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Calcium and Vitamin D deficiencies

WHY ARE CALCIUM & VITAMIN D IMPORTANT?

Vitamin D and calcium are both very important for optimal human health. Vitamin D is needed for bone mineralisation and has a major role in the absorption of calcium from the intestine, while calcium has a role in maintaining the rigidity and strength of the skeleton. Calcium is involved in a large number of metabolic processes, including blood clotting, cell adhesion, muscle contraction, hormone neurotransmitter release, glycogen metabolism, and cell proliferation and differentiation1, 2.

 

WHAT PROBLEMS ARE ASSOCIATED WITH CALCIUM & VITAMIN D DEFICIENCIES? WHO IS AT RISK?1,2

A lack of both vitamin D and calcium can lead to serious bone and skeletal problems. In children, this can present as rickets and in adults, as low bone mineral density and osteoporosis1.

CHILDREN AND ADOLESCENTS3

Why?

Childhood and adolescence are a very important time for the formation of the skeleton. Calcium requirement is increased during this period. However, many young people do not have a proper breakfast, with its traditional variety of calcium-rich foods.

Low levels of vitamin D in children have been reported in studies worldwide, due in part to young peoples’ increasingly indoor lifestyles, pollution in urban settings, and use of sunscreen.

Which consequences?

Although rare in industrialized countries, severe vitamin D deficiency in children can lead to growth retardation and bone deformities known as rickets.

An inadequate bone health during youth result in an increased susceptibility to osteoporosis and fractures in later life

References:
3. Bess Dawson-Hughes, Ghada El-Hajj Fuleijan & Patricia Clark. Building strong bones in children and adolescents. International Osteoporosis Fondation. World Osteoporosis Day 2013.

WOMEN GOING THROUGH OR POST MENOPAUSAL PERIOD3

Why?

Oestrogen plays a vital role in regulating the bone turnover process throughout life. However, as women become oestrogen deficient when menses cease, bone resorption exceed bone formation and is associated with a decrease in calcium intestinal absorption and calcium kidney retention.

Which consequences?

One in three women over the age of 50 will suffer a fracture caused by osteoporosis.

References:
3. Bess Dawson-Hughes, Ghada El-Hajj Fuleijan & Patricia Clark. Building strong bones in children and adolescents. International Osteoporosis Fondation. World Osteoporosis Day 2013.

THE ELDERLY4

Why?

The elderly are often subject to malnutrition and reduced sunlight exposure.

In addition, their calcium intestinal absorption and calcium kidney retention are decreased, as well as, their capacity to synthetise vitamin D and convert it to its active form.

Which consequences?

Fractures due to osteoporosis are a major cause of pain, long-term disability and loss of independence among older adults, and can even result in premature death.

References:
4. Cyrus Cooper, Bess Dawson-Hughes, Catherine M. Gordon, René Rizzoli. Healthy Nutrition, Healthy Bones. International Osteoporosis Fondation. World Osteoporosis Day 2015.

  • People on diets poor in calcium and vitamin D.
  • As vitamin D is also produced by exposure to sunlight, people who do not get exposure to enough sun and do not make up through dietary vitamin D consumption are at risk.

WHAT ARE THE LONG-TERM RISKS OF THESE DEFICIENCIES?5
WHAT ARE THE SIGNS OR SYMPTOMS?

  • Increased risk of fractures.
  • The development or worsening of skeletal disorders : Ricket, osteomalacia.
  • Stunted growth.
  • Osteoporosis.

There are often no clear symptoms of vitamin D and calcium deficiencies, except in more severe cases.

HOW ARE CALCIUM & VITAMIN D DEFICIENCIES TREATED?

RESPONSIBLE SUN EXPOSURE

The main source of vitamin D is sunlight (UVB irradiation). 
Our skin can make vitamin D from exposure to sunlight. 
However sunlight is not a reliable source of vitamin D and there are also associated risks of skin ageing and cancer.5

SUPPLEMENTS

If your diet does not provide adequate amounts of calcium or vitamin D, or you are allergic to certain foods it may be a good idea to add supplements to the diet. 
Calcium supplements should be combined with vitamin D for optimum effect.

Ask your pharmacist or you GP about the best options available for you.

DIETARY CHANGES

The best way to avoid calcium and vitamin D deficiencies is to consume foods containing high levels of each:

CALCIUM:
  • Milk
  • Yogurt, Cheese
  • Tofu, Soya bean
  • Curly kale
  • Sardines
  • Figs, whitebait, almonds
VITAMIN D:
  • Salmon, sardines, mackerel
  • Tuna
  • Cod liver oil
  • Shiitake mushrooms
  • Egg yolk

You may be referred to a specialist dietician if you need specific guidance about increasing the amount of vitamin D or calcium in your diet.

References:
1. Lindsay A. et al. Guidelines on foodfortification withmicronutrients. WHO Library Cataloguing-inPublicationData. 2006. 3-86
2.Heike A. Bischoff-Ferrari. Threestepsto unbreakablebones, vitaminD, calcium and exercise. International OsteoporosisFondation. World OsteoporosisDay 2011. 
3. Bess Dawson-Hughes, GhadaEl-Hajj Fuleijan& Patricia Clark. Bonescare for postmenopausalwomen. International OsteoporosisFondation. World OsteoporosisDay 2013.
4. Cyrus Cooper, Bess Dawson-Hughes, Catherine M. Gordon, René Rizzoli. Healthy Nutrition, Healthy Bones. International OsteoporosisFondation. World OsteoporosisDay 2015.
5. Heike A. Bischoff-Ferrari. THREE STEPS TO UNBREAKABLE BONES, VITAMIN D, CALCIUM AND EXERCISE. International OsteoporosisFondation. World OsteoporosisDay 2011.