As this article states, a large proportion of the population is actually in need of additional Vitamin D supplementation in order to prevent deficiency.
One thing I don't agree with in this article is the advice to wear sunscreen, as sunscreens contain some toxic chemicals that shouldn't be put on your skin. There are other safer and less damaging ways to prevent sunburn. Wear a hat or cover up, and only stay in the sun for limited amounts of time at the beginning of the summer season in order to build up the melanin pigment in your skin slowly which will then help to prevent you burning so fast. Skin cancer is not caused by sun exposure alone, or else, by this reasoning, everyone who stays in the sun for a long time should have skin cancer. Rather, skin cancer is caused by a person exposing their skin to the sun when it is in a sub-optimal condition due to compromised nutrition, deficiencies etc, which then allows the cells to mutate as a result of the damage caused by the UV rays. The important way to prevent skin cancer is from the inside out, not the outside in. Maintaining optimum health is more important than putting on sunscreen and more effective.
I also don't agree with the need to drink Vitamin D fortified milk, as the form of Vitamin D supplemented in the milk is the synthetic Vitamin D2 form (ergocalciferol) which is the form of Vitamin D that has been shown to cause toxicity in high doses due to the synthetic form behaving slightly differently in the body than the natural form. I would only ever recommend Vitamin D in the natural form - cholecalciferol or Vitamin D3, which is obtainable from oily fish (in cod liver oil supplements) and as a Vitamin D3 supplement.
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Who may need extra vitamin D to prevent a deficiency?
It can be difficult to obtain enough vitamin D from natural food sources. For many people, consuming vitamin D fortified foods and adequate sunlight exposure are essential for maintaining a healthy vitamin D status. In some groups, dietary supplements may be needed to meet the daily need for vitamin D.
Infants who are exclusively breastfed
In infants, vitamin D requirements cannot be met by human (breast) milk alone [4,19], which usually provides approximately 25 IU vitamin D per liter [20]. Sunlight is a potential source of vitamin D for infants, but the American Academy of Pediatrics (AAP) advises that infants be kept out of direct sunlight and wear protective clothing and sunscreen when exposed to sunlight [21]. The American Academy of Pediatrics (AAP) recommends a daily supplement of 200 IU vitamin D for breastfed infants beginning within the first 2 months of life unless they are weaned to receive at least 500 ml (about 2 cups) per day of vitamin D-fortified formula [20]. Children and adolescents who are not routinely exposed to sunlight and do not consume at least 2, 8-fluid ounce servings of vitamin D-fortified milk per day are also at higher risk of vitamin D deficiency and may need a dietary supplement containing 200 IU vitamin D [20].
Formula fed infants usually consume recommended amounts of vitamin D because the 1980 Infant Formula Act requires that infant formulas be fortified with vitamin D. The minimal level of fortification required is 40 IU vitamin D per 100 calories of formula. The maximum level of vitamin D fortification allowed is 100 IU per 100 calories of formula [22]. This range of fortification produces a standard 20 calorie per ounce formula providing between 265 and 660 IU vitamin D per liter.
Older adults
Americans age 50 and older are believed to be at increased risk of developing vitamin D deficiency [14]. As people age, skin cannot synthesize vitamin D as efficiently and the kidney is less able to convert vitamin D to its active hormone form [4,23-26]. It is estimated that as many as 30% to 40% of older adults with hip fractures are vitamin D insufficient [13]. Therefore, older adults may benefit from supplemental vitamin D.
Persons with limited sun exposure
Homebound individuals, people living in northern latitudes such as in New England and Alaska, women who wear robes and head coverings for religious reasons, and individuals working in occupations that prevent sun exposure are unlikely to obtain much vitamin D from sunlight. It is important for people with limited sun exposure to consume recommended amounts of vitamin D in their diets or consider vitamin D supplementation [27-29].
Persons with greater skin melanin content
Melanin is the pigment that gives skin its color. Greater amounts of melanin result in darker skin. The high melanin content in darker skin reduces the skin's ability to produce vitamin D from sunlight. It is very important for African Americans and other populations with dark-pigmented skin to consume recommended amounts of vitamin D. Some studies suggest that older adults, especially women, in these groups are at even higher risk of vitamin D deficiency [16,30]. Individuals with darkly pigmented skin who are unable to get adequate sun exposure and/or consume recommended amounts of vitamin D may benefit from a vitamin D supplement.
Persons with fat malabsorption
As a fat soluble vitamin, vitamin D requires some dietary fat for absorption. Individuals who have a reduced ability to absorb dietary fat may require vitamin D supplements [31]. Symptoms of fat malabsorption include diarrhea and oily stools [31]. Fat malabsorption is associated with a variety of medical conditions [9]:
Pancreatic enzyme deficiencyis characterized by insufficient secretion of pancreatic enzymes. Pancreatic enzymes are essential for fat absorption, and a deficiency of these enzymes can result in fat malabsorption.
Crohn's Disease is an inflammatory bowel disease that affects the small intestines. People with Crohn's disease often experience diarrhea and fat malabsorption.
Cystic Fibrosis (CF) is a hereditary disorder that causes the body to secrete a thick, sticky mucus. This mucus clogs the pancreas and lungs. People with CF often experience fat malabsorption.
Sprue, often referred to as Celiac Disease (CD), is a genetic disorder. People with CD are intolerant to a protein called gluten. In CD, gluten can trigger damage to the small intestines, where most nutrient absorption occurs. People with CD often experience fat malabsorption. They need to follow a gluten free diet to avoid malabsorption and other symptoms of CD.
Liver disease includes a wide variety of disorders that impair liver function. Some people with liver disease experience fat malabsorption.
Surgical removal of part or all of the stomach or intestines can impair digestion and absorption of many nutrients. Fat malabsorption can occur after this type of surgery.
http://ods.od.nih.gov/factsheets/vitamind.asp
One thing I don't agree with in this article is the advice to wear sunscreen, as sunscreens contain some toxic chemicals that shouldn't be put on your skin. There are other safer and less damaging ways to prevent sunburn. Wear a hat or cover up, and only stay in the sun for limited amounts of time at the beginning of the summer season in order to build up the melanin pigment in your skin slowly which will then help to prevent you burning so fast. Skin cancer is not caused by sun exposure alone, or else, by this reasoning, everyone who stays in the sun for a long time should have skin cancer. Rather, skin cancer is caused by a person exposing their skin to the sun when it is in a sub-optimal condition due to compromised nutrition, deficiencies etc, which then allows the cells to mutate as a result of the damage caused by the UV rays. The important way to prevent skin cancer is from the inside out, not the outside in. Maintaining optimum health is more important than putting on sunscreen and more effective.
I also don't agree with the need to drink Vitamin D fortified milk, as the form of Vitamin D supplemented in the milk is the synthetic Vitamin D2 form (ergocalciferol) which is the form of Vitamin D that has been shown to cause toxicity in high doses due to the synthetic form behaving slightly differently in the body than the natural form. I would only ever recommend Vitamin D in the natural form - cholecalciferol or Vitamin D3, which is obtainable from oily fish (in cod liver oil supplements) and as a Vitamin D3 supplement.
------
Who may need extra vitamin D to prevent a deficiency?
It can be difficult to obtain enough vitamin D from natural food sources. For many people, consuming vitamin D fortified foods and adequate sunlight exposure are essential for maintaining a healthy vitamin D status. In some groups, dietary supplements may be needed to meet the daily need for vitamin D.
Infants who are exclusively breastfed
In infants, vitamin D requirements cannot be met by human (breast) milk alone [4,19], which usually provides approximately 25 IU vitamin D per liter [20]. Sunlight is a potential source of vitamin D for infants, but the American Academy of Pediatrics (AAP) advises that infants be kept out of direct sunlight and wear protective clothing and sunscreen when exposed to sunlight [21]. The American Academy of Pediatrics (AAP) recommends a daily supplement of 200 IU vitamin D for breastfed infants beginning within the first 2 months of life unless they are weaned to receive at least 500 ml (about 2 cups) per day of vitamin D-fortified formula [20]. Children and adolescents who are not routinely exposed to sunlight and do not consume at least 2, 8-fluid ounce servings of vitamin D-fortified milk per day are also at higher risk of vitamin D deficiency and may need a dietary supplement containing 200 IU vitamin D [20].
Formula fed infants usually consume recommended amounts of vitamin D because the 1980 Infant Formula Act requires that infant formulas be fortified with vitamin D. The minimal level of fortification required is 40 IU vitamin D per 100 calories of formula. The maximum level of vitamin D fortification allowed is 100 IU per 100 calories of formula [22]. This range of fortification produces a standard 20 calorie per ounce formula providing between 265 and 660 IU vitamin D per liter.
Older adults
Americans age 50 and older are believed to be at increased risk of developing vitamin D deficiency [14]. As people age, skin cannot synthesize vitamin D as efficiently and the kidney is less able to convert vitamin D to its active hormone form [4,23-26]. It is estimated that as many as 30% to 40% of older adults with hip fractures are vitamin D insufficient [13]. Therefore, older adults may benefit from supplemental vitamin D.
Persons with limited sun exposure
Homebound individuals, people living in northern latitudes such as in New England and Alaska, women who wear robes and head coverings for religious reasons, and individuals working in occupations that prevent sun exposure are unlikely to obtain much vitamin D from sunlight. It is important for people with limited sun exposure to consume recommended amounts of vitamin D in their diets or consider vitamin D supplementation [27-29].
Persons with greater skin melanin content
Melanin is the pigment that gives skin its color. Greater amounts of melanin result in darker skin. The high melanin content in darker skin reduces the skin's ability to produce vitamin D from sunlight. It is very important for African Americans and other populations with dark-pigmented skin to consume recommended amounts of vitamin D. Some studies suggest that older adults, especially women, in these groups are at even higher risk of vitamin D deficiency [16,30]. Individuals with darkly pigmented skin who are unable to get adequate sun exposure and/or consume recommended amounts of vitamin D may benefit from a vitamin D supplement.
Persons with fat malabsorption
As a fat soluble vitamin, vitamin D requires some dietary fat for absorption. Individuals who have a reduced ability to absorb dietary fat may require vitamin D supplements [31]. Symptoms of fat malabsorption include diarrhea and oily stools [31]. Fat malabsorption is associated with a variety of medical conditions [9]:
Pancreatic enzyme deficiencyis characterized by insufficient secretion of pancreatic enzymes. Pancreatic enzymes are essential for fat absorption, and a deficiency of these enzymes can result in fat malabsorption.
Crohn's Disease is an inflammatory bowel disease that affects the small intestines. People with Crohn's disease often experience diarrhea and fat malabsorption.
Cystic Fibrosis (CF) is a hereditary disorder that causes the body to secrete a thick, sticky mucus. This mucus clogs the pancreas and lungs. People with CF often experience fat malabsorption.
Sprue, often referred to as Celiac Disease (CD), is a genetic disorder. People with CD are intolerant to a protein called gluten. In CD, gluten can trigger damage to the small intestines, where most nutrient absorption occurs. People with CD often experience fat malabsorption. They need to follow a gluten free diet to avoid malabsorption and other symptoms of CD.
Liver disease includes a wide variety of disorders that impair liver function. Some people with liver disease experience fat malabsorption.
Surgical removal of part or all of the stomach or intestines can impair digestion and absorption of many nutrients. Fat malabsorption can occur after this type of surgery.
http://ods.od.nih.gov/factsheets/vitamind.asp
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