Vitamin D Status and Its Consequences for Health in South Africa

Abstract

In this review, reports were retrieved in which vitamin D status, as assessed by serum 25-hydroxyvitamin D [25(OH)D] levels, was measured in South African population groups with varied skin colours and ethnicities. Healthy children and adults were generally vitamin D-sufficient [25(OH)D level >50 nmol/L] but the majority of those aged above 65 years were deficient. A major role for exposure to solar ultraviolet radiation (UVR) in determining 25(OH)D levels was apparent, with the dietary contribution being minor. Limited data exist regarding the impact of recent changes in lifestyles on vitamin D status, such as urbanisation. With regard to disease susceptibility, 11 of 22 relevant publications indicated association between low 25(OH)D levels and disease, with deficiency most notably found in individuals with tuberculosis and HIV-1. Information on the relationship between vitamin D receptor variants and ethnicity, disease or treatment response in the South African population groups demonstrated complex interactions between genetics, epigenetics and the environment. Whether vitamin D plays an important role in protection against the range of diseases that currently constitute a large burden on the health services in South Africa requires further investigation. Only then can accurate advice be given about personal sun exposure or dietary vitamin D supplementation.

Vitamin D status in adult patients with nonmelanoma skin cancer in Cape Town, South Africa: a cross‐sectional study

“…Norval et al . found that healthy adults in South Africa were generally vitamin D‐sufficient [25(OH)D level >20 ng/mL], but most of those aged above 65 years were deficient . The latter is in agreement with our findings, since our study consisted of mostly older individuals (median = 72 years, IQR = 61–78).…”

“…Age distribution International Journal of Dermatology 2018, 57, 922-927 ª 2018 The International Society of Dermatology Report Vitamin D status in patients with nonmelanoma skin cancer Van Deventer et al including South Africa. Norval et al found that healthy adults in South Africa were generally vitamin D-sufficient [25(OH)D level >20 ng/mL], but most of those aged above 65 years were deficient 22. The latter is in agreement with our findings, since our study consisted of mostly older individuals (median = 72 years, IQR = 61-78).…”

“…Limited data are available about vitamin D levels in healthy South African populations . In a recent review by Norval et al, healthy children and adults in South Africa were generally vitamin D‐sufficient (25[OH]D level >20 ng/mL [>50 nmol/L]), but most of those aged above 65 years were deficient.…”

The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa

“…Thus, a balanced approach to sun exposure is important for holistic health and wellbeing. A review published in 2016 indicated that vitamin D status among different South African population groups and ethnicities was generally sufficient in children and adults, but was insufficient in many individuals over the age of 65 years [51].…”

Vitamin D Deficiency and Evaluation of the Parathyroid Hormone Status in People Living with HIV in Côte d’Ivoire

“…Similarly, a deficiency was observed in approximately 12% of HIV negative controls and insufficiency in 44% of controls. Sufficiency in 25 (OH) vitamin D reserves observed in our study could be explained due to the fact that Côte d'Ivoire is a tropical country with heavy sunshine, the major intakes pathway of vitamin D is through skin synthesis [30,31]. But the deficiency cases observed in control subjects may be due to the consumption of diets poor in vitamin D or other factors, since its supply has two sources (food and synthesis) [32].…”