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Vitamin D deficiency in India https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060930/ Prevalence of Vitamin D deficiency ranged from 40% to 99% Most of the studies reporting a prevalence of 80%–90% Prevalent in all the age groups and high-risk groups alike Factors Major source, synthesis in skin on exposure to sunlight Ultraviolet B (UV-B) radiation, wavelength 290–320 nm Fish, fortified food, supplements Vegetables and grains are poor sources Latitude, solar zenith angle, atmospheric pollution, ozone layer, and melanin pigmentation Defining levels Threshold levels of serum 25(OH) D required to optimize effects may vary in the various target organs Deficiency, less than 20 ng/ml (50 nmol/L) Insufficiency, 21 – 29 ng/ml (52 - 72 nmol/L) Sufficiency, more than 30 ng/ml (75 nmol/L) Toxicity, more than 150 ng/ml (375 nmol/L) Desirable and safe range of serum 25(OH) D level would be 30–100 ng/mL (75 – 250 nmol/L) Metabolism Vitamin D is needed to facilitate calcium absorption from the gut PTH is secreted in response to low blood serum calcium Maintains serum calcium by moving calcium from bones to blood At less than 20 ng/mL of serum 25(OH) D, PTH is elevated to maintain serum calcium from bony reserves At serum 25(OH) D levels of intestinal calcium absorption reaches its peak, and PTH levels continue to fall up to levels 30 ng/mL Consequences of Vitamin D deficiency Rickets Muscle strength reduction Autoimmune diseases Cardiovascular diseases Depression Suicide Parkinson’s Cancer Infections Tuberculosis Obesity Diabetes mellitus type 2 Important for: Immune function Inflammation Cell proliferation and differentiation What to do Create awareness among the public and healthcare providers about the importance of Vitamin D and the consequences of deficiency Indian diet generally fails to satisfy the daily requirement of Vitamin D for a normal adult Need for fortifying various foods with Vitamin D, through national programs This silent epidemic should be addressed appropriately with concrete public health action. we can imagine the burden, this silent epidemic would cause the development of the country.

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