Its always sunny in the UAE, so why do so many UAE residents have a Vitamin D deficiency?

Vitamin D, or rather testing for Vitamin D, has always been a thorny issue for doctors. Part of our thinking when doing a test is why do the test, what will the results tell us and what can we do about it? Vitamin D testing has therefore always proven to be a difficult subject.

To answer these questions, we must look at what exactly is Vitamin D?

Vitamins are essentially micro-nutrients, needed by the body to maintain healthy tissues and processes. There are many vitamins – A, B, C, D etc. Most are taken into the body by consuming food rich in these nutrients.

Vitamin D is slightly more complex; when one talks about Vitamin D you can be talking about a group of substances that are all closely linked.

You can get vitamin D from diet sources like fish and eggs but in actual fact, most Vitamin D is actually synthesized in the skin by the reaction of sunlight on the skin.

It is this point that makes people potentially deficient in Vitamin D, even in the UAE!

Why might people be deficient in Vitamin D?

Poor diet is one cause – you can get Vitamin D from diet, but in actual fact it is difficult to meet your daily needs, even with a ‘healthy’ diet. Additionally, most modern diets are quick meals and so there is less chance of meeting your needs this way.

Lack of sun exposure – in most parts of Northern Europe (e.g. UK), people do not get enough sunshine, for at least 6 months of the year, in order for the body to make enough Vitamin D. In the UAE, a lot of time is spent indoors – home, shopping and work. Despite the weather here, most people avoid the sun!

Pigmented skin – individuals with pigmented skin are thought to be less able to convert the sun exposure to Vitamin D. In addition, if the skin is covered for religious reasons then there is even less chance to produce enough Vitamin D.

Pregnancy – pregnant ladies use up their Vitamin D. Successive pregnancies in quick time frames can cause Vitamin D deficiency.

Lactation – breast feeding can use up Vitamin D.

Bowel disorders – certain bowel conditions may mean Vitamin D can’t be absorbed.

Why is it important?

This is where it gets tricky for the medical professionals. It has been well known that Vitamin D deficiency in children causes Rickett’s (a bone deformity) and in adults Osteomalacia (weak bones). These conditions are thankfully rare, especially since dietary improvements and fortification of foods with vitamins has occurred over the last 30 years.

Recently, a lot of thinking has gone into determining whether Vitamin D deficiency, or even just slightly lower than normal levels, can cause other illnesses.

Some people have postulated that low Vitamin D can cause anything from poor immune functioning, weakness, lethargy, cardiovascular disease and multiple sclerosis to name a few. However, strong evidence of a link with these conditions remains to be fully proven.

Drawbacks

The potential drawbacks for high sun exposure should be well known – skin cancers are the main issue. It is therefore important to strike a sensible balance.

Sun block will stop Vitamin D production. It is said that in the UK, one only needs to be in the midday sun for 30 minutes, 3 times a week and only expose arms and face to get enough sun exposure to create enough Vitamin D. Here in the UAE, much less time is needed therefore, and precautions against sun burn need to be prioritized.

Solutions

Most health professionals will be happy to discuss the issues surrounding Vitamin D, diet and sun exposure. When embarking on any treatment, it should be discussed with your doctor who can advise for each particular situation. Blood testing can be undertaken to establish your active vitamin D levels. Replacement of vitamin D or supplementation can be undertaken; currently the thinking is around 400 units of Vitamin D (10 micrograms) a day for adults should suffice, in those that are deficient.

Article courtesy of Dubai London Clinic