Sikhs are Especially Prone to Vitamin D Deficiency Issues

May 25th, 2009 by Dr. Soram Singh Khalsa, M.D.

Our faith in our Guru gives us so many riches and so much happiness. To make a riddle, in the face of all that the Guru gives us, what is it that most Sikhs do not have? The answer to this question is something that I see in my office all the time.  Almost none of us have enough vitamin D to keep us at optimal health!

I first learned about the importance of vitamin D over five years ago.  When I first measured my own blood level, I was shocked to see that I was extraordinarily low.  This was in spite of all the many vitamins that I take to stay healthy.  We get most of our vitamin D from exposure of our skin to the sun, and I realized that because I always wear full Bana, almost all of my skin is blocked from the sun.  In addition I put sunblock on my face in order to not get skin cancer.  Over the last five years I have normalized my own and many of my Sikh friends vitamin D levels by directly supplementing them.

My own health including my sense of well-being and the ability of my immune system to fight colds and flus has markedly improved.  My energy and vitality also are significantly better.  All of my Sikh friends, as well as all my patients have noticed big improvements in their health and well-being from taking the correct dose of vitamin D.

Vitamin D deficiency is now associated with 17 varieties of cancer, high blood pressure, coronary artery disease (heart disease), as well as  diabetes and most recently autism.  The benefits for these diseases occur only when the vitamin D level in the blood tests significantly over 30 ng/ml and preferably over 40 ng/mg.  Prior to the recent studies of the last 10 years it was believed that a vitamin D level around 20 ng/ml was sufficient.  

Indeed this level is ONLY sufficient to prevent rickets.  It will not benefit in preventing these other diseases whose relationship to vitamin D has been newly discovered in the last 10 years. To get benefit for protection against those diseases your level must be over 30 or preferably over 40 ng/ml.

Let me give you a specific example of the power of Vitamin D to protect us. In 2007, researchers Grant, Garland, and Gorham estimated that it would cost $1 billion each year to provide all adult Americans with 1,000 IU of vitamin D daily. They also estimated that in the United States, the daily provision of 1,000 IU of vitamin D would reduce cancer mortality for females by 9 percent and by 7 percent for males. The researchers estimated that this would reduce the country’s annual cost of cancer treatment by USD16 billion to USD 25 billion. And that is just treatment costs. We should also add the emotional and psychological costs to patients, family and friends.

To my brothers and sisters in India who are reading this article: Vitamin D deficiency is extremely widespread in cities in India because of poor sunshine exposure and also because of skin pigmentation.

Because India is approximately 70% rural, and because there is so much sun, it has long been assumed that vitamin D deficiency in rural India would not be a problem, given the sun exposure.

Now an article has appeared in October 2008 that evaluated 200 families’ in a rural community east of Delhi in February.  The highest level of vitamin D in all the subjects was 23 ng/ml.  The average vitamin D level was 14.5 which is rickets causing level!

In the people with five hours of daily sunshine exposure, only 31% had vitamin D levels over 20 ng per milliliter which is again rickets level.  Therefore 70% of people in this study in rural India had significant vitamin D deficiency.  I encourage all of our brothers and sisters in India to be sure to have their vitamin D blood level checked and to take enough vitamin D every day to keep their blood levels normal.

Another recent medical study has found that in spite of all the sunshine, over 88% of adolescent girls in a rural Indian community were deficient in vitamin D.  In addition 74% of the pregnant women in this same community had vitamin D deficiency.  If the mothers are low in vitamin D than certainly their fetuses will also be low in vitamin D.  In addition, nursing women with low vitamin D will not provide enough vitamin D to their newborns.  Low vitamin D levels in young children are now being associated with an increased incidence of the triple childhood epidemics of asthma, juvenile diabetes, and autism.

Because of my excitement about the power of this vitamin, in May 2008 I decided to write a book for the layman about vitamin D.  I am very happy to announce to the Sangat that this book is now released and available at Amazon.com and also on my website.  

Through modern technology I am now also able to offer everybody an at- home vitamin D test kit.  This way everyone can measure their own vitamin D level and then bring their levels up to normal or optimal.

In addition I have decided to create my own brand of vitamin D capsules so that I am able to provide guaranteed quality for everybody who wants to replace their vitamin D.  I have partnered with a company which normally only makes products for physicians’ offices.  We will also be able to make this pharmaceutical quality vitamin D available to the consumer at supermarket prices.

By way of simple suggestion, if you do not have a blood test, as an otherwise healthy adult, you can safely start on vitamin D 2000 IU per day and it will at least give you a moderate benefit of vitamin D protection.  Of course optimally you should get a blood test with your physician or through a home test kit and find out exactly what your level is so that you may bring it up exactly to an optimal level.

I encourage all my brothers and sisters in the Sikh faith to get their blood tested as soon as possible for vitamin D and to learn to optimize their levels.

To read and understand more about this important health issue. please visit my website www.vitaminDrevolution.com

Comments

WAHEGURU JI KA KHALSA

WAHEGURU JI KA KHALSA WAHEGURU JI KI FATEH i just have one question, how do people living in countries where they don't see the sun for 6 months manage.. it does'nt seem they are prone to any sort of cancer stuff?? regards, das singh

Reply

Singh13 the studies DO show that people in Northern Climates have higher incidences of almost all the diseases associated with Vitamin D. My book goes into great detail in the case of Juvenile Diabetes for example. Studies consistently show that these diseases are more common about the 35th parallel.

it gets even more complex!

With all due respect to the sentiment expressed by Manjit Singh, this is a perfect opportunity to be a bit of a pest and keep the discussion moving. (Vitamin D deficiency is a very significant issue, so I feel justified in doing so.) Dairy products (or other foods) which are fortified with vitamin D are TERRIBLE places to go to get your vitamin D. Foods and beverages are fortified with either vitamin D2 or D3, both of which are synthetic forms of the real vitamin and they are both vastly inferior to the real thing. D2 is toxic and has been linked to heart disease and D3 is very difficult for the body to absorb. The natural form of vitamin D (which is also D3, but it is not the same as the synthetic D3 used by the food industry) is best found in natural foods, such as butterfat, eggs, liver, organ meats, marine oils and seafood. Vegetarian Sikhs would do well to include lots of high quality butterfat (e.g. butter, whole milk, whole milk yogurt and lassi, cream, etc.) in their diets, preferably in its raw form (which rules out ghee) direct from farmers who graze their cows exclusively on grass (i.e. no grain feeding). As for spending time in the sun, that is absolutely vital but there is virtually zero chance that most people can get sufficient vitamin D by relying on this alone. It must be a part of the diet as well. Sat Nam, Jim Earles

Comment

Thanks Jim, your comments reflect the replies that I've given to this post. I agree with your comment that most people can not get sufficient vitamin D from the Sun alone. However there is a significant subset of our population in the United States that uses tanning booths year-round and they always have normal vitamin D levels. However, getting the right amount of sun but not too much is an art that is dependent upon at least 11 variables, as I discuss in my book. However most people in America can get enough vitamin D from the sun in the summertime by proper exposure without overexposure to the sun. Dr. Soram

Drink milk, eat yogurt and bask in the sun!

Since most Sikhs don't eat fish, meat etc., I say stick with fortified Vitamin D thru milk, yoghurt, lassi etc. and get some sun on your skin.

Vitamin D and food

Manjit Food is a TERRIBLE source of Vitamin D. It is easy to understand how you might think otherwise as Vitamin D and milk were associated in childhood. Milk contains NO vitamin D by itself. It is added on the request of the government by the milk producers. Milk if it has D at all has about 100 IU per 8 oz glass. So if you use milk to get your D you will need 20 glasses of milk PER DAY to get the recommended 2000IU per day I recommend. Take D as a Pill! Dr Soram

vitamin D is complex subject!

Vitamin D is a complex issue. One of the best places to learn the facts about it is at http://www.westonaprice.org/basicnutrition/vitamindmiracle.html. As you will see from the article, it is virtually impossible to get enough D from sunlight...although it is still very important to get plenty of exposure to sunshine. It is also very important to get the natural, biologically-active form of vitamin D, which is found in certain foods and in cod liver oil. Sat Nam, Jim Earles

Vitamin D and food part 2

Jim, As I mentioned in my note to Manjit , food is a very poor source of vitamin D. Fatty fish, like salmon is probably the richest source of vitamin D. It contains 360 IU per serving of salmon. However as Sikhs we do not eat any fish. This is part of the reason why in my practice I've not found even one Sikh that has a normal vitamin D reading on his or her first blood test. That is why I wrote this article for Sikhnet to alert my brothers and sisters to the need to take supplementary vitamin D. Dr. Soram

Vitamin D Deficiency

Dr. Soram Singh, Does this apply only to Sikh men? What about Sikh women, the average Sikh woman? In India, the sun is strong and shines for almost 9 months of the year. For the common person, it is hard to avoid the sun, hence the deep tans of most North Indians. Do genes play a part in the deficiency?

Vitamin D and Sikhs

Dear Ignorance is not bliss...
thank you for your questions. The vitamin D deficiency issue is definitely relevant to Sikh men as well as women. I certainly know in India that the sun is strong and shines for almost 9 months of the year, but the studies clearly show that in northwest India there is a huge vitamin D deficiency issue. The study did show that the deficiency issue is slightly less bad in men than women but it is still an issue.

I am copying the abstract of a recent article about Vitamin D in northern India. This does not say they studied Sikhs but it was northern India and it was not even in City Dwellers who will have lower Vitamin D levels.

I hope that helps. Dr Soram

J Assoc Physicians India. 2008 Oct;56:755-7. PMID: 19263699 [PubMed - in process] Presence of 25(OH) D deficiency in a rural North Indian village despite abundant sunshine.

Goswami R, Kochupillai N, Gupta N, Goswami D, Singh N, Dudha A. Department of Endocrinology, Maulana Azad Medical College, New Delhi. BACKGROUND AND OBJECTIVE: Several studies have shown wide prevalence of vitamin D deficiency with serum 25(OH)D <49.9 nmol/L in urban Indians related to their poor sunshine exposure and skin pigmentation. However, there is limited information in rural Indians. We hypothesized presence of higher 25(OH)D in rural subjects as compared to urban because of farming related abundant sunshine exposure. DESIGN AND METHODS: We assessed serum 25(OH)D levels in residents of a North Indian village with 200 families, located 90 km East of Delhi during February (winter). Fifty seven subjects (32 males and 25 females) from 50 families consented for the study. RESULTS: The mean 25(OH)D values of all subjects in the rural area was 36.4 +/- 22.5 nmol/l/L. Males had significantly higher 25(OH)D values than females. When compared to urban subjects, the mean 25(OH)D value of rural males and females was six and three folds higher, respectively. However even with five hours of daily sunshine exposure only 31.5% had serum 25(OH)D levels > or = 50 nmol/L. CONCLUSIONS: Thus, with longer sunshine exposure subjects residing in rural area had better mean 25(OH)D values than that of urbans. However, 70% of them were still vitamin D deficient. These facts indicate the need for the countrywide vitamin D food fortification program irrespective of rural or urban setting.

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