Vitamin D deficiency, which is often seen in post-menopausal women and older Americans, has been associated with greater incidence of hip fractures. In a review of women with osteoporosis hospitalized for hip fractures, 50 percent were found to have signs of vitamin D deficiency. Daily supplementation with 20 800 IU of vitamin D may reduce the risk of osteoporotic fractures in elderly populations with low blood levels of vitamin D. The Decalyos II study examined the effect of combined calcium and vitamin D supplementation in a group of elderly women who were able to walk indoors with a cane or walker. The women were studied for two years, and results suggested that such supplementation could reduce the risk of hip fractures in this population.
Rickets and osteomalacia are classic vitamin D deficiency diseases. In children, vitamin D deficiency causes rickets, which results in skeletal deformities. In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones. Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals, exclusively breastfed infants, and those who have limited sun exposure. Also, individuals who have fat malabsorption syndromes (e.g., cystic fibrosis) or inflammatory bowel disease (e.g., Crohn's disease) are at risk.
Older Americans (greater than age 50) are thought to have a higher risk of developing vitamin D deficiency. The ability of skin to convert vitamin D to its active form decreases as we age. The kidneys, which help convert vitamin D to its active form, sometimes do not work as well when people age. Therefore, some older Americans may need vitamin D from a supplement.
It is important for individuals with limited sun exposure to include good sources of vitamin D in their diets. Homebound individuals, people living in northern latitudes such as in New England and Alaska, women who cover their body for religious reasons, and individuals working in occupations that prevent exposure to sunlight are at risk of a vitamin D deficiency. If these individuals are unable to meet their daily dietary need for vitamin D, they may need a supplement of vitamin D.
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