The Importance of Vitamin D by Dr. Sarah Brewer

Dr. Sarah Brewer is a medical nutritionist, nutritional therapist and the author of over 60 popular health books. We are excited about her guest blog post on this vital topic. 

At one-time, vitamin D was all about ensuring good calcium absorption from the diet to maintain healthy bones. Researchers now realize this important vitamin does a lot more than that and has beneficial effects all over the body.

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What is it?

Vitamin D, or calciferol, is the collective term for five different, fat-soluble vitamins. The most important for human health is vitamin D3 (cholecalciferol) which we can make in our skin to some extent. Vitamin D3 is also obtained from animal-based foods such as liver, oily fish, meat, eggs, and dairy products and is added to some fortified foods. We also obtain small amounts of vitamin D2 (ergocalciferol) from a few plant foods such as mushrooms.

What does it do?

As well as regulating the absorption of calcium and phosphate from the diet, and helping to maintain strong bones, vitamin D helps to stimulate immune cells to reduce the susceptibility to infections such as pneumonia. It’s no coincidence that sun exposure was once a leading sanatorium treatment for tuberculosis before antibiotics were available.

Vitamin D helps to reduce calcium deposition in arteries, is involved in memory and mood, and has a strengthening effect on muscle fibres that improve stability and help reduce falls.

Studies have also found associations between good vitamin D status and reduced risks of:

  • breast cancer[i]
  • type 2 diabetes[ii]
  • depression[iii]
  • Alzheimer’s disease and Parkinson’s disease[iv]
  • stroke[v].
The difficulty with making vitamin D

Even in youth, it’s difficult to make all the vitamin D3 you need, which is why it is classed as an essential micronutrient. Its synthesis depends on the presence of a cholesterol-like building block (7-dehydrocholesterol) in the skin, and exposure to sunlight when the UV index is greater than 3.

People living at a latitude of 52 degrees N (which passes through the center of the UK and Canada) are not exposed to enough UVB radiation to make vitamin D between October and April. Those living at a latitude 42 degrees N (which forms the northern limit of Spain and part of the border between Canada and North America) are unable to synthesise vitamin D3 between November to February.

Low vitamin D levels are frequently seen in people living at northern latitudes, especially in those who cover up in the sun, use high factor sun protection, or who stay indoors most of the time – which includes many older people, especially those who are frail or relatively immobile.

People who are taking a statin drug are also at risk of vitamin D deficiency as they produce less of the cholesterol-like precursor in their skin.[vi]

Skin synthesis falls with age

Over the age of 50, the ability to synthesise vitamin D3 reduces so that skin concentrations fall by at least half between the ages of 20 to 80 years. One study showed that people aged 62 and over synthesised four times less natural vitamin D than those in their 20s.[vii]

Due to a combination of less sun exposure, and less ability to make vitamin D3 even when the sun is shining, vitamin D deficiency becomes more common with increasing age.

Vitamin D3 deficiency has wide-ranging effects on health

In older people, lack of vitamin D is associated with the bone diseases, osteomalacia and osteoporosis, and has been linked with muscle weakness, falls and bone fractures.

In the Health, Aging and Body Composition study, involving 2,099 older people (average age around 75 years) who were initially well-functioning, a low vitamin D level was associated with increased risk of developing mobility limitation, disability and poor physical function. [viii]

In the United States, the CDC Injury Center estimates that the number of fatal falls in older people will rise to 100,000 per year by 2030, but that these future fatal falls could be reduced by nearly a quarter through screening for fall risks, reviewing medications, and recommending Vitamin D supplementation.[ix]

Vitamin D deficiency may also play a role in constipation and increase the risk of common age-related conditions such as type 2 diabetes, arterial calcification, hypertension and heart disease as well as some cancers.

What’s the answer?

Despite the limitations mentioned, it’s important to encourage the elderly to spend time out of doors, to obtain some sun exposure, and to eat food sources of vitamin D regularly. The most important intervention, however, is to offer them a vitamin D3 supplement.

Elderly lady using a walker in the garden standing on a pathway with buildings in the background smiling at the camera.

What’s the best dose?

Opinions vary, with recommendations ranging from 10mcg to 50 mcg vitamin D3 per day. Some researchers have found that the United States, for examples, studies show that an intake of 100 mcg (4000 IU) is needed to maintain vitamin D levels in all older women. [x] This intake is equivalent to the currently suggested EU Upper Safe Level.[xi] If in doubt, blood tests can predict the best dose.

Safety

Intakes above 100mcg vitamin D3 are best taken under medical supervision. Excess can lead to side effects associated with high calcium levels, such as demineralization of bone, kidney stones, headache and weakness.

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Read more about vitamin D and health here: https://drsarahbrewer.com/a-z-of-vitamins/vitamin-d

Subscribe to my newsletter to get a FREE 46-page PDF Do You Need A MultiVitamin? at nutritionupdates.subscribemenow.com

For more information on diet and supplements, visit my Nutritional Medicine website at www.DrSarahBrewer.com.  Read my general health articles at www.MyLowerBloodPressure.com and www.ExpertHealthReviews.com @DrSarahB  

References

Make Elderly Taste Buds Tingle with Good Nutrition

Eating is a sensory experience on so many levels. Not only does a good meal nurture our bodies, but it also awakens all of our senses. Beautiful food has amazing visual appeal. The aroma of home cooking literally makes the mouth water. The texture and crunch of food make our taste buds tingle. When mealtime is fun, it also feeds our souls.

Healthy eating keeps our bodies in better working order, lessens the effects and duration of illness, and increases energy. Leafy green vegetables, nuts and fish rich in Omega-3 fatty acids can increase mental acuity and may even stave off memory loss. The fact is, when we eat better, we feel better.

Nutrition in the elderly

Our appetites naturally decrease with age as does our sense of thirst.  Thus, many of the elderly do not get the nutrition their bodies need.  Sometimes this is simply because eating has ceased to be an enjoyable experience. The elderly actually experience a decreased sense of taste and smell and the side-effects of certain medications can intensify this. Older adults are also prone to digestive issues that make them cautious and less adventurous about what they will eat. Slower metabolism, poor dentition and depression can also contribute to seniors not getting the recommended daily vitamins and minerals for their age.

The United States Department of Agriculture lists 10 tips for older adults who would like to improve their nutrition.

1. Drink plenty of fluids especially since some medications can dehydrate you.  It’s best to stay away from sugary drinks likes juices and stick to water or even add more soups into the mix.

2. Turn mealtime into a fun social event! Make eating a pleasant experience by sharing the time with others either in your home at a senior center. You can even listen to music as you eat.

3. Plan healthy meals in advance and the National Institute on Aging has a handy tool ChooseMyPlate.gov for building a balanced plate that includes fruits, vegetables, grains and protein.

4. Have an idea of how much to eat – both too much and too little.  There is so much emphasis on how obesity carries health risks that we can sometimes forget that deficiencies in the frail elderly can be just as dangerous. 

5. Vary your vegetables using the old rule of thumb. Follow your mother’s advice and make sure different colored vegetables are amply included in your diet as each is composed of different and important nutrients.

6. Keep your teeth and gums healthy both in terms of what you eat to strengthen them and proper hygiene and maintenance.  Losing teeth can also affect your taste buds, so it is best to take care even in your choice of hard to chew versus softer foods. 

7. Use herbs and spices to counteract any new sense of blandness to your food. A bonus is the newly included spices can bring with them added nutrition such as turmeric with its anti-inflammatory effects and mental acuity. 

8. Keep food safety top of mind.  Often seniors forget how old something is or are hesitant to throw out food due to financial constraints.  Better to be safe than sorry – don’t eat anything that can jeopardize your health.

9. Read those nutrition and ingredient labels.  In addition to calorie, carbohydrate and fat content, they will clue you into the important nutrients contained. 

10. Ask your doctor about personal nutritional requirements and deficiencies and speak to him/her about vitamins and supplements. Many necessary prescription drugs have side effects that deplete your body of important nutrients which are important to replace.  For example, it is important to beware of anemia which can actually contribute to dementia or to take CoQ10 while on cholesterol reducing statin drugs which can zap your strength. 

Healthy eating is a lifestyle choice that promotes good nutrition in the elderly. For additional tips on helping our senior family members stay active and productive, contact us.  David York Agency could provide direction as to how to manage the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website DavidYorkAgency.com to become acquainted with all we offer. Please like us on Facebook or follow us on Twitter, Google+ or LinkedIn.