Vitamin D deficiency in Bangladesh: A review of prevalence, causes and recommendations for mitigation.

Vitamin D is essential for the maintenance of calcium homeostasis and bone mineralization. Overt deficiency of vitamin D causes rickets in children and osteomalacia in adults. Vitamin D deficiency is an important public health problem worldwide. This review examines the available published data from all peer-reviewed original research articles of community and hospital-based research carried out on vitamin D status in different population groups in Bangladesh. Baseline data of intervention trials are also included. The available selected articles were in English and retrieved from 2002 to January 2022. The paper concentrates on underlying factors for increased prevalence of vitamin D deficiency in Bangladesh. Studies uniformly report very high prevalences of hypovitaminosis D among different population groups. Age and sex-specific comparisons indicate that prevalence is higher for the elderly and women. Hypovitaminosis D ranged from 21 to 75 % for infants, children, and adolescents, 38 to 100 percent for premenopausal women, 66 to 94.2 % for pregnant women, 6 to 91.3 % for adult men and 82 to 95.8 % for postmenopausal women. Important underlying factors related to this silent epidemic include dark skin colour, homebound and sedentariness, insufficient sunlight exposure, atmospheric pollution, clothing style, obesity, use of sunscreen and no supplementation. A comprehensive strategy to alleviate and control the health consequences of vitamin D deficiency is needed. This would include the creation of public awareness, refrain in sunscreen usage, exposure to sunlight, regular exercise, food fortification, and supplementation with vitamin D (bearing in mind potential differences between them and food-based sources).

A History of Cow's Milk Allergy Is Associated with Lower Vitamin D Status in Schoolchildren.

BACKGROUND/AIMS: Vitamin D insufficiency is common in children. We aimed to evaluate the main determinants of vitamin D status in Finnish school-aged children, including the history of allergic diseases. METHODS: We conducted a cross-sectional study on 171 ten-year-olds where serum 25-hydroxyvitamin D (25[OH]D) levels were measured, and data on food consumption and use of vitamin D supplements were collected. The history of allergic diseases was evaluated with a validated questionnaire. RESULTS: Vitamin D insufficiency (<50 nmol/L) was observed in 16% of the children. In children with a history of cow's milk allergy, the mean 25(OH)D levels were lower than in children without allergy (60.5 ± 12.6 nmol/L vs. 75.5 ± 22.3 nmol/L, p = 0.004). Lack of vitamin D supplementation, female gender, non-Caucasian ethnicity, and a history of milk allergy were associated with lower vitamin D status. CONCLUSION: The vitamin D status in our study sample of Finnish schoolchildren was sufficient, which suggests that health policy strategies - such as the recommendation of vitamin D supplementation and the fortification of food products with vitamin D - have been successful in improving vitamin D status in children. Special concern should be given to children with a history of milk allergy to ensure their vitamin D sufficiency.

Dairy products, meat and sports performance.

Creatine supplementation improves repetitive, short-term performance. It has not been shown that exclusion of meat from the diet would impair repetitive short-term performance. In contrast, reduction of protein intake and a concomitant increase of carbohydrate intake during a period of 3-5 days improves anaerobic (2-7 minutes) performance. The protein intake in a mixed or lacto-vegetarian diet is adequate even for elite athletes, providing that energy requirements are met. Many dietary supplements have been suggested to increase muscle mass and/or to decrease fat mass. Although the effects of conjugated linoleic acid on body composition in athletes are not clear, some positive findings in untrained, obese individuals call for more studies. Strenuous training may impair immune function and increase the susceptibility to infections. Exclusion of meat from the diet does not seem to have adverse effects on immune function. Glutamine supplementation (>3-6 g/day) may improve immune function, but more studies are needed. Similarly, more studies on the possible effects of whey protein and probiotic supplementation on immune function and performance in physically highly active individuals are warranted. Vitamin and mineral balance are not usually a problem among athletes. Notable exceptions may be calcium and iron in some females. Increased calcium intake in athletes with hormonal and menstrual disturbances could theoretically help in maintaining bone status; however, no data are available. A diet with meat may help in maintaining adequate iron stores.