Journal of Alternative Complementary & Integrative Medicine Category: Medicine Type: Review Article
Improving Vitamin D Status in the Deficient Obese Population
- Guinevere Bennett1*
- 1 Department Of Occupational Therapy, Tennessee State University, 3500 John Merritt Boulevard, Nashville, TN 37209-1561, United States
*Corresponding Author:Guinevere Bennett
Department Of Occupational Therapy, Tennessee State University, 3500 John Merritt Boulevard, Nashville, TN 37209-1561, United States
Received Date: Mar 30, 2018 Accepted Date: Aug 21, 2018 Published Date: Sep 05, 2018
Normal serum levels of vitamin D are essential for bone health, immune, nervous and cardiovascular systems, and are suggested as a preventative measure for multiple forms of cancer. Vitamin D deficiency is extensive in the general population, with the obese population being especially susceptible. This review investigates literature for the association between vitamin D and obesity. A literature review found vitamin D deficiency was inversely related to obesity and BMI, and increasing serum 1,25D improved glucose handling and insulin resistance. The obese population is more deficient in vitamin D and has lower serum levels of 1,25D than the non-obese population. Possible causes include adiposity of vitamin D, volumetric dilution, decreased sun exposure and a diet lacking in foods rich in vitamin D. Solutions include correction of RDA of vitamin D for improved dosing recommendations, 15 minutes of sunlight without SPF, an increase in consumption of foods high in vitamin D, supplementation for obese and non-obese populations and education for the individual and family. Toxicity of high levels of vitamin D was found to be only relevant above 50,000 UI daily intakes and not of concern for the general population. Public health policy change and improvements in Vitamin D status in obese populations will improve health status for a significant portion of the population.
In the United States obesity is at epidemic levels, 1 in 3 adults are obese and 1 in 6 children are obese. According to Healthy People 2020, the goal by the year 2020 is to reduce the number of obese adults to 30.5% (a 10% reduction) and children age 2-19 to 14.5% (a 10% reduction) . Obesity has many factors, one of which is insulin resistance. Merriam-Webster defines insulin resistance as “reduced sensitivity to insulin by the body’s insulin-dependent processes (as glucose uptake, lipolysis and inhibition of glucose production by the liver) that results in decreased activity of these processes or an increase in insulin production” . Incomplete or delayed sugar metabolism leads to various disease processes, including metabolic syndrome, hyperglycemia and diabetes mellitus. Insulin resistance is a key factor in the obese populations’ ability to lose weight and limit or resolve disease processes associated with sugar metabolism.
Sufficient serum vitamin D levels are 50-75 nmol/l and Recommended Daily Allowance (RDA) is 600 IU/day, with the recommended dosage for insufficiency and deficiency ranges from 1000-50,000 UI for up to 3 months . Research has suggested optimal serum vitamin D levels have a positive impact on insulin resistance in the obese population . Recent studies found the optimal level of vitamin D is significantly higher than was originally reported, well beyond 2000-4000 UI for non-deficient populations and current RDA is not meeting requirements for bone health and disease prevention [8,9]. Additionally the Endocrine Society recommends 2-3 times more vitamin D for obese populations . Susceptible populations may require individualized dose recommendations to achieve optimal serum vitamin D levels . In this review vitamin D deficiency in obese populations, current and recommended RDA guidelines and current solutions to the population deficiency will be discussed.
RESULTS AND DISCUSSION
Correct RDA vitamin D
Increase vitamin D in dietary sources
Improve insulin resistance in obese population
Minutes a day of sunshine and no SPF
Vitamin D supplementation
Alternatively, severe deficiencies may require intramuscular injections of 100,000 IU weekly .
Toxicity is rare at 10,000 IU/day and recommendations in males have been found safe and higher levels are safe as long as serum 1,25D does not exceed 200 ng/mL . The range of toxic levels varies in studies from 20,000 - 50,000 IU but is generally not seen unless serum levels reach 500 nmol/L [6,10].
In conclusion, the deficiency of vitamin D in the obese population is worse than the non-obese populations. Solutions of RDA update, dietary changes, supplementation, increased sun exposure and education are possible solutions to improve vitamin D serum status. Improvement of serum vitamin D will result in decreased BMI and improved insulin resistance which both have positive impacts in reducing obesity. These steps will improve health outcomes of the obese population and decrease prevalent disease processes.
DECLARATIONS OF INTEREST
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Citation:Bennett G (2018) Improving Vitamin D Status in the Deficient Obese Population. J Altern Complement Integr Med 4: 052.
Copyright: © 2018 Guinevere Bennett, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.