What Causes Vitamin D Deficiency That Most Indians Are Struggling With: Here's What You Need To Know

Despite abundant sunlight, number of Indians are facing a silent health crisis – vitamin D deficiency. Experts weigh in on the causes, consequences, and solutions.

India, a land blessed with year-round sunlight, should be immune to vitamin D deficiency. Yet, paradoxically, millions of Indians suffer from insufficient levels of this essential nutrient, leading to a host of health problems. From urban office workers to rural farmers, the deficiency is pervasive across age, gender, and socioeconomic boundaries. Experts warn that this silent epidemic demands immediate attention and a multi-pronged approach to address its root causes. "The major reason for Vitamin D deficiency is limited exposure to sunlight, not eating foods enriched with vitamin D, or being diagnosed with cardiovascular problems that can make it challenging for your body to absorb vitamin D in any form, resulting in vitamin D deficiency," says Dr Manjusha Agarwal, Senior Consultant Internal Medicine, Gleneagles Hospital Parel in Mumbai.

The Paradox of Sunshine and Deficiency

India receives ample sunlight, the natural source of vitamin D, but studies show that nearly 70-90% of the population is deficient.“It’s ironic,” says Dr. Agarwal. “We have an abundance of sunlight, yet our lifestyle choices and lack of awareness have created a massive health problem."

Dr. Anumiita Pathakk, a Nutritionist explains that factors such as urbanization, increased indoor living, and the use of sunscreen to protect against harmful UV rays contribute to this deficiency. “People, especially in urban areas, spend most of their time indoors, and when they go out, they cover up or use sunscreen. This reduces the skin’s ability to synthesize vitamin D,” she notes.

Additionally, Dr. Pathakk says poor diet and obesity can contribute to Vitamin D deficiency in the body.

Widespread Impact on Health

Vitamin D is crucial in bone health, immunity, and even mental well-being. Its deficiency has been linked to conditions like osteoporosis, cardiovascular diseases, diabetes, and depression. Pediatrician Dr. Vikas Menon emphasises the risks for children. “A lack of vitamin D during childhood can lead to rickets, delayed growth, and weakened bones. Unfortunately, many parents overlook this until it’s too late.”

For adults, the consequences can be just as severe. “ Vitamin D deficiency can significantly hamper your bone health making them weak and more prone to frequent falls or fractures,” says Dr. Agarwal. “What’s more concerning is the link between vitamin D deficiency and autoimmune diseases. It’s a public health issue we can no longer ignore," adds Dr. Pathakk.

While the experts show concern over the growing number of people being Vitamin D deficient, some of the early symptoms can help treat the issue. One can experience a range of symptoms that can indicate vitamin D deficiency. Dr. Agarwal says the symptoms can include feeling extremely tired, bone pain, muscle weakness, and frequent colds or infections. It is advisable not to overlook these symptoms and immediately consult a doctor for further diagnosis.

Some of the major symptoms Dr. Pathak notes:

• Bone pain: Pain or tenderness in the bones, especially in the hips, pelvis, or ribs.
• Hair loss: Thinning or falling hair, particularly on the scalp.
• Skin issues: Acne, eczema, psoriasis, or other skin conditions.
• Cognitive impairment: Difficulty concentrating, memory loss, or decreased cognitive function.
• Sleep disorders: Insomnia, sleep apnea, or restless leg syndrome.
• Weight gain: Unexplained weight gain or difficulty losing weight.
• Osteomalacia: Softening of bones in adults, causing muscle weakness, bone pain, or increased risk of fractures.
• Increased risk of diseases: Higher risk of developing conditions like osteoporosis, diabetes, hypertension, or certain types of cancer.
• Cardiovascular disease: Increased risk of heart disease, high blood pressure, or stroke.
• Neurological problems: Increased risk of multiple sclerosis, Parkinson's disease, or other neurological disorders.

Other Long-term Challenges

Vitamin D deficiency can negatively increase the risk of osteoporosis (a condition where your bone becomes fragile), heart disease, depression, and even a weakened immune system. "The deficiency can also impact the kidney or liver. "Certain conditions, such as weight loss surgery, celiac disease, Crohn's disease, or ulcerative colitis, can impair Vitamin D absorption from food," says Dr. Pathakk. "Hyperparathyroidism, a rare condition where the parathyroid glands are overactive, leading to impaired Vitamin D regulation can also happen in the long run." Some of the long-term health challenges Dr. Pathakk notes are:

Representational Image (Getty Images)

• 1. Weakened immune system: Increased susceptibility to infections, particularly respiratory tract infections.
• 2. Skin issues: Acne, eczema, psoriasis, and other skin conditions.
• 3. Hair loss: Thinning or falling hair, particularly on the scalp.
• 4. Fatigue and muscle weakness: Persistent fatigue, muscle weakness, and decreased physical performance.
• 5. Impaired wound healing: Slower wound healing due to impaired collagen synthesis and tissue repair.
• 6. Increased risk of falls: Weakened bones and muscles, increasing the risk of falls and related injuries.

Cultural and Dietary Factors

India’s diverse dietary habits also play a role. Traditional vegetarian diets, while rich in other nutrients, often lack sufficient sources of vitamin D, which is primarily found in fatty fish, egg yolks, and fortified foods. “Most Indians rely on vegetarian diets that don’t provide enough vitamin D,” says Dr. Pathakk. “Even non-vegetarians don’t consume adequate amounts of fish or fortified products. "Foods, such as fatty fish, fortified dairy products, and mushrooms are high in Vitamin D. If one doesn't consume them, and have excess body fat can reduce the availability of Vitamin D in the body," adds the nutritionist. ”

Additionally, cultural practices such as wearing full-body clothing for modesty further limit sun exposure. “These cultural factors, combined with a lack of education about the importance of sunlight and supplementation, exacerbate the problem,” Dr. Pathakk adds.

Pregnancy and breastfeeding can also lead to a decrease in Vitamins if not adequately addressed.

Solutions and Strategies

Addressing this issue requires public health initiatives, education, and individual action. Experts recommend:

• Fortification of Foods: Fortifying staple foods like milk, flour, and oil with vitamin D can help combat deficiency on a large scale. “Countries like the US and Canada have successfully implemented fortification programs. India should follow suit,” says Dr. Aamir Hussain, consultant physician.
• Regular Screening: Routine screening for vitamin D levels should become part of annual health check-ups. “Early detection can prevent long-term complications,” emphasizes Dr. Agarwal.
• Safe Sun Exposure: Encouraging people to spend 15-20 minutes in the sun daily, preferably in the morning, can make a significant difference. “It’s a simple, cost-free solution that can yield tremendous benefits,” Dr. Hussain advises.
• Supplementation: For those unable to get sufficient sunlight or dietary intake, vitamin D supplements can be an effective alternative. “Vitamin D supplements are available in various forms such as tablets, capsules, or drops. Always consult a doctor before taking any supplements to improve your health," recommends Dr. Agarwal.

Vitamin D deficiency is a silent epidemic, but it’s not insurmountable. "It's essential to address vitamin D deficiency promptly to prevent these long-term challenges. If you suspect you have a vitamin D deficiency, consult with your healthcare provider for proper diagnosis and treatment," says Dr. Agarwal.