Vitamin D and Calcium Insufficiency-Related Chronic Diseases: an Emerging World-Wide Public Health Problem

Abstract

Vitamin D and calcium insufficiencies are risk factors for multiple chronic diseases. Data from 46 recent studies from Europe, North America, South-East Asia and the South Pacific area clearly indicate that a low vitamin D status and inadequate calcium nutrition are highly prevalent in the general population (30–80%), affecting both genders. The extent of insufficiencies is particularly high in older populations, and in some geographical areas, also in children and in young women of child-bearing age, in ethnic minorities and immigrants, as well as in people of low socio-economic status. Enrichment of cereal grain products with vitamin D and calcium would be a viable approach to increase consumption and improve health outcomes in the general population worldwide.

Vitamin D deficiency is a problem for adult out-patients? A university hospital sample in Istanbul, Turkey

“…The inverse 25(OH)D and obesity relationship is explained by 'trapping' of the vitamin D parent compound, cholecalciferol, in adipose tissue (5,15) as well as due to a difference in sunbathing habits between obese and lean persons while not confirmed in the elderly (29,30) . The significant correlation of 25(OH)D with HDL-C (positively) and PTH (negatively) levels in our population is important with respect to the consistently reported relationship of vitamin D and its insufficiencies with greater mortality from chronic CVD (2) , higher incidence of cardiovascular risk factors such as hypertension, obesity, metabolic syndrome and diabetes mellitus type 2 (2) and higher risk for incident cardiovascular symptoms including angina, coronary insufficiency, myocardial infarction, transient ischaemic attack and stroke (2) . Over the last few years, discussions have focused on determining desirable serum 25(OH)D levels to optimize bone health, using various surrogate markers of vitamin D status, including the relationship between serum 25(OH)D and PTH levels (5) .…”

“…Consequently, the duration of vitamin D insufficiency, the responsiveness of the vitamin D receptor, dietary Ca intake, and individual Ca requirements and absorption capacity of the intestines were reported to likely modify the clinical consequences of vitamin D deficiency or insufficiency, which seems difficult to assess on the basis of concentrations of 25(OH)D alone (1) . Nevertheless, while direct comparison of studies on vitamin D intake in different parts of the world has been considered difficult due to differences in lifestyle and clothing habits, consumption of traditional foods or supplement intake, combined evidence from all studies clearly indicates that vitamin D insufficiency and Ca malnutrition are common in both genders worldwide, not only in elderly people as previously believed but also in younger adults (2,33) . Besides, based on an increasing incidence of CVD, diabetes, metabolic syndrome and cancer rates in the general population, it seems reasonable to speculate on the relationship among these conditions and the seemingly prevalent finding of vitamin D deficiency in most of countries (34,35) .…”

“…Either synthesized in the form of vitamin D 3 (cholecalciferol) under the influence of solar UV-B radiation in the epidermis or absorbed from the diet or from supplements and food additives, which in some countries may contain vitamin D 2 (ergocalciferol), vitamin D is transferred to the liver, where it is metabolized to 25-hydroxyvitamin D (25(OH)D) (2) . Since it denotes the sum of 25(OH)D 3 and 25(OH)D 2 , the plasma level of this metabolite has been considered as the most stable, plentiful and reliable indicator of an individual's vitamin D status (2) , reflecting the sum of vitamin D from endogenous synthesis and from dietary intake (1) . Hypovitaminosis D is a global problem, prevalent across both genders and all age groups, even in sunny countries (3) .…”

“…There is growing evidence that vitamin D sufficiency is required for optimal health in general, and musculoskeletal health in particular (5,6) . In this respect, once thought to be primarily a determinant of bone health, it is now recognized that vitamin D is a requisite hormone involved in a myriad of physiological processes including immune modulation, genetic regulation, hormone production and cellular functioning throughout the life cycle (2,7) . Indeed, the requirement for vitamin D in a wide variety of essential biological functions such as bone and mineral metabolism, muscle function and immunity (8) explains why many chronic diseases including osteoporosis and fractures, falls, cancer, psoriasis, diabetes mellitus, obesity, hypertension, multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease and sixteen different cancer types (4,9,10) show significant negative associations with serum 25(OH)D as has been noted in a variety of populations (8) .…”

Prevalence of and Factors Associated with Osteoporosis among Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

“…Lower serum levels of vitamin D and calcium result in higher PTH levels, increasing the rate of bone loss (Filipponi et al, 1990). Previous studies indicated that a nutritional calcium deficit was popular in different population groups, however, level of calcium intake in male population was not so lower than female population (Peterlik et al, 2009). However, male cancer survivors can undergo difficulties of calcium intake because of loss of GI tract due to surgery or loss of appetite due to chemotherapy.…”