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Don't be deficient when it comes to vitamin D.

About 70 percent of Americans have insufficient levels of vitamin D, and with winter approaching, your D levels could fall even further. This is particularly dangerous because, according to research published in the September issue of the European Journal of Clinical Nutrition, low vitamin D levels are associated with frailty, and all-cause mortality in older adults. Conversely, there is some evidence that maintaining a normal level of vitamin D may benefit your overall health, and it also is associated with a reduced risk of falls. The good news is that there are steps you can take to raise your levels, even without the aid of the summer sun.

Vitamin D promotes calcium absorption in the gut and helps maintain adequate serum calcium and phosphate concentrations which enable normal mineralization of bone. It is also needed for bone growth and bone remodeling. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Together with calcium, vitamin D helps protect older adults from osteoporosis. The nutrient also promotes cell growth, improves immune function, and reduces inflammation in the body.

Who's at risk? "Because exposure to the sun helps to raise vitamin D levels, the winter months are a particular problem," says Fran C. Grossman, RD, MS, CDE, CDN, a nutrition consultant at Mount Sinai School of Medicine. "During the winter, people get less sunlight exposure, they are more covered up, and they tend to spend less time outside. All of these factors can decrease vitamin D levels."

According to Grossman, other factors that can put someone at risk of low vitamin D levels include inadequate intake of vitamin D-rich foods over time; conditions such as Crohn's disease, celiac disease, or cystic fibrosis which can cause fat malabsorption in which the digestive tract does not properly absorb vitamin D; and kidney disease, which makes the body unable to convert vitamin D to its active form. People who do not eat a lot of dairy, including those with lactose intolerance and vegans, are also at an increased risk of vitamin D deficiency.

In addition, individuals with dark skin make less vitamin D from sun exposure due to pigment melanin, and those living in northern parts of the country are often exposed to less direct sunlight than those in the southern region.

People who are obese (defined as a body mass index or BMI of greater than 30) tend to have decreased levels of vitamin D in the blood, and older adults cannot synthesize vitamin D from sun exposure as effectively as their younger counterparts.

Boosting your vitamin D levels Grossman recommends that older adults have a blood test to detect their vitamin D levels. "Ask to have your serum 25-hydroxy vitamin D levels checked," Grossman says. "If they are low, ask your doctor what steps you need to take to raise them."

Older adults should consume foods rich in vitamin D, which include fatty fishes such as salmon, mackerel, and tuna; beef liver; fortified milk; whole eggs; and fish oils, such as cod liver oil. If you cannot raise your levels through diet and sun exposure, your doctor may recommend that you take a vitamin D supplement.


The recommended daily intake of vitamin D is:

* 600 international units (IU) for people ages 9-70.

* 800 IU for those age 71 and up.

* Do not exceed 4,000 IU per day.
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Title Annotation:NUTRITION
Publication:Focus on Healthy Aging
Date:Nov 1, 2012
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