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SUNDAY, 19 MAY 2013
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Deficiencies in vitamin D worryingly high among Lebanese population
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BEIRUT: We’ve all been told that too much sun is bad for your health, but medical researchers are discovering that soaking up some golden rays might be just what the doctor ordered – to get a good dose of vitamin D.

Hala Darwiche was diagnosed with vitamin D deficiency around 10 years ago, after going to the doctor to find out why her knees hurt when she climbed the stairs. She at first attributed it to the long and cold Michigan winter where she was doing her PhD. The cold kept her indoors for a long stretch of time.

Upon her return home to Lebanon, she expected the sunnier climate to help her situation. Instead, her demanding work schedule continued to keep her indoors, depriving her of the vital UV rays needed to absorb the vitamin – essential for maintaining healthy bones and muscles, as well as to prevent rickets disease in children and osteoporosis in the elderly. Some studies have also linked vitamin D deficiency to depression, Type 1 Diabetes and memory loss.

As managing director at the Abu Haider Neuroscience Institute and Multiple Sclerosis Center at the American University of Beirut, Darwiche began embarking on a study of vitamin D levels in the Lebanese population. To her surprise, in her sample of 250 men and women of different ages, 70 percent were short of the healthy level of vitamin D, leading Darwiche to initiate more research to determine the cause of this phenomenon.

“It’s a difficult question, but we have some speculation. Our lifestyles have changed. People are spending more time indoors, and when the go to the beach they use sunscreen. They need to prevent cancer, but they’re not getting vitamin D from UV rays,” she says, sitting at her desk in the basement of an AUB medical building, where she spends most of the day. She now takes weekly supplements to get her adequate dosage, although she emphasizes that absorbing it naturally through regular sun exposure is the best source.

“It’s possible that wearing the veil affects people’s vitamin D absorption, but young men have also tested low in vitamin D."

“By anyone’s definition, there are large deficiencies in the Middle East including Lebanon, which surprised the world because it is close to the equator where vitamin D synthesis in the skin was assumed to be adequate,” says Connie Weaver, head of the Nutrition Science Department at Purdue University in Indiana, who visited AUB in December as part of the International Breast Cancer and Nutrition project.

In addition to research on the classical effects of vitamin D deficiency and its cognitive impact, there are currently two studies under way to determine if there is a genetic component.

The required intake of vitamin D varies, but those with a darker complexion require more of the vitamin. Tanning can also affect how much vitamin D one needs to absorb: As your skin darkens, you require more and more of the vitamin, sometimes causing a vicious cycle.

For many people, taking supplements is the best option.

Researchers in the U.S. estimate that 50 percent of the world’s population has some sort of vitamin D deficiency, with some experts dubbing the problem a pandemic. Meanwhile, those in Lebanon have found a 70 percent deficiency in their sample studies, surprising for a country with more than 300 days of sunshine a year.

“Research is still trying to pin down why it’s so important, but we have some pretty good clues to date,” says Brant Cebulla, development director at the Vitamin D Council based in California, an organization founded to research and educate the public about the importance of vitamin D.

“Bare minimum, you need vitamin D for bone health. After that, research is starting to show that it’s important for the immune system and preventing internal cancers, heart disease and a laundry list of other illnesses.”

He adds, “It’s pretty simple why this is a big problem. Humans live indoor lifestyles more so than ever before. We don’t get nearly enough full body sun exposure.”

Although vitamin D deficiency is a worrying phenomenon, the good news for those who lack it is that their situation can be reversed within approximately 10 weeks of regular unfiltered sunshine (not through glass or sunscreen), just 15 minutes per day.

The vitamin is also found in egg yolks, fatty fish such as salmon and sardines, cheese and milk. However, vast quantities of these foods would need to be consumed to get the required daily intake.

The sun is still the best option, and experts suggest that those worried about protecting themselves from skin cancer should spend just 15 minutes in the sun before applying sunscreen. If they can’t afford any exposure to the sun they should take oral supplements.

Cebulla says vitamin D deficiency first became a serious problem in the early 1980s, when people were making recommendations with only skin cancer in mind.

“They forgot that you need sun exposure to produce vitamin D. Plus, they didn’t know much about vitamin D back then,” he said.

“As research continues to pour out on the importance of vitamin D, I think the message will change, and that moderate and frequent sun exposure will be recommended for good health.”

Indeed, many people appear to be getting the message. A 2010 report by the Washington-based Institute of Medicine tripled the recommended vitamin D intake from 200 to 600 international units in 1997. Overall sales of vitamin D supplements reached around $425 million in 2009, 10 times what was spent in 2001, according to the Nutrition Business Journal.

Cebulla says, “It’s about a balance moving forward. Avoiding burning, but get a little full body sun exposure.”

 
A version of this article appeared in the print edition of The Daily Star on June 15, 2012, on page 2.
This article was amended on Friday, June 15 2012

The correct sample size of the AUB study on vitamin D deficiency was 250.

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