/d
• I recommend an optimal level of 52-80 ng/mL. One study demonstrated that a level of 52 ng/mL decreases your risks of colon, breast and ovarian cancer by up to fifty percent!
• Supplements of 1000 IU can be purchased without a perscription and are relatively inexpensive.

Reference:
Ginde AA, et al. Dmographic differences and trends of vitamin D insufficiency int he US population, 1988-2004. Arch Intern Med. 2009;169(6):626-632.