126:
44:
268:
134:
tetany and seizures. During the late 19th century autopsies conducted in the
Netherlands concluded that 80–90% of children were suffering from Rickets. The incidents of rickets observed within Sydney hospitals during the years of 2003–2004 have doubled. This major spike can be attributed to the growing population of migrants in Australia, many of whom are considered at high risk of vitamin D deficiency.
225:
greater risk of vitamin D deficiency, as human milk often has minimal vitamin D present. Recommendations for infants of the age 0–12 months are set at 5 ug/day, to assist in preventing rickets in young babies. 80% of dark skinned and or veiled women in
Melbourne were found to have serum levels lower than 22.5 nmol/L considering them to be within moderate ranges of vitamin D deficiency.
117:
Vitamin D have also been associated with other conditions such as heart disease, cancer and kidney disease but further research is required. Recent evidence suggests
Vitamin D is also linked to many other health diseases such as cardiovascular disease, chronic kidney disease, diabetes mellitus, multiple sclerosis and some form of cancer.
917:
186:
Veiled women or individuals with dark skin pigmentation are vulnerable to a fall of vitamin D to levels considered deficient in
Australia. This is most likely because the clothing worn acts as a direct barrier to, or absorbs the UVB irradiation. Dark Skin has high levels of melanin pigmentation which
170:
Several studies conducted in
Australia have revealed a deficiency ranging from 15 to 52% amongst the senior population. These deficiencies have been found to be higher amongst those who are home bound or living within institutions with less access to sun exposure. Vitamin D concentration levels below
51:
Vitamin D plays an important role in which it supports calcium absorption in the body, sustaining good bone health as well as muscle function. When calcium in the body becomes under provided for normal bodily functions, calcitriol, an active form of
Vitamin D, pairs with parathyroid hormone. Together
253:
Other factors previously mentioned are sun exposure, geographical longitude as well as season change. Greater latitudes receive sunlight that is of lesser ultra radiation strength in contrast to regions close to the equator, who receive lower variation to hours of daylight during the summer periods.
245:
that have increased the general public's awareness of the risks associated with excessive sun exposure and skin cancers. The 'sun smart' campaign created in 1988 had a significant impact on the public approach and behaviours towards sun exposure. The success of this campaign reduced the sunburn rate
224:
Pregnancy also poses as another high risk factor for vitamin D deficiency. The status levels of vitamin D during the last stages of pregnancy directly impact the newborns first initial months of life. Babies who are exclusively breastfed with minimal exposure to sunlight or supplementation can be at
208:
There is conflicting evidence to suggest whether obesity contributes to vitamin D deficiency. Obese individuals have an increased risk of being vitamin D deficient likely caused by lack of sun exposure from reduced mobility and or low levels of physical activity. The serum levels of obese
Australian
55:
The popular term
Sunshine vitamin, as it is often called, is one of the one main sources of achieving sufficient Vitamin D through sunlight on the skin known as D3. The second form is commonly known as D2, which is found in foods such as fatty fish and fortified products like margarine and fortified
149:
have become widespread among
Australians over 60. Osteoporosis can be defined as very fragile and brittle bones, in which serious fractures can occur with just the slightest bump or fall. Osteoporosis Australia have predicted that half of all women and one third of men over the age of 60 years will
182:
In
Australia, vitamin D deficiency has been recognised within particular subgroups such as aged, dark skinned and veiled women. There is deficiencies in around 80%, particularly in dark skinned and or veiled populations. The prevalence of vitamin D deficiency amongst those with dark skin, or those
59:
Additionally, if you consume vitamin D through your diet, or make vitamin D in your skin from UVB exposure, it is processed through two organs before it becomes activated. Vitamin D is first processed in the liver, before heading to the kidneys where it becomes activated to the form 1-25 dihydroxy
116:
This fundamental fat-soluble vitamin has been long known for its important role in calcium absorption in the body, especially in musculoskeletal health. The health impacts commonly caused by deficiency of Vitamin D are rickets in children and osteoporosis in the elderly populations. Low levels of
199:
To ensure adequate vitamin D levels are reached, an average daily exposure, roughly 10% of the sunburn threshold is required on a significant area of skin, not just on the back of the hands. A burn time for a fair-skinned person could be limited to just 8 minutes in the middle of the day, during
68:
Vitamin D deficiency historically used to be identified through counting cases of rickets. The old theory was that if someone had enough vitamin D to prevent rickets and osteomalacia, two skeletal disorders, they were considered safe from a deficiency. Nowadays through technological advancements
195:
Despite Australia having a sunny climate, Australians are falling short of adequate levels of ultraviolet B (UVB) light from the sun. Associated factors contributing to the low vitamin D levels are seasonal variations such as winter, when there is minimal sunlight, less time spent outdoors, and
133:
Rickets can be traced back to the 1600s, where a pandemic arose with children around the globe from Vitamin D deficiency. The inadequate intake of UV exposure consequently lead children to numerous health problems such as, growth retardation, muscle weakness, skeletal deformities, hypocalcemia,
749:
Daly, Robin M.; Gagnon, Claudia; Lu, Zhong X.; Magliano, Dianna J.; Dunstan, David W.; Sikaris, Ken A.; Zimmet, Paul Z.; Ebeling, Peter R.; Shaw, Jonathan E. (1 July 2012). "Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national,
69:
Vitamin D deficiencies are now identified and thus calculated through the measurement of the serum 25-OH. According to the Australian Bureau of Statistics National Health Measures Survey (NHMS), the recommend Vitamin D levels to determine deficiency are categorised as follows:
209:
were 8.3- 9.5 nmol/L lower in both genders comparable to those of healthy weight ranges. During the AusDiab study conducted throughout Australia serum levels within obese people were shown to be 57% lower than with normal weight after receiving the same amount of UV exposure.
283:
In response to recent advances, public policies are being reconsidered to ensure vitamin D is evidently being measured. With the vitamin D deficiency resurfacing the nutrient reference value guidelines were established, in turn creating the dietary vitamin D recommendations.
308:
to maintain healthy levels which in most cases can be provided by sun exposure. Increased amounts are required for individuals who are previously diagnosed as deficient. For those of moderate deficiencies, oral supplementation can be implemented into the diet at levels of
200:
summer without sunscreens. A dark skinned person may need 45 minutes, while a covered individual might need several hours to achieve that same required exposure. The strength of the UVB changes throughout the day, so exposure time will need to change accordingly.
275:
In light of the increase of vitamin D deficiency throughout Australia the federal government introduced mandatory fortification of vitamins and minerals such as vitamin D in certain foods like edible oil spreads as indicated in the:
280:. It is mandatory for all food manufacturing companies producing table spreads like spreadable butter and margarine to have no less than 55 mg/kg of vitamin D, as a response to a growing public health requirements.
216:(ABS) found there to be no correlation between weight levels and vitamin D serum level. According to ABS the Vitamin D supplementation was said to not be a contributing factor as supplement use was similar across all weight ranges.
249:
In addition to the reduced sun exposure amongst the Australia populations, there have been decreases in the form of dietary intake as many people are no longer taking fatty fish oil tablets as a method of regulating vitamin D.
187:
decreases the cutaneous production of vitamin D. Compared with those of European descent, African-Americans require six times more UVB dosage to stimulate the same production of vitamin D in the skin.
171:
28 nmol/L are common amongst the studies conducted. Throughout Sydney nursing home studies, it has been revealed that 86% of woman and 68% of men are falling into the moderate deficiency range.
30:. Outlined throughout the article are the causes of increase through subgroups populations, influencing factors and strategies in place to control deficiency rates throughout Australia.
174:
In a study based in Western Australia, 63% of patients admitted with hip fractures were observed to have serum levels less than 50 nmol/L compared to 25% in the control group.
22:
has become a worldwide health epidemic with clinical rates on the rise. In the years of 2011–12, it was estimated that around 4 million adults were considered deficient in
496:
374:
196:
people cover up due to cold weather. Environmental factors that impact vitamin D production are the elevation of the sun above the horizon and amount of cloud cover.
560:
887:
679:
183:
who cover their skin for religious reasons, can be directly attributed to extremely low sun exposure, which is the main source of vitamin D in Australia.
801:
836:
423:
Shrapnel, William; Truswell, Stewart (1 December 2006). "Vitamin D deficiency in Australia and New Zealand: What are the dietary options?".
125:
26:
throughout Australia. The Australian Bureau of Statistics (ABS) found 23%, or one in four Australian adults suffer from some form of
233:
Australia's vitamin D deficiency levels in recent years have been on the increase, due to factors such as the long-term success of
137:
As shown in the image the skeletal deformities such as knock knees and bow legs in these young children as a result of rickets.
213:
503:
381:
942:
145:
Because of the high prevalence of vitamin D deficiency alongside the ageing of Australia's population, conditions such as
937:
598:
895:
157:
as in most cases individuals don't know they are affected until they suffer a bone fracture as a result of a fall.
686:
542:
328:
to assist in raising stores faster to ensure physical health in restored to prevent further illness or disease.
104:, was 27.6% among Australians over the age of 15. In 2011–2012, 23% of adults had a deficiency defined as below
277:
242:
465:
246:
by 50%, which researchers believe to have contributed to the rise in vitamin D deficiencies across Australia.
543:"Australian Health Survey: Biomedical Results for Nutrients, 2011–12 | Australian Bureau of Statistics"
561:"Vitamin D deficiency remains prevalent despite increased laboratory testing in New South Wales, Australia"
808:
337:
27:
783:
775:
767:
656:
590:
440:
866:
759:
646:
638:
580:
572:
432:
320:
Severe deficiency is treated through megadose therapy where patients are given doses around
238:
43:
267:
651:
626:
585:
870:
931:
763:
436:
787:
287:
The dietary vitamin D guidelines are assuming limited exposure to UVB sunlight are:
52:
they act to assemble cells in order to increase the calcium stores taken from bone.
347:
146:
771:
716:
528:
444:
342:
290:
Infants, Children and Adults < 50 years: 5 μg/day (200 IU/day)
23:
779:
660:
594:
576:
234:
831:
829:
642:
375:"Australian Health Survey: Biomedical Results for Nutrients, 2011-12"
857:
Timms, Brad (2002). ""Slip, Slop, Slap" campaign may need rethink".
497:"Australian Health Survey: Biomedical Results for Nutrients,2011-12"
313:
for a 6- to 12-week period continued by an ongoing reduced dose of
266:
124:
42:
293:
Adults > 50 - < 70 years: 10 μg/day (400 IU/day)
100:, was 2.8%, and the prevalence of insufficiency, defined as <
882:
880:
491:
489:
487:
559:
Quaggiotto, P; Tran, H; Bhanugopan, M (1 January 2014).
296:
Adults > 70 years: 15 μg/day (600 IU/day)
711:
709:
707:
96:
In 1997, the prevalence of deficiency, defined as <
60:
vitamin D or alternatively named chemical calcitriol.
460:
458:
456:
454:
304:
Day to day requirements of vitamin D are set around
212:Inconsistent to the findings of AusDiab Study, The
837:"Vitamin D deficiency and multicultural Australia"
627:"Resurrection of vitamin D deficiency and rickets"
150:suffer the debilitating effects of osteoporosis.
744:
742:
740:
738:
418:
416:
414:
412:
410:
408:
406:
404:
402:
620:
618:
616:
554:
552:
852:
850:
8:
674:
672:
670:
369:
367:
365:
363:
650:
584:
271:Vitamin D fortification in table spreads
717:"Vitamin D | Nutrient Reference Values"
359:
153:Osteoporosis is also commonly known as
888:"Vitamins and minerals added to food"
680:"Calcium, Vitamin D and Osteoporosis"
7:
129:Photograph of children with rickets
14:
631:Journal of Clinical Investigation
918:"Vitamin D deficiency in adults"
841:The Medical Journal of Australia
764:10.1111/j.1365-2265.2011.04320.x
625:Holick, M. F. (1 January 2006).
437:10.1111/j.1747-0080.2006.00080.x
317:to maintain stores in the body.
214:Australian Bureau of Statistics
1:
871:10.1016/S1470-2045(02)00892-6
959:
237:government campaigns like
750:population-based study".
565:Singapore Medical Journal
425:Nutrition & Dietetics
278:Australian Standard 2.4.2
90:•Severe deficiency: <
892:www.foodstandards.gov.au
802:"Vitamin D in Australia"
243:Cancer Council Australia
263:Mandatory fortification
72:•Adequate levels: >
39:Importance of vitamin D
752:Clinical Endocrinology
577:10.11622/smedj.2014071
272:
130:
84:•Moderate deficiency:
48:
47:Synthesis of Vitamin D
270:
258:Government strategies
128:
46:
943:Vitamin deficiencies
898:on 24 September 2015
509:on 23 September 2015
387:on 23 September 2015
338:Vitamin D deficiency
229:Contributing factors
64:Vitamin D deficiency
28:Vitamin D deficiency
20:Vitamin D deficiency
938:Health in Australia
601:on 22 December 2015
545:. 12 November 2013.
315:1000–2000 IU/d
311:3000–5000 IU/d
273:
155:the silent disease
131:
78:•Mild deficiency:
49:
472:. 31 October 1999
86:13–29 nmol/L
80:30–49 nmol/L
950:
922:
921:
914:
908:
907:
905:
903:
894:. Archived from
884:
875:
874:
854:
845:
844:
833:
824:
823:
821:
819:
813:
807:. Archived from
806:
798:
792:
791:
746:
733:
732:
730:
728:
713:
702:
701:
699:
697:
692:on 21 March 2016
691:
685:. Archived from
684:
676:
665:
664:
654:
643:10.1172/jci29449
637:(8): 2062–2072.
622:
611:
610:
608:
606:
597:. Archived from
588:
556:
547:
546:
539:
533:
532:
531:. 17 March 2014.
525:
519:
518:
516:
514:
508:
502:. Archived from
501:
493:
482:
481:
479:
477:
462:
449:
448:
420:
397:
396:
394:
392:
386:
380:. Archived from
379:
371:
327:
325:
316:
312:
307:
306:800–1000 IU
239:Slip, Slop, Slap
161:High-risk groups
107:
103:
102:37.5 nmol/L
99:
98:17.5 nmol/L
93:
87:
81:
75:
16:Health condition
958:
957:
953:
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951:
949:
948:
947:
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901:
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886:
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878:
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855:
848:
835:
834:
827:
817:
815:
814:on 4 March 2016
811:
804:
800:
799:
795:
748:
747:
736:
726:
724:
723:. 17 March 2014
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114:
105:
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97:
91:
85:
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73:
66:
41:
36:
17:
12:
11:
5:
956:
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946:
945:
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930:
929:
924:
923:
909:
876:
846:
825:
793:
734:
721:www.nrv.gov.au
703:
666:
612:
571:(5): 271–280.
548:
534:
520:
483:
470:Radio National
450:
431:(4): 206–212.
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162:
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142:
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122:
119:
113:
112:Health effects
110:
106:49 nmol/L
92:13 nmol/L
74:50 nmol/L
65:
62:
40:
37:
35:
32:
15:
13:
10:
9:
6:
4:
3:
2:
955:
944:
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939:
936:
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919:
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688:
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63:
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38:
33:
31:
29:
25:
21:
912:
900:. Retrieved
896:the original
891:
862:
858:
840:
816:. Retrieved
809:the original
796:
758:(1): 26–35.
755:
751:
725:. Retrieved
720:
694:. Retrieved
687:the original
634:
630:
603:. Retrieved
599:the original
568:
564:
537:
523:
511:. Retrieved
504:the original
474:. Retrieved
469:
428:
424:
389:. Retrieved
382:the original
348:Sun exposure
319:
303:
295:
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286:
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252:
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232:
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211:
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191:Sun exposure
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147:osteoporosis
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141:Osteoporosis
136:
132:
115:
95:
89:
83:
77:
71:
67:
58:
54:
50:
19:
18:
902:3 September
865:(10): 588.
818:3 September
727:2 September
605:3 September
529:"Vitamin D"
476:2 September
466:"Vitamin D"
241:as well as
178:Skin colour
932:Categories
354:References
34:Background
772:1365-2265
696:31 August
513:31 August
445:1747-0080
391:31 August
343:Vitamin D
300:Treatment
220:Pregnancy
24:Vitamin D
859:Oncology
788:22371996
780:22168576
661:16886050
595:24862752
332:See also
326: IU
235:SunSmart
920:. 2010.
843:. 2001.
652:1523417
586:4291993
204:Obesity
121:Rickets
786:
778:
770:
659:
649:
593:
583:
443:
56:milk.
812:(PDF)
805:(PDF)
784:S2CID
690:(PDF)
683:(PDF)
507:(PDF)
500:(PDF)
385:(PDF)
378:(PDF)
904:2015
820:2015
776:PMID
768:ISSN
729:2015
698:2015
657:PMID
607:2015
591:PMID
515:2015
478:2015
441:ISSN
393:2015
867:doi
760:doi
647:PMC
639:doi
635:116
581:PMC
573:doi
433:doi
324:000
322:100
166:Age
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429:63
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395:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
