Interventions for Prevention and Control of Epidemic of Vitamin D Deficiency.

Abstract

Vitamin D deficiency (VDD) remains a significant health challenge globally with its overwhelming effects on skeletal growth and varied associations with extra-skeletal diseases. The last decade has reported a high prevalence of VDD in all age-groups across all zones of India. Children and adolescents are most vulnerable to ill-effects of VDD as peak linear growth and bone mass accrual occurs during these years. Vitamin D deficiency in mothers predisposes their infants to have low serum vitamin D levels. Indians have increased susceptibility to develop VDD due to predominant vegetarian dietary habits, high melanin skin content, atmospheric pollution, modest tradition of clothing and limited availability of fortified foods. Vitamin D supplementation during infancy and childhood has emerged as an effective strategy to combat VDD. However, effects of vitamin D supplementation are transient and are not cost-effective as a maintenance strategy. Fortification of foodstuffs has been adopted by many developed countries globally which has emerged as a safe, efficacious and cost-effective strategy to control VDD. A strong political will and support is required to sustain food fortification in India. The current review focuses on strategies to prevent and control the epidemic of VDD in children.