Fit & Proper: Don't shy away from the sun

Siddharth Garg, 28, works with a finance company in Gurgaon. He leaves home early in the morning and returns after sunset. The day is spent cooped in his office cabin. Breaks include going to the cafeteria for lunch or a snack in the evening. Thrice a week, he tries to make time to hit the office gym and yet he has been feeling fatigued and listless for the past few months. His doctor has now told him he's not getting enough sun.
Deficiency and insufficiency of vitamin D, or the "sunshine" vitamin, is becoming a global public health problem. Vitamin D is a nutrient that helps build strong bones and teeth and helps your body use and absorb calcium. Low levels of vitamin D mean higher risk for bone disease (osteoporosis) and broken bones.

The lifestyle we follow these days has increased the number of cases of vitamin D deficiency. Cultural and social taboos, such as vegetarianism and clothing that may limit sun exposure, often dictate lifestyle patterns. (Remember, the sun is the ideal source of vitamin D).

The extreme discomfort of the scorching heat on most summer days and the desire of most Indians to attain a fair complexion are some of the reasons why a person's primary focus is on finding ways to avoid the sun, at all costs. People, thus, tend to stay more in air-conditioned homes or offices, often located in multi-storey complexes where direct sunlight does not reach. Children also play more of indoor games.

Additionally, lack of space offers limited options for outdoor activities. This has also promoted the gym culture, which again keeps people indoors. Pollution and the use of sunscreen creams and umbrellas do not help either. The prevalence of vitamin D deficiency has, in fact, been found to be higher in women.

A diet deficient in vitamin D, in conjunction with inadequate sun exposure, causes osteomalacia (softening of the bones), osteoporosis (bones become weak and brittle) or rickets in children. In fact, the vitamin's deficiency has been shown to play a role in almost every major disease like in a variety of cancers (including breast, prostate and colon), heart disease, obesity, diabetes, autoimmune diseases, multiple sclerosis, rheumatoid arthritis, infertility, Parkinson's and Alzheimer's disease and depression. It is also the cause of chronic fatigue.

Many people remain asymptomatic despite having low levels of vitamin D. But there are some common symptoms of the deficiency such as fatigue, general muscle pain, weakness and cramps, joint pain, weight gain, high blood pressure, restless sleep, poor concentration, headaches, bladder problems and constipation or diarrhoea.


QUICK TIPS

• Most children and adults require 600-2,000 IUs (international units) of vitamin D daily. All it takes is a simple blood test to find out if you are deficient. The preferred test is 25-hydroxyvitamin D, written as 25(OH)D
• For vitamin D-deficient children and adults, higher doses of the vitamin are recommended either daily or weekly, followed by an increase in the daily dose
• Sensible sun exposure, especially between 10 am and 3 pm, produces vitamin D in the skin that can last twice as long in the blood as compared to ingested vitamin D
• Restrict use of sunscreen
• While most dietary sources do not contain sufficient amounts of the vitamin to meet daily requirements, the following foods contain high amounts of vitamin D3: Oily fish such as salmon, mackerel and blue fish, white mushrooms, cod liver oil, Swiss cheese and some other forms of cheese, eggs, soy milk, salami, oysters, sardines, butter, shrimp, fortified oats and other cereal, milk and other dairy products, juices, ice-creams and yogurt

D S Chadha
Associate director, internal medicine, Fortis Flt Lt Rajan Dhall Hospital, New Delhi