Vitamin D Deficiency in Ethnic Populations Lily Talakoub M. Frontline Medical News Many clinicians are unaware that ethnic populations in North America do not achieve optimal serum 25-hydroxyvitamin D—25(OH)D—because of the increased pigmentation in their skin, which reduces vitamin D production. Vitamin D insufficiency is more prevalent among individuals with darker skin compared with those with lighter skin at any time of year, even during the winter months. Contributing to the deficiency, the dietary intake of vitamin D intake among African Americans, in particular, is often below the recommended intake in every age group after puberty. However, data have shown vitamin D protects against Sjögren’s syndrome, psoriasis, type 1 and type 2 diabetes, multiple sclerosis, and rheumatoid arthritis. Vitamin D also may protect against cardiovascular disease through its anti-inflammatory effects and may reduce the risk for colorectal cancer, breast cancer, and prostate cancer by promoting cell differentiation and down-regulating hyperproliferative cell growth. While vitamin D can be obtained from sun exposure, this is not always a viable option. UV exposure is linked to skin cancer, which leads clinicians to encourage sun avoidance, but they may disregard the need for vitamin D. In addition, darker pigmentation reduces vitamin D synthesis in the skin. How can you help your patients of color get enough vitamin D, especially in the winter? Nutritional sources of vitamin D include salmon, sardines, and cow’s milk; however, many individuals do not achieve optimal vitamin D status from food intake alone. Since UV exposure and diet are not sufficient sources of vitamin D, supplementation has become crucial for our patients, particularly those with darker skin. Dietary reference intakes for vitamin D have been under considerable scrutiny, and many experts now believe that intakes of 25 mcg/d (1000 IU) or more may be needed for most people to achieve optimal blood levels of 25(OH)D. The two forms of vitamin D used in dietary supplements are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Cholecalciferol is the form of choice when supplementing with vitamin D. Types of D3supplements include gel caps, liquid, powders, and tablets. Vitamin D is often measured in international units (IU) or mcg; 1 mcg of cholecalciferol is equal to 40 IU of vitamin D. The debate continues over the most effective forms of vitamin D acquisition; however, many health professionals agree that vitamin D supplementation, particularly in winter months, should be an integral part of our armamentarium of therapeutics for ethnic patients, especially those who suffer from psoriasis and other autoimmune and inflammatory skin conditions.
Posted on: Tue, 04 Feb 2014 03:20:47 +0000
Trending Topics
Recently Viewed Topics
© 2015