Are you ever amazed at the number of dietary supplements some of your clients are taking? From vitamin C to zinc, it’s no wonder they don’t rattle when they walk. Most health professionals have no problem with supplements if they’re truly indicated. If a person is diagnosed with iron deficiency anemia, by all means- treat with iron supplementation. But ideally, we should recommend food to obtain adequate nutrients in our diets. One of the most “in vogue” supplements is vitamin D. This week’s focus on the food label will highlight vitamin D.
Vitamin D is a fat-soluble vitamin that’s found primarily in dairy products (fat-free versions are fortified), fatty fish (tuna, salmon, mackerel), fortified orange juice, beef liver and egg yolks. It’s long been hailed as the “sunshine vitamin” as our bodies produce vitamin D from 7-dehydrocholesterol from exposure to ultraviolet-B (UVB) radiation from sunlight. Vitamin D3 is the animal-based form while D2 (ergocalciferol) can be obtained from plant sources such as yeast and mushrooms. 1 Your nutrition-savvy clients recognize that vitamin D is needed for calcium absorption and bone health, but it’s being added to the Nutrition Facts label in 2020 for many other reasons.
According to the CDC, it’s estimated that up to 50% of Americans may be deficient in vitamin D. Deficiency is defined as having a level below 20 ng/ml. A level between 20-29 ng/ml is considered insufficient and sufficiency is defined as have a level above 30 ng/ml. African Americans and other populations with darker skin are at higher risk for deficiency as high amounts of melanin in skin reduce the body’s ability to convert vitamin D from sun exposure.2
At bare minimum, vitamin D deficiency causes bone demineralization. Children may develop rickets-a form of bone deformity, while adults may suffer bone loss and osteoporosis related to hyperparathyroidism, a condition caused by hypocalcemia (low calcium levels in the blood). 3 Vitamin D deficiency is associated with other medical conditions including cardiovascular disease, autoimmune disease, diabetes and certain cancers. Vitamin D and vitamin D receptor (VDR) after binding, can impact gene expression. VDR is expressed in the kidney and immune cells. In addition, vitamin D binding protein, known as VDBP acts as a carrier for vitamin D. Studies have found that a low level of VDBP is associated with a variety of cancers, including breast, prostate and colorectal. Metabolites of vitamin D act on multiple areas of cardiovascular function such as inflammation, clot formation, blood pressure regulation and progression of atherosclerosis. 4
The Institutes of Medicine (IOM), the governing body that develops the Dietary Reference Intakes for nutrients, updated recommendations for vitamin D in 2010 following several meta-analyses and RCT studies. The committee determined that, “For most North Americans, regardless of age group, an EAR of 400 international units, or IUs, of vitamin D per day is needed. An RDA of 600 IUs was set for children ages 1 year and older, as well as for adolescents, pregnant and lactating women, and adults as old as 70." 5
For people ages 71 and older, an RDA of 800 IUs of vitamin D per day is advisable, the committee said. Other subgroups, such as those with dark skin pigmentation, may also be at increased risk for getting too little vitamin D. ULs range from 1,000 IUs per day for infants to 4,000 IUs per day for people ages 9 years and up. 5
Consumers may already see vitamin D listed on the nutrition facts label as some companies have voluntarily added it. Including at least 3 servings of foods high in vitamin D daily including either dairy, fatty fish or fortified products, will ensure your clients are meeting their dietary needs.
1. Naveen R Parva, 1 Satish Tadepalli,2 Pratiksha Singh,2 Andrew Qian,1 Rajat Joshi,3 Hyndavi Kandala,1Vinod K Nookala,1 and Pramil Cheriyath2 Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus. 2018 Jun; 10(6): e2741.
- Hanmin Wang,1,2Weiwen Chen,1,2,* Dongqing Li,1,2 Xiaoe Yin,1,2 Xiaode Zhang,2 Nancy Olsen,3 and Song Guo Zheng2,3,* Vitamin D and Chronic Diseases. Aging Dis. 2017 May; 8(3): 346–353.
Submitted by Lisa Andrews, MEd, RD, LD