The Vitamin D dilemma

While most articles say the best source of Vitamin D is sunshine, I believe we are still not getting enough.

Vitamin D3, also known as cholecalciferol, is found in certain fish like salmon, mackerel and cod.   -  C. Suresh Kumar

Vitamin D is known as the sunshine vitamin. However, I am coming to realise it is a paradox for athletes. Athletes are exposed to the outdoors in nearly every sport. Hence, they should never be low on Vitamin D.

Vitamin D is necessary for optimal health, and there is emerging evidence that its deficiency increases the likelihood of autoimmune and non-skeletal chronic diseases and can also have an impact on immunity, inflammation and muscle function.

A recent internal survey of child athletes at our Qua Nutrition Clinics — ranging in age from eight to 16 years with an average age of 13 — found that 72 in 100 children had a Vitamin D deficiency. We have even found adult sportspersons who enrol for nutrition plans with low levels of Vitamin D.

Medical researchers and scientists worldwide are slowly realising that Vitamin D is responsible for the proper functioning of a number of systems in the human body. These include:\

1. Bone development and maintenance

2. Building a robust immune system

3. Lower cardiovascular risk

4. Reducing risk of cancer of the colon, prostrate and breasts

5. Lower body fat percentage

6. Better testosterone levels in both men and women

7. Better insulin management

Vitamin D is called the sunshine vitamin because your skin is able to synthesise it when exposed to certain ultraviolet rays. Vitamin D belongs to a family of fat-soluble vitamins that also include Vitamins A, E and K. They are very well absorbed with fat in the diet and are commonly stored in the liver and the fatty tissues of the body.

One startling fact is that people with darker skin are more prone to Vitamin D deficiency. That’s because of the higher level of melanin, the pigment that gives the skin its colour. Melanin protects the skin from UV rays, reducing its ability to produce Vitamin D.   -  Getty Images

 

Vitamin D comes in two forms in the diet:

1. Vitamin D2, also called ergocalciferol, is found in some foods like mushrooms.

2. Vitamin D3, also known as cholecalciferol, is found in certain fish like salmon, mackerel and cod. Sunlight is actually the best way to get vitamin D3. UV rays from sunlight convert cholesterol inside your skin into vitamin D3.

Scientists have found that persons with higher Vitamin D levels (higher than 33 nanogram per millilitre) had a 50 percent lower risk of developing colorectal cancer. We prescribe higher than normal levels of proteins and carbohydrates for sportspersons, which puts their digestive systems under greater stress and strain. If they have low Vitamin D levels, these athletes are at greater risk of developing colorectal cancer.

Therefore, I am always looking to see that my athletes maintain healthy Vitamin D levels (the normal range is 30-100 ng/ml). In nutrition counselling, I always ask the athletes if they would like to be at the lower end of the normal range, i.e. 30 ng/ml, or around the middle, i.e. 70 ng/ml. If an athlete consumes 1,000 IU (international units) daily, then the vitamin D level should reach 33 ng/ml.

How can you know if you have Vitamin D deficiency? The first way is to do a blood test. A level of less than 10 ng/ml indicates an insufficiency; between 11 and 30 ng/ml is deficient; between 30 and 50 ng/ml is sufficient; while anything greater than 50 ng/ml is considered high.

Now, while most articles say the best source of Vitamin D is sunshine, I believe we are still not getting enough. We had one athlete take off his T-shirt and play for three hours in sunshine for three months, and we had another take a supplement.

At the end of the period, the shirtless athlete saw his Vitamin D level increase from 20 ng/ml to 29, while the athlete taking the supplement saw his rise from 21 to 48 ng/ml.

This, along with various research papers, convinced me that supplementation of Vitamin D is truly beneficial.

I suggest testing for Vitamin D levels once every four months. For athletes between the ages of 13 and 20 years, it should be once in six months, and once a year for those between six and 13 years.

One startling fact is that people with darker skin are more prone to Vitamin D deficiency. That’s because of the higher level of melanin, the pigment that gives the skin its colour. Melanin protects the skin from UV rays, reducing its ability to produce Vitamin D. That’s why people in the Indian subcontinent tend to have Vitamin D deficiency, and sunbathing doesn’t really help Asians develop higher levels. Evolution has led to people living closer to the equator building a resistance to sunshine through high melanin levels, but the downside is lower Vitamin D levels.

As a nutritionist, Vitamin D is the first vitamin whose levels I look to improve. A word of caution, though: high doses can affect the kidney and lead to the formation of stones and even kidney failure in severe cases. I advise serious caution regarding supplements. Meet your sports medicine doctor or sports nutritionist first.

The author is chief nutritionist at Qua Nutrition Clinics. For more information on improving your vitamin D levels and for references for this article, go to www.ryanfernando.in.