Let’s face it, this winter was awful. When the Farmer’s Almanac predicted an unusually harsh winter, thoughts of snow days and hot chocolate rushed through the minds of New Jersey residents. Never did we think we’d be shoveling snow on what felt like every other week, battling below-zero temperatures and calling to find alternative childcare when schools were delayed or closed.
With an unusually long winter comes vitamin D deficiency. Vitamin D is an essential nutrient that plays an important role in bone health. Historically, vitamin D deficiency in children leads to rickets, a bone-deforming disease. In adults, vitamin D deficiency leads to osteomalacia, the softening of the bone, which produces bone pain and weakness and increased risk of fractures. More recently, vitamin D deficiency has been linked to depression, poor dental enamel health, increased risk for allergies or asthma and perhaps coronary artery disease and diabetes .
Who is at Risk?
Those at risk for vitamin D deficiency include those who may not get enough sun exposure, such as seniors, hospitalized or institutionalized patients, those who live in countries far from the equator and those with darker skin pigmentation (since melanin acts as natural sunblock). Poor dietary intake also may play a role, especially in seniors and infants exclusively breastfed. Those with malabsorption issues, such as celiac disease, post-gastric bypass and intestinal resection patients, can’t effectively absorb vitamin D. Those with chronic renal disease also have a vitamin D deficiency.
How to Get More Vitamin D
Say goodbye to electronics and hello to the sunshine. Go outside! Enjoy a picnic in the park, take a walk or ride a bike. Vitamin D is obtained in two major ways: dietary and via the skin. Eating foods like salmon, egg yolk and yogurt help, but enjoying the sun outside is far more entertaining!
The recommended daily allowance (RDA) for children and adults under age 70 is 600 IU. Those aged 80 and older require 800 IU. It’s often difficult to get the recommended daily allowance of vitamin D through diet alone, since common fortified foods contain less than the recommended amount. Examples include:
- 8oz of milk – 100IU
- 8oz of orange juice – 100IU
- One serving of fortified cereal – 40-80IU
- 100g of Swiss cheese – 44IU
Is Sun Exposure Safe?
I recommend supplementing your diet with a daily multivitamin and sunlight exposure. When weighed against the risk for skin cancer, sun exposure becomes more important in trying to reach the recommended amount. During winter months when UV-B rays are not strong and snow and freezing temperatures restrict access to outdoor time, vitamin D deficiency rises and additional supplementation becomes very important.
However, when the sun and warmer weather returns during the spring, summer and fall, 10 to 15 minutes of sun exposure, without the use of sunblock during the mid-day, is enough to provide the RDA of vitamin D in the lightly pigmented population. Darker skinned individuals require more time in the sun to absorb the RDA of vitamin D.
Put aside the chores, turn off the TV and computer and go outside to enjoy the fresh air and sunshine. It’ll do your bones some good!
By Kristine Samson, MD
About Kristine Samson, MD
Kristine Samson, MD, joined eMedical Urgent Care in 2013. She is board-certified in emergency medicine. She completed her residency at Jacobi/Montefiore Medical Centers, Bronx, N.Y. She is an assistant professor of emergency medicine at Jacobi Medical Center.