Vitamin D deficiency is a global epidemic affecting over 1 billion people worldwide. The document discusses how despite plentiful sunlight, 78% of UAE residents have vitamin D deficiency due to indoor lifestyles and clothing habits. It also summarizes that three quarters of US teens and adults are deficient in vitamin D and this is linked to diseases like rickets, osteomalacia, heart disease, cancers, diabetes and more. The document advocates for vitamin D supplementation and sensible sun exposure to help regulate over 2000 genes and 160 metabolic pathways influenced by vitamin D.

1. THE D-LIGHTFUL
VITAMIN AND THE
SILENT GLOBAL
EPIDEMIC
DR.RISHIKESAN K.V MD
VENNIYIL MEDICAL CENTRE
SHARJAH

2. GLOBAL EPIDEMIC - an
estimated 1billion people

3. MOST AMERICANS ARE LACKING
VIT.D
Archives of Int.Med. April2007
THREE QUARTERS OF U.S TEENS AND
ADULTS ARE DEFICIENT IN VITAMIN D
THE SO CALLED SUNSHINE VITAMIN
THE LACK OF VITAMIN D IS LINKED TO
RICKETS THE SOFT AND WEAK BONES AND
THINNING OF BONES IN ELDERLY -
OSTEOMALACIA
BUT SCIENTIST ALSO BELIEVE IT MAY
PLAY A ROLE IN HEART DISEASE,CANCERS
AND DIABETES

4. UAE SCENARIO
DESPITE THE YEAR-
ROUND SUNLIGHT 78%
OF RESIDENTS HAVE VITAMIN D
DEFICIENCY BECAUSE OF INDOOR
LIFE STYLE,CLOTHING HABITS AND
ABSENCE OF A CLEAR
FORTIFICATION POLICY.
HIGH PREVALENT IN
EMIRATI WOMEN

5. POOR IGNORANCE
WE ARE GOING
THROUGH A
PUBLIC HEALTH
CRISIS OF
EPIDEMIC
PROPORTION
BECAUSE OF
POOR
IGNORANCE &
MISINFORMATI-
ON

6. VITAMIN D
VITAMIN D IS A VITAMIN AS WELL AS A POTENT
REPAIR AND MAINTENANCE STEROID HORMONE
VITAMIN D RECEPTOR IS PRESENT IN ALMOST ALL
ORGANS ,TISSUES AND CELLS

7. HUMAN GENOME
PROJECT……..
APPROXIMATELY 30000 GENES
DIFFERENTIATE US FROM
LOWER ANIMALS.
AMONG THESE 30000 GENES VITAMIN D
REGULATES AND INFLUENCES MORE THAN
2000 GENES.
MORE THAN 160 METABOLIC PATHWAYS
ARE INFLUENCED BY VIT D
SUPPLEMENTATION
THAT IS WHY THIS UNIQUE MOLECULE IS
SO VITAL AND CRUCIAL FOR SO MANY
DISEASES AND MORBIDITIES

8. DRIVES THE GENES

9. Vitamin D deficiency:
*Inadequate exposure to sunlight
*Adults in nursing homes
*Vitamin D malabsorption problems -
*People who have undergone resection of
the small intestine are at risk for this
condition
*Celiac sprue, short bowel syndrome, and
cystic fibrosis.
*Minimal amounts of vitamin D in human
breast milk .
* Some medications Dilantin,
phenobarbital, and rifampin can induce
hepatic p450 enzymes to accelerate the
catabolism of vitamin D

10. DEVOLUTION?????
Throughout
evolution, humans
have depended on
the sun for their
vitamin D
requirement.
Indeed, a likely reason
that melanin
devolved was to
permit humans who
migrated north and
south of the equator to
make enough vitamin D
in their skin to satisfy
their requirement

11. CAUSES &CONSEQUENCES

14. UVB AND D VITAMIN…..

15. FROM MASAAI……

16. SYNTHESIS

17. The production of vitamin D3 in the skin involves a
series of reactions initiating with 7DHC.
Upon exposure to ultraviolet B (UVB) radiation between the
wavelengths of 290-315 nm, 7DHC is converted to pre vitamin
D3, which is then converted to vitamin D3 .
From the skin, newly formed vitamin D3 enters the
circulation by binding to DBP. In order to become
active, Vitamin D is hydroxylated in the 25 position by the
hepatic microsomal and/or mitochondrial enzyme vitamin D
25-hydroxylase.
The second hydroxylation occurs in the kidney and is
performed by the P450 enzyme 25-hydroxyvitamin D-1 alpha-
hydroxylase. Upon entering the cell, the 1,25(OH)2 D
hormone binds to VDR.
The bound vitamin D receptor then forms a heterodimer with
the retinoic acid X receptor (RXR).
This heterodimer then goes to the nucleus to bind
deoxyribonucleic acid (DNA) and increases

18. SYNTHESIS OF VITAMIN D

20. Sensible sun exposure, between the hours
of 10:00 am & 3:00 pm produces
vitamin D in the skin that may last twice as
long in the blood compared with ingested
vitamin D.
If sun exposure produces slight
pinkness, the amount of vitamin D
produced in response to exposure of the full
body is equivalent to ingesting
10,000-25,000 IU.
A variety of factors reduce the skin’s vitamin D-3
production:
Increased skin pigmentation, aging,
& the topical application of a sunscreen.

21. RECOMMENDATION……

23. Foods with high amounts of vitamin D3
#Oily fish: salmon, mackerel, &blue
fish, as well as fortified milk and
other dairy products.
#A single serving (3.5 oz) of wild-caught salmon
has 988 ± 524 IU of vitamin D3; decreases by 50%
if the salmon is fried in vegetable oil.
#Farm-raised salmon has only 25%
of the vitamin D3 content found in
the flesh of wild salmon.
Blue fish and mackerel have vit.D3
levels of 280 ± 68 IU and 24
IU, respectively.
#Fortified milk may contain less
than the stated amount of vit.D3
on the product .
#Vegetables are not a good

25. VIT.D2 AND D3

27. VITAMIN D STATUS

28. BAROMETER

29. Vitamin D deficiency is often a
silent disease.
In adults, results in osteomalacia
which presents as a poorly
mineralized skeletal matrix.
Can experience chronic muscle aches and pains.
Can reveal periosteal bone pain.
Best detected using firm
pressure on the sternal bone
or tibia.
Vitamin D deficiency is the
most common cause of nutritional
rickets; bowing in the legs.
By definition, rickets occurs in children whose
growth plates have not fused.
They are often found to have started
walking late or prefer to sit down for

34. VIT.D and AUTISM
Several findings suggest that low Vit.D levels
(in mothers during
pregnancy and in
infants) may affect
the risk of autism.
The risk of autism
could be lowered significantly by women using
vit. D supplements before conception, during
pregnancy, and after birth.
Research suggests that pregnant and nursing
women require 6000 IU (150 mcg)/day of
vitamin D3 (cholecalciferol) during pregnancy
and lactation for best pregnancy outcomes and
in order to give the infant sufficient vitamin D3
during nursing.

36. BREAST AND BOTTLE

37. MOMS AND BABIES

38. LIKE MOMS…LIKE BABIES

39. MUMMY AND ME

40. CANCERS & VIT.D
In the 80s and 90s, several
observations suggested that living at
higher latitudes increased the risk of
developing and dying of colon,
prostate, breast, and several other
cancers. A meta-analysis showed that
increasing intake of vitamin D3 to
1000 IU/d would be associated with a
decreased risk of colorectal and breast
cancer of as much as 50%

42. VIT.D INHIBITS CANCER
UPREGULATES:
DIFFERENTIATION,
APOPTOSIS
DOWNREGULATES:
PROLIFERATION, INVASIVENESS,
METASTATIC POTENTIAL,
ANGIOGENESIS, and INFLAMMATION

47. CANCER IN WOMEN
Postmenopaus-
al women who
received 1100
IU vitamin D3
and 1000 mg Ca
daily for 4yrs.
reduced their
risk of
developing
cancer by 60%.

49. Conclusions: Vit.D status, which is amenable to
intervention by safely increasing sun exposure or
vit.D supplementation, was associated inversely
with BP in a large sample representative of the US
population.

51. CONCLUSIONS: Vitamin D
deficiency is associated with
incident cardiovascular disease

52. CONCLUSIONS: Low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin
D levels are independently associated with all-cause and
cardiovascular mortality.

56. LOW VIT.D & ANOVULATION
Low vit.D levels may negatively
affect ovulation :Dr. Lubna Pal.
She found a significant link between low
vitamin D and ovary disturbance. While the
preliminary results are interesting, more
research is needed to confirm a link.
A level of 50 nanomoles per liter and
above is sufficient for most
people, according to the National
Institutes of Health Office of Dietary
Supplements.

58. Vitamin D is positively associated with
sperm motility and increases
intracellular ca++ in human
spermatozoa
METHODS:
Cross-sectional association study of semen quality and VD
serum level in 300 men from the general population, and in
vitro studies on spermatozoa from 40 men to investigate the
effects of VD on intracellular calcium, sperm motility and
acrosome reaction
CONCLUSIONS:
1,25(OH)(2)D(3) increased intracellular
ca++ concentration, sperm motility and
induced the acrosome reaction in mature
spermatozoa, and VD serum levels were
positively associated with sperm motility,
suggesting a role for VD in human sperm function.

60. LOW VIT.D LEVELS LINKED TO
COLD Archives of Int.Med.2009 Feb
Conclusion:
Serum 25(OH)D levels have an independent,
inverse association with recent URTI.
25(OH)D levels less than 30 ng/mL and URTI
were higher in the winter season.
Individuals with respiratory tract diseases, such
as asthma, who have low serum 25(OH)D levels
may be even more susceptible to RTI.
Vitamin D supplementation may reduce the
incidence of URTI and exacerbations of
respiratory tract diseases.

61. DAILY VIT.D FOR COLD

64. Low serum vitamin D
levels and
tuberculosis: a systematic
review and meta-analysis-
Conclusions:
Low serum vit. D
levels are associated
with higher risk of
active TB. It is more
likely that low body
vitamin D levels
increase the risk of
active tuberculosis.

66. Dietary vit. D supplementation is associated with reduced risk
of type1diabetes.
Adequate vit.D supplementation for infants could
help to reverse the increasing trend in the
incidence of type1 diabetes.

67. TYPE 2 DM
Conclusion: vitamin D
insufficiency is under
recognized and may be a
significant contributor to
neuropathic pain in type 2
diabetes. Vitamin D
supplementation may be an
effective “analgesic” in
relieving neuropathic pain.

68. Low serum 25(OH)D, a stable
marker of vitamin D status, are
associated with increased
prevalence of cognitive
dysfunction, AD and all-cause
dementia , raising the possibility
that vitamin D plays a role in the
aetiology of cognitive dysfunction
and dementia

71. TAKE HOME MESSAGE &
CONCLUSION

72. TAKE
VITAMIN D
….. LIVE
LONGER

73. THE TRUTH……
ALL TRUTH GOES
THROUGH 3 STAGES:
AT FIRST IT IS RIDICULED
SECOND, IT IS VIOLENTLY OPPOSED
FINALLY IT IS ACCEPTED AS SELF
EVIDENT
THANK YOU VERY MUCH