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When the body is exposed to the sun, vitamin D is formed within the body. Different foods or supplements can be used to gain vitamin D in a person. For improving and maintaining the health of bones and teeth, vitamin D is necessary for the body. It also helps to protect against different diseases and disorders like type 1 diabetes. Although the name suggests that vitamin D is a vitamin, it is not, but rather a precursor or prohormone of a hormone. Vitamins must be gained through a person’s diet; it cannot be synthesized within the body. But vitamin D can be produced by the body. This article goes through the uses of vitamin D and what happens if we lack it, and what measures to take to keep its amount normal through the intake. Why is vitamin D important? Even though it is labeled as a “vitamin” (i.e., a nutrient is taken from diet), it is still not really a vitamin. When the skin gets exposed to the UVB rays of the sun, the body synthesized it using cholesterol, making it act more like a hormone. About 2000 genes are regulated by vitamin D, which has been calculated, making it a lot of critical operation that occurs in the body. Many health conditions are related to this nutrient, including those of bones and muscle health, brain health, pregnancy, immune activity, cardiovascular functions, and many more. Lack of vitamin D can lead to a number of disorders and health issues, with about 42% of American adults being deficient in it. A few of the health aspects affected by vitamin D are mentioned below. Vitamin D benefits and the consequences of deficiency Usually, people associate vitamin D with their bones and think in this regard. Many varieties of minerals like sodium, phosphorus, calcium, and magnesium can be balanced due to this vitamin, leading to mineralization and healthy bone formation. Even though skeletal health is maintained using vitamin D, its uses, however, encompasses more than just the bones. Due to the large quantities of minerals present and with vitamin D receptors in the body, it contributes, directly or indirectly, to a number of physiological functions. For example, a number of its functions include maintaining immune activity, acting as an antioxidant, regulating cardiovascular health, maintaining blood sugar balance, enhancing neurotransmitter synthesis, and many more. Vitamin D gained through sun, food, or supplements are in an inactive form. It is first to move to the liver where it is transformed into 25(OH) vitamin D and then transported to the kidney where it is activated to form 1.25(OH)2 vitamin D. The activated form of vitamin D then travels throughout every organ present in the body. Many organs like lungs, kidney, pancreas, intestine, thyroid, etc., contain vitamin D receptors, so; vitamin D plays a role in their functions and health. Some organs that function by utilizing vitamin D are mentioned below, and the negative consequences of vitamin D deficiency in some health conditions. Benefits of Vitamin D Healthy bones Calcium and phosphorus levels within the blood are maintained with the help of vitamin D. These components are useful in forming healthy bones. Vitamin D is needed for the body to activate and reabsorb the calcium, which would otherwise be eliminated from the body through the kidney. Vitamin D deficiency causes rickets, a condition marked by the softening of bones, which causes a bowlegged appearance. Likewise, deficiency of vitamin D forms softening of bones or osteomalacia in adults. It is characterized by weak muscles and poor bone density. Reduced risk of flu Current researches in the 2018 review showed that vitamin D works to protect against the influenza virus. But, different authors also studied similar researches regarding how vitamin D showed no effects on flu or the risks associated with it. More research is required to obtain clear results on the protective effects of vitamin D on the flu. Healthy infants Many children suffer from high blood pressure due to deficiency of vitamin D. A relation between the rigidness of children’s arterial walls and insufficient amounts of vitamin D levels was found in the 2018 study. As shown by data obtained from the American Academy of Allergy Asthma and Immunology (AAAAI) that refers to a relation between the elevated level of allergic sensitization and low vitamin D exposure. An example related to this are children who live near the equator and do not have high admission rates of the hospital due to allergies, plus scarcely any prescriptions of epinephrine autoinjectors. They would also have low rates of peanut allergy. Moreover, vitamin D can improve the anti-inflammatory effects of glucocorticoids. So, people having steroid-resistant asthma can make use of it as a supportive therapy. Healthy pregnancy A review of 2019 theorized that vitamin D deficiency in pregnant ladies might lead to increased risks of preterm births or preeclampsia. Pregnant women deficient in vitamin D may also suffer from bacterial vaginosis and gestational diabetes. In a study of 2013, it was noted by the researchers that increased levels of vitamin D if occurs in pregnancy can cause elevated risk of food allergy in the starting two years of a child’s life. Vitamin D and immunity and respiration As vitamin D shows an important role in maintaining the immune system, it also shows beneficial effects on conditions like acute and chronic respiratory complications and works to decrease any symptoms that may occur due to it. Like, they were taking adequate amounts of vitamin D minimizes the risk of respiratory issues and risks in adults and children. Research shows that pregnant women administered with 4,400 IU of vitamin D every day are less likely to develop any respiratory issues in their newborn to three-year-old kids, as opposed to those pregnant ladies administered with 400 IU each day. Vitamin D and cardiovascular health Vitamin D functions to improve respiratory function as well as cardiovascular functions of the body, which helps in decreasing risks and complications associated with heart and blood vessels. For example, it was observed by the researchers that a variety of doses of vitamin D supplementation every day (i.e., 600 IU, 2000 IU, 4000 IU) helps in removing rigidness of blood vessels after using for eight weeks, as compared to the placebo. A dose-response relationship in vitamin D and its influences was noted down, which meant that consuming more vitamin D resulted in the wellbeing of blood vessel structure in the body. Vitamin D and metabolism Vitamin D is responsible for many metabolic processes occurring within the body, including many results showings that it has a hand in maintaining blood sugar imbalances and any metabolic complications. Various metabolic and cardiovascular abnormalities result in an increased risk of obesity. Research suggests that people with obesity are most likely those who are deficient in vitamin D (But less likely in people who are overweight) and those having abnormal blood-sugar balance. Evidently, the relation between vitamin D and metabolic complication is seen in dose-dependent; a good balance of vitamin D present means a decreased rate of abnormal imbalances. How much is Vitamin D essential? The recommended amount of Vitamin D is proposed by federal and research institutions and by scientists. The recommended amount of Vitamin D is: - Children of 12 months need 400 IU of vitamin D. - Children of more than one year and adults up to 70 years need 600 IU of Vitamin D. - People of more than 70 years need 800 IU of vitamin D. Sources and forms of vitamin D Vitamin D from sunlight The strongest factor in synthesizing vitamin D is sunlight. Approximately 10,000-20,000 IU of vitamin D is produced from exposing your body fully (wearing only a bathing suit) for about 20 minutes in the sun. Dietary sources of vitamin D Since many factors are involved in producing considerable amounts of vitamin D by the skin, still more amount of vitamin D is required, which is obtained through the diet. Organic food sources of vitamin D3 (known as cholecalciferol, vitamin D, which is animal-based) are egg yolks, fatty fish, and cod liver oils. Shiitake mushrooms are an excellent source of vitamin D2 (known as ergocalciferol, vitamin D based on plant source). Supplements: Which form of vitamin D is best? Supplements are essential for those people who are not able to get sufficient amounts from diet or sun exposure. Vitamin D2 and vitamin D3 are the two types of vitamin D used as supplements. They vary in their structure and sources. Both types of vitamin D are transformed into calcitriol [25(OH) vitamin D], the form of vitamin D, which is measured in a person’s blood to check their vitamin D level. There has been proof that as compared to vitamin D2, vitamin D3 is more likely to maintain normal levels of vitamin D in the blood. Vitamin D2 is preferred by those who are vegetarians and want plant source-based vitamin D for supplementation instead of animal-based vitamin D3. For those demanding plant-based vitamins, a form of vitamin D3 is available made from lichen, fungi, and algae plant-like organisms. Forms of D2 or D3 or a mixture of both are present as multivitamins, which consist of 400, 500, or 1000 IU vitamin D. A separate vitamin D supplement is present as vitamin D3 form in values of 400-50,000 IU.
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– डा. अरुणा उप्रेती (जनस्वास्थ्य विज्ञ) ‘२०७६ सालको मंसिर महिनामा मलाई असह्य किसिमले ढाड दुख्यो । उपचारको क्रममा विभिन्न अस्पतालहरु धाएँ, विभिन्न औषधिको सेवन गरेँ। तर पनि उन्नाइसको बीस भएन । त्यसपछि मैले डाक्टरको सल्लाहबमोजिम भिटामिन ‘डी’को जाँच गराएँ । मेरो शरीरमा भिटामिन ‘डी’को कमी भएको पाइयो । भिटामिन ‘डी’को कमीले ढाड दुखेको भन्ने निष्कर्ष आयो । मैले शरीरलाई आवश्यक पर्ने भिटामिन ‘डी’ के–केमा पाइन्छ भनेर इन्टरनेटमा खोजेँ । यस क्रममा कुखुराको अण्डा र बोक्रामा प्रशस्त मात्रामा भिटामिन ‘डी’ पाइन्छ भन्ने थाहा पाएँ । त्यसपछि मैले नियमित अण्डा खान थालेँ। साथै अण्डाको बोक्रालाई सफा गरी घाममा सुकाएपछि मिक्सचरमा पिनेर उक्त धूलो २–२ चम्चा हरेक बिहान–बेलुकी दूधमा घोलेर सेवन गर्न थालेँ । त्यसपछि दुखाइमा केही कमी भयो । २ महिनापछि पुनः भिटामिन ‘डी’को जाँच गराएँ । मेरो शरीरमा भिटामिन ‘डी’को मात्रा सही ठाउँमा आएको थियो ।’ यो अनुभव ४० वर्षीय कपिल लामिछानेको हो । अहिले हाम्रो समाजमा ‘ढाड’ दुखेपछि औषधि मात्र खाने युवाहरु प्रशस्तै छन् । भोजन र व्यायाममा ध्यान दिँदैनन् अनि बारम्बार ‘ढाड’ दुखाइको समस्याबाट पीडित हुन्छन् । एक संस्थामा काम गर्ने ४० वर्षीया प्रधान थरकी महिलाले केही वर्षअघि मलाई भनेकी थिइन्, ‘मलाई काम गर्दा धेरै ढाड दुख्यो । तैपनि सहेर काम गरी नै रहेँ । डाक्टरलाई देखाउँदा भिटामिन ‘डी’को कमी, बढी कम्प्युटरमा काम गरेको भनेर मलाई घाममा बस्न, काम गर्दा धेरै ननिहुँरिन, व्यायाम गर्न सल्लाह दिए । तर बिहानदेखि बेलुकासम्म कामको चक्करमा घाममा बस्ने, व्यायाम गर्ने फुर्सद नै भएन । अहिले मेरो ढाड, घुँडा सबै दुख्छ । अहिले काम पनि कम गर्छु, औषधि खान्छु तर दुखाइ छ । शायद आफूले काम गर्दा केही समय आफ्नो शरीरको लागि छुट्याएको भए मलाई सहज हुने थियो होला ।’ कतिपय महिलाहरु ‘पकाएर खाने फुर्सद हुन्न, कतिखेर घाममा बस्नु ? ढाड दुखे क्याल्सियम र भिटामिन ‘डी’को चक्की खाने हो’ भन्छन् । अहिले हरेक दिन २० मिनेटजति घाममा बस्ने फुर्सद नहुँदा, व्यायाम नगर्दा केही पछि १५ दिनसम्म घुँडा र ढाड दुखेर बस्नुपर्ने स्थिति आउन सक्छ । वर्षैभरि सजिलैसँग सूर्यको स्रोतबाट पाइने नेपालका घर–आँगनमा छरिएको भिटामिन ‘डी’को हामी वास्ता नै गर्दैनौँ, महत्व नै बुझ्दैनौँ । हाड–जोर्नीहरुमा समस्या भएर ढाड दुख्ने, घुँडा दुख्ने भएपछि डाक्टरले भिटामिन ‘डी’को चक्की लेखिदिएपछि महँगोमा किनेर खान्छौँ । चिकित्सकले घाममा बस्नु भनेको कुरालाई समेत हामी त्यति वास्ता गर्दैनौँ । सित्तैमा सूर्यबाट प्राप्त हुने भिटामिन ‘डी’का लागि घाममा बस्ने फुर्सद छैन भन्ने बहाना गर्छौं । वास्तवमा भिटामिन ‘डी’लाई ‘सनसाइन’ भिटामिन अर्थात् सूर्यको प्रकाशबाट पाइने भिटामिन पनि भनिन्छ । सूर्यको किरणमा रहेको विशेष तत्व मानिसको छालामा परेपछि भिटामिन ‘डी’ बन्ने प्रक्रिया हुन्छ । भिटामिन ‘डी’ले बाथरोग जोखिम कम गर्छ । चिसो ठाउँमा बसेर काम गर्ने व्यक्तिलाई हुने दुखाइ पनि सूर्यको तापले कम गर्छ । कतिपय औषधि कम्पनीहरुले सकेसम्म मानिसहरुले क्याल्सियम र भिटामिन ‘डी’ बढी प्रयोग गर्नुपर्छ भन्छन् । नेपाललगायत विश्वका कतिपय ठाउँमा स्वास्थ्यकर्मीले महिलालाई २०–२५ वर्षको उमेरदेखि नै क्याल्सियम र भिटामिन ‘डी’का चक्कीहरु दिन शुरु गर्दछन् । प्रत्येक समस्यालाई औषधिले मात्र समाधान गर्न थाल्नाले हामी प्राकृतिक तत्वको उपयोग नै गर्न बिर्सिन थालेका छौं । अहिले नेपालमा सबै गर्भवती महिलालाई भिटामिन ‘डी’ दिनुपर्छ भनिन्छ तर उनलाई घाममा बस्नुपर्छ भन्ने सल्लाह दिइँदैन । वास्तवमा भिटामिन ‘डी’को अभावले अनेक किसिमका समस्या पैदा हुन सक्छन् । तर सत्य के हो भने, शरीरलाई आवश्यक पर्ने भिटामिन ‘डी’को मात्रामध्ये करिब ८०–९० प्रतिशत भिटामिन ‘डी’ सूर्यको किरणबाट प्राप्त गर्न सकिन्छ । करिब १०–२० प्रतिशत हामीले खाने खाना वा अन्य पौष्टिक तत्वबाट प्राप्त हुन्छ । तर यसबारेमा हामी त्यति सचेत भएका छैनौँ । यसको महत्वलाई बुझिरहेका छैनौँ । घाममा बसेर बच्चालाई तेल लगाउँदा आफू र बच्चा कालो हुन्छ भन्ने डर लाग्ने आमा–बा पनि धेरै छन् । तर यसरी घाममा बस्दा प्राप्त हुने भिटामिन ‘डी’ले नै बालबालिकामा दम र श्वास–प्रश्वाससम्बन्धी समस्या घटाउने र रोगसँग लड्ने शरीरको क्षमतालाई वृद्धि गर्ने गर्छ । यस्तो क्षमता वृद्धि गर्ने सूर्यबाट सित्तैमा पाइने औषधिलाई बेवास्ता गर्नुहुन्न । विभिन्न अध्ययनले देखाएका छन्, भिटामिन ‘डी’ले बाथरोग जोखिम कम गर्छ । चिसो ठाउँमा बसेर काम गर्ने व्यक्तिलाई हुने दुखाइ पनि सूर्यको तापले कम गर्छ । सूर्यको किरणमा रहेको विशेष तत्व मानिसको छालामा परेपछि भिटामिन ‘डी’ बन्ने प्रक्रिया हुन्छ । शारीरिक स्वास्थ्यमा विभिन्न सूक्ष्म पोषक तत्वहरूको ठूलो भूमिका रहन्छ । एउटा पोषक तत्व मात्र धेरै दिएर स्वस्थ रहन सकिन्न । प्राकृतिकरुपमा खाइने खानाहरू मिलाएर खाँदा यस्ता पौष्टिक तत्व शरीरले सहजै प्राप्त गर्छ । शरीरमा भिटामिन ‘डी’ प्राप्त गर्न घाममा बस्दा पनि हामीले शरीरमा क्यल्सियमयुक्त खाना पुगोस् भनेर विचार गर्नुपर्छ । हड्डी, मासंपेशी, दाँत आदि बलियो बनाउन यी दुवैको ठूलो महत्व हुन्छ । क्याल्सियम पाइने खानाहरु लट्टे, कोदो, जौ, चिनो, गहत, मस्याङ, राजमा, चना, काउली, मूला, सहजनको पात, करीपत्ता, कर्कलो, मेथीको साग, खोले साग आदि हुन् । यिनीहरुमा अन्य पौष्टिक तत्वहरु पनि पाइन्छ । कतिपय किशोरीहरु छाला कालो हुन्छ भनेर घाममा बस्न रुचाउँदैनन् । तर उनीहरुलाई घाममा बस्न झन् बढी जरुरी छ । भिटामिन ‘डी’को कमी हुँदा उनीहरुको प्रजनन स्वास्थ्यमा पनि असर पर्छ । घाममा बस्दा पुठ्ठाका हड्डी बलियो हुने भएकोले गर्भावस्था, प्रसूति समय र उमेर पुगेपछि हुने रजोनिवृत्तिको अवस्थामा पनि हड्डी दुख्ने समस्या कम हुन्छ । स्वास्थ्य निकायहरुमा प्रायः भिटामिन ‘डी’ र क्याल्सियमको गोली सँगै खाने सलाह दिने गरिन्छ । तर घरेलु पौष्टिक तत्वहरुबाट नै पर्याप्त क्याल्सियम प्राप्त हुन्छ । १ सय ग्राम गहतमा २ सय ८७ मि.ग्रा. क्याल्सियम पाइन्छ । यस्तै १ सय ग्राम तिलमा १ हजार ४ सय ५० मि.ग्रा. क्याल्सियम प्राप्त हुन्छ । गहत, आलस, ज्वानो, भटमास, गुन्द्रुक, मस्याङ, तोफु, दही, मही आदिमा पनि पर्याप्त मात्रामा क्याल्सियम प्राप्त हुन्छ । तर क्याल्सियमका लागि औषधि नै खानुपर्छ भन्ने धेरैलाई भ्रम छ । यो भ्रमबाट मुक्ति पाउन महिलाहरुले हाम्रा पुर्खाहरुले कसरी घाममा बसेर आफूलाई स्वस्थ राख्थे भन्ने कुरा विचार गर्नुपर्छ । औषधिको भरमा मात्र सबै समस्या समाधान हुन्छ भन्ने विचार ठीक होइन । सन् २०१९ मा गरिएको एक अनुसन्धानमा भारतजस्तो बर्सैभरि घाम लागिरहने देशमा पनि विभिन्न शहरमा ७०–८० प्रतिशत भारतीयलाई भिटामिन ‘डी’को कमी भएको पाइयो । साथै यो अध्ययनमा ८४.२ प्रतिशत मधुमेहका बिरामीहरूमा भिटामिन ‘डी’को कमी भएको पाइयो । गर्भवती महिलालाई पनि भिटामिन ‘डी’को कमी देखियो । त्यसकारणले सधैँ घाम लाग्ने भूभागमा बसोबास गरेका भरमा भिटामिन ‘डी’ पाइँदैन, त्यसका लागि सूर्यको किरण शरीरमा पर्ने गरी दैनिकरुपमा घाममा बस्नुपर्छ । घामको किरण शरीरका छालामा प्रत्यक्षरुपमा नै पर्नुपर्ने हुन्छ । सूर्यको किरणबाहेक विभिन्न खानाहरुमा पनि भिटामिन ‘डी’ पाइन्छ । तर खानाबाट हाम्रो शरीरका लागि २० प्रतिशत मात्र भिटामिन ‘डी’ उपलब्ध हुन्छ । बाँकी त सूर्यको किरणबाटै प्राप्त हुने हो । भिटामिन ‘डी’ पाइने वनस्पति च्याउ, जई, बदाम आदि पनि हुन् । साथै माछा, अण्डाको पहेँलो भाग र दुग्धजन्य पदार्थबाट पनि भिटामिन ‘डी’ प्राप्त हुन्छ । कतिपयले भिटामिन ‘डी’का क्याप्सुलहरु नै प्रत्यक्षरुपमा खाने गरेका हुन्छन् । फाइदा हुन्छ भनेर लामो समयसम्म यस्ता क्याप्सुल खाने गर्छन् । भिटामिन ‘डी’को क्याप्सुल खानेहरूले के विचार गर्नुपर्छ भने, शरीरमा चाहिनेभन्दा बढी भिटामिन ‘डी’ भयो भने पनि यसले मुटु र मिर्गौलामा नराम्रो असर पार्न सक्छ । घाम कम लाग्ने देश जस्तो– क्यनडा र फिनल्यान्डमा जनस्वास्थ्यको दृष्टिकोणले भिटामिन ‘डी’ शरीरमा पुगोस् भनेर भोजनमा नै भिटामिन ‘डी’ हालेर वितरण गर्ने कार्यक्रम सञ्चालन गरिएको छ । तर नेपालजस्तो मुलुकमा सधैँ प्रशस्त घाम लाग्ने भएकाले निःशुल्क पाइने सूर्यको किरणबाट भिटामिन ‘डी’ प्राप्त गर्नु नै उत्तम विकल्प हो ।