Perspective on assessment of vitamin D nutrition.
Although routine fortification of milk and a few other dairy products has been successful in preventing rickets in children, its impact on preventing vitamin D depletion in adults is less than satisfactory. The prevalence of vitamin D depletion in the elderly is on the rise again and appears to be more common than is currently appreciated. Several groups of individuals are at risk of developing vitamin D depletion, and a significant minority of otherwise healthy individuals is vitamin D insufficient. Unrecognized vitamin D depletion leads to secondary hyperparathyroidism, accelerates cortical bone loss, and increases the risk of hip fractures. With the availability of techniques to assess vitamin D nutrition, it is probably cost effective to routinely measure 25-hydroxyvitamin D levels in individuals at the greatest risk and in patients with various metabolic bone diseases to prevent vitamin D depletion. Early recognition and prompt treatment of vitamin D depletion improves functional well being of the individual, reduces morbidity related to bone loss and fractures, and is associated with a highly favorable cost/benefit ratio.
Rao
D S
DS
Division of Bone and Mineral Metabolism, Department of Medicine, Henry Ford Health System, Detroit, MI 48202, USA. danrao50@hotmail.com
D006801:Humans; D012307:Risk Factors; D014807:Vitamin D / Q000502:physiology; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control
D014807:Vitamin D