Importance of vitamin d

Importance of Vitamin D

1. Vitamin D Importance for Human Life Hidaa Lifescience LLP Dr. Raj kumar maurya D’bello Naturally High vitamin D Mushroom powder

2. Vitamin D Importance for Human Life

3. Vitamin D (Sunshine Vitamin) Vitamin D is commonly known as: The “sunshine” vitamin. Vitamin D2 ( Ergocalciferol ) which is found in plants. Vitamin D3 ( Cholecalciferol ) which can be obtained from sunlight via our skin. Both Vitamin D2 & D3 form, 25 hydroxyvit D & then Active form of vitamin D ( 1,25-dihydroxyvitamin D).

4. Vitamin D Fat Soluble Vitamin Found in trace amounts in food Formed through sunlight exposure Converted to hormone form through liver and kidney Vitamin D is needed for the absorption of calcium & Phosphorous from foods to keep bones and teeth healthy.

5. Functions of Vitamin D Vitamin D is needed for Calcium absorption (small intestine) urinary calcium reabsorption (kidney) and Bone mineralization Helps with the travel of calcium and phosphorous in the blood Modulation of neuromuscular and immune function. Reduction of inflammation. Prevents rickets in children and Osteomalacia in adults

6. How much Vitamin D do we need? Ages 19-50: 200 International Units (IU) Ages 51-69: 400 IU Age 70 and older: 600 IU

7. Vitamin D deficiency Global Health problem 70-90% apparently healthy population is VDD VDD is prevalent irrespective of age , sex, profession, rural/urban or regional distribution Imparts musculoskeletal health

8. Deficiency Symptoms and Diseases Osteoporosis results from inadequate calcium intakes Vitamin D plays a role in the prevention of colon, prostate, and breast cancers hence, lack of this vitamin can trigger these diseases. Vitamin D deficiency is also associated with heart disease and hypertension

9. Symptoms of VDD Vague muscle or joint pain Weakness Bonepain Tiredness Fatique or even depression Weakens bones, causes rickets, tooth decay, kidney stones, muscle weakens, poor absorption of cal.

10. Deficiency Symptoms and Diseases Rickets and Osteomalacia are the classical vitamin D deficiency diseases Rickets, is characterized by a failure of bone tissue to properly mineralize, resulting in soft bones and skeletal deformities Osteomalacia , is characterized by fragile bones that significantly increases the risk of bone fractures

11. When can vitamin D deficiency occur? Rickets Osteomalacia

12. These lead to:- Learning disability Impaired work capacity. Increased susceptibility to infection

13. Bowed legs ( genu varum ) Knock-knees ( genu valgum ) or "windswept knees. Costochondral swelling ( " rickety rosary " or " rachitic rosary ") Harison’s sulcus and pot belly

14. Signs and Symptoms Bone pain or tenderness. muscle weakness ( rickety myopathy or "floppy baby syndrome ") Increased tendency for fractures (easily broken bones), especially greenstick fractures Hypocalcemia Tetany Craniotabes (soft skull) Skeletal deformity:Cranial , spinal, and pelvic deformities

15. Current Research Deficiency Increases Risks for Cancers Heart Disease Stroke Diabetes Depression Muscle Weakness Birth Defects Obesity

16. Vitamin D and chronic diseases Regulating calcium and phosphate metabolism for bone health, Autoimmune diseases, Atopic dermatitis, Cardiovascular disease, Chronic respiratory diseases Crohn’s disease and Inflammatory bowel disease , Diabetes, type 1 and type 2 Kidney disease, Osteoarthritis , Periodontal disease, Rheumatoid arthritis, Skin disorders, Some cancers, Infectious disease, Schizophrenia 1,25-dihydroxyvitamin D plays an important role in:

17. Why Vitamin D deficiency occurs? Due to:- Inadequate sunlight exposure. Poor access to micronutrients rich food. Disorder that limit its absorption. Deficient soil quality. Impaired conversion into active metabolites. Possible role of dietary fibers.

18. Diagnosis: Blood tests: Serum calcium : may show low levels of calcium serum phosphorus : may be low serum alkaline phosphatase : may be high Aerial blood gas: may reveal metabolic acidosis . Xray : Bow legs {outward curve of long bones.} Dec. Bone opacity-poor bone mineralization. square headed appearance of skull . (Changes seen in late stage)

19. Vitamin D and cancer Linked with colon, rectum, breast, ovarian, prostate, stomach, bladder, esophagus, kidney, lung, pancreas, and uterine cancers, as well as for non-Hodgkin lymphoma and multiple myeloma. Higher levels of serum 25(OH)D leads to lower incidence of cancers. Sunnier latitudes - Lower mortality. Black individuals: lower level of active vitamin D. Blacks have higher rates of colon, breast, prostate, and ovarian cancers.

20. Vitamin D and cancer Vitamin D prevents tumor angiogenesis, it allows for effective communication between cells, and it helps to maintain a healthy calcium concentration in the cells. Vitamin D also enhances cell death when appropriate .

21. Role in cancer prevention and recovery Calcitriol – Induces death of cancer cells Regulates Cell growth, Differentiation etc. Daily intake of 1,000IU/day reduces risks

22. Vitamin D and Obesity Seasons Altitude Calcium Link between other diseases Treatable

23. Vitamin D and cardiovascular disease Plaque results from a chronic low-grade inflammation. Endothelial dysfunction, LDL particles accumulation. Low level of vitamin D = 2 x risk for cardiovascular incidents.

24. Hypertension and Vitamin D Hypertension peaks in the winter. Short-term (8 wks) supplementation with vitamin D and calcium reduced blood pressure, heart rate, and parathyroid hormone levels in women 70 yrs of age or older.

25. Vitamin D and Diabetes Low serum levels at greater risk Lack of Vitamin D interferes with insulin secretion

26. Vitamin D and depression SAD( Seasonal affective disorder)- winter depression 130 patients 600 or 4,000 IU supplements Re-evaluated 1 year later Patients actually felt better with supplements

27. Diabetes and vitamin D Type 1 diabetes results from beta cell destruction. Vitamin D is an immunosuppressive agent. Supplementation by vitamin D reduced the risk for diabetes by about 80% in children. Vitamin D might protect pancreas. Supplementation of mother’s diet reduced incidence of type 1 diabetes in children. Children who are deficient in vitamin D have a 200% increased risk in developing type 1 diabetes.

28. Multiple sclerosis Lower incidence of MS in countries with more sunlight. Vitamin D intake is associated with lower incidence of MS and slower rate of progression of the disease.

29. Vitamin D sources Exposure to sunlight Reduced cutaneous synthesis due to Limited uv exposure due to increased skin pigmentation Topical application of sunscreen

30. Sun exposure Solar ultraviolet radiation ( UV-radiation ) beneficial harmful skin cancer Vitamin D obtained by UV-induced photosynthesis in the skin.  Sunscreens and sunblocks completely blocks photosynthesis of vitamin D

31. Exposure to sunlight Important source of vitamin D Season, latitude, time of day

32. Food Sources of Vitamin D Food IUs per serving Percent DV Cod liver oil, 1 tablespoon 1,360 340 Swordfish, cooked, 3 ounces 566 142 Salmon (sockeye), cooked, 3 ounces 447 112 Tuna fish, canned in water, drained, 3 ounces 154 39 Orange juice fortified with vitamin D, 1 cup 137 34 Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup 115-124 29-31 Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces 80 20 Margarine, fortified, 1 tablespoon 60 15 Sardines, canned in oil, drained, 2 sardines 46 12 Liver, beef, cooked, 3 ounces 42 11 Egg, 1 large (vitamin D is found in yolk) 41 10 Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 1 cup 40 10 n ih.gov

33. Conversion of Vitamin D to the active form Cholesterol from diet 7 dehydrocholesterol in the skin Sunlight converts 7-dehydrocholesterol to previtamin D3 Cholecalciferol ( Previtamin D3) The liver converts previtamin D to 25-hydroxyvitamin D which appears in circulation. 25-hydroxyvitamin D (circulating form) T he kidneys and other tissues convert it to an active form of 1,25-dihydroxyvitamin D 1,25-dihydroxyvitamin D (active form)

34. Vitamin D conversion The conversion of Vitamin D to its active form occurs in the kidneys, but it can also occur in the skin, prostate, brain, pancreas, adipose tissue, skeletal muscle, heart, colon, monocyte/macrophages and in neoplastic tissues.

35. Dietary requirement The dietary requirement for vitamin D depends upon the amount of vitamin synthesized by solar irradiation of the skin. Exposing hands, arms and face on a clear summer day for 10–15 min, two to three times a week, should yield sufficient cutaneous production of vitamin D to meet daily needs. To maintain satisfactory plasma 25(OH)D levels without any input from skin irradiation, an oral input in the region of 10–15 μg of vitamin D per day would be required.

36. RDA Recommended Dietary Allowances (RDAs) for Vitamin D Age Male Female Pregnancy Lactation 0–12 months* 400 IU (10 mcg) 400 IU (10 mcg)     1–13 years 600 IU (15 mcg) 600 IU (15 mcg)     14–18 years 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 19–50 years 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 51–70 years 600 IU (15 mcg) 600 IU (15 mcg)     >70 years 800 IU (20 mcg) 800 IU (20 mcg)     Institute of Medicine, and Endocrine Society Recommended Vitamin D intake (2011) * Adequate Intake (AI)

37. What are Superfoods ? Functional foods that prevents us from taking medicines Vitamin D has an important role together with calcium in mineral metabolism and bone growth and maintenance. Most cells in the body have been found to have receptors for vitamin D, and is therefore now seen as an important nutrient in preventing many chronic diseases.

38. Vitamin D intake recommendations Obese children and adults, and children and adults on anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole, and medications for AIDS be given at least two to three times more vitamin D for their age group to satisfy their body’s vitamin D requirement. The maintenance tolerable upper limits (UL) of vitamin D, which is not to be exceeded without medical supervision, should be 1000 IU/d for infants up to 6 months, 1500 IU/d for infants from 6 months to 1 yr , at least 2500 IU/d for children aged 1–3yr ,3000 IU/d for children aged 4–8yr, and 4000 IU/d for everyone over 8 yr. Higher levels of 2000 IU/d for children 0–1 yr , 4000 IU/d for children 1–18yr, and10,000IU/d for children and adults 19 yr and older may be needed to correct vitamin D deficiency .

39. Food As Medicine supports the immune system may reduce risk of cancer helps to maintain healthy cholesterol levels may reduce risk of heart disease

40. Mushroom Fun Facts

41. Recommendations Increase consumption of foods that have been fortified with vitamin D Sensible sun exposure limits Assess vitamin D levels in the blood at annual check ups

42. A mushroom has almost as much potassium as a small banana. Mushrooms contains 8% of the daily value. D’BELLO Mushroom powder contains ~250% of daily value, available online.

43. Conclusion Vitamin D – The wonder drug? Laboratory testing -Testing volume doubled every ear for the past four years Quest Diagnostics – Testing volume tripled between May 2006 and May 2008

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