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Vitam in D: The Forgotten Hormone by Ihor M agun, M .D., F.A .C.P. Vitamin D is a hormone, a substance formed by one organ and conveyed or carried (for example, through the blood stream) to another organ, which is then stimulated to function by chemical activity. Vitamin D is exactly this. It is a fat soluble vitamin that is found not only in food but can also be made by the body after exposure to ultraviolet rays from the sun. The most active form of vitamin D is synthesized during a series of chemical reactions in the liver and kidney. It is transported through the blood to target tissues of the body where it regulates calcium and phosphorus balance. It also exerts biologic effects that control mineral metabolism. Its most dramatic effect is that is facilitates intestinal absorption of calcium, help ing to keep bones strong. Most of us know that the sun provides us with vitamin D. At the same time, most of us have become health conscious about too much exposure to sun, and we either avoid sunlight or use sun screen wisely. These precautions, in turn, decrease the amount of vitamin D that we get from the sun and places many of us at risk for vitamin D deficiency. And this somewhat ironic twist comes at a time when the National Osteoporosis Foundation (NOF) has just advocated an increase to 800-1000 IU of vitamin D per day for adults 50 years and older. Maintaining adequate levels of vitamin D is obviously important. Vitamin D deficiency in child ren can lead to rickets (not common in the United States); vitamin D deficiency in adults leads to a condition referred to as osteomalacia, an impaired mineralization of newly synthesized bone. Vitamin D deficiency occurs most often in postmenopausal women. In fact, nearly 70% of women between the ages of 50 and 70 and almost 90% of women older than 70 are not getting enough vitamin D. Low levels of vitamin D are associated with bone loss, reduced calcium absorption, and increased risk of fracture. Sunscreens with an SPF of 8 or above effectively block vitamin D, and in an aging popu lation concerned with bone health, the ability to make vitamin D through the skin is diminished. To counter this effect, we need other sources o f sup plemental vitamin D. Fortified foods are a major dietary source of vitamin D. Milk is a prime example, but milk products are not fortified enough to compensate for diminished exposure to sunlight. In fact, you must drink four 8-oz glasses of milk to get 400 IU of vitamin D. Only a few foods contain significant amounts of vitamin D; these include fish oils and fatty fish such as salmon, but even people who like fish are not likely to eat fish every day. Because we know the dangers of excessive exposure to sun, and because most people cannot consume milk products and fish in the amounts that satisfy the recommended daily intake of vitamin D, the best approach is eating healthy foods fortified with vitamin D and taking vitamin D supplements in tablet form. Fortunately, all multivitamins contain vitamin D so this is an easy guideline to follow. As always, read labels carefully and “supplement the supplement” with moderate exercise. This combina tion of healthy diet, vitamin D supplements, and exercise can help strengthen your bones and pro mote an active, fracture-free life. The UNWLA gratefully acknowledges Rose Worobel for her generous donation o f $50 to Our Life Press Fund in memory o f Nellie Federkowicz (Branch 106). Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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