Vitamin D is endogenously synthesized in human beings from photo conversion of 7-dehydrocholestrol in the skin to cholecalciferol on exposure to ultraviolet radiation of sun. In a tropical country like India, where sunlight exposure is abundant, vitamin D deficiency seems unlikely. However, as opposed to this, various studies have highlighted that 70-100% Indians in different age groups vitamin D insufficient or deficient .

The probable reasons of the wide spread vitamin D deficiency in Indians could be because of low dietary vitamin D intake, high fiber and phytate intake that depletes vitamin D levels , reduced exposure to sunlight, pollution or reduced exposure of skin to sun light because of cultural and traditional habits like “burkha” or “parda”. However, what is really alarming is that despite the wide spread vitamin D deficiency, Indian Council of Medical Research (ICMR) has not given specific recommendations for daily vitamin D consumption except in specific medical conditions where it recommends a daily supplement of 400 IU. For normal healthy children and adults, ICMR only recommends outdoor activities in sun as a means to acquire adequate vitamin D levels which really doesn’t seem to be sufficient in the current Indian scenario to achieve optimum levels of vitamin D given the wide spread prevalence of deficiency in India.

To elevate the prevalence of vitamin D deficiency in India, it’s very important that public and the private health sector work very closely with each other.

• Daily recommendations for Vitamin D levels
• Educational programs need to be planned to increase public awareness regarding vitamin D deficiency, causes, long term consequences and treatment
• Vitamin D supplementation should be made available at affordable rates that are easy to consume and widely available to the general public.
• Prophylaxis programme could be planned for vitamin D supplementation especially for vulnerable groups such as infants, toddlers, pregnant and lactating women and elderly
• Public health policies should be devised for fortification of foods such as oil, milk, infant cereals, breakfast cereals with vitamin D
• Daily physical activity of half an hour in sun should be made compulsory part of school curriculum in India

It is thus very evident that vitamin D deficiency is wide spread and prevalent in all age groups in India. The prevalence in most studies is alarmingly very high. Long term vitamin D deficiency has severe consequences. Food fortification, educational programs and public health policies soon need to be formulated to reduce the prevalence of vitamin D deficiency in India.

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