2. Rickets – Why Vitamin D was discovered?
At the end of the 19th Century
90% of dead children in industrialized cities
had clinical rickets.
A cure had to be found for this
cruel disease. This was done in 1925 when a
substance was isolated by McCollum from cod
liver oil and named Vitamin D.
4. Vitamin D - definition
The term vitamin D in this presentation designates a group of closely aligned
compounds, known as cholecalciferol (vitamin D3) and the first metabolite of D3,
25-hydroxycholecalciferol (25(OH)D3)
1 μg D3 = 40 international units (IU) of vitamin D
1 μg 25(OH)D3 = 200 international units (IU) of vitamin D
25-hydroxyvitamin D3 has up to 5 times the biological vitamin D equivalence in
human nutrition compared to D3
5. Function Vitamin D – all vertebrates
A major role of Vitamin D is to control calcium and phosphorus homeostasis in the
body of vertebrates. This control is exerted by;
• Vitamin D controls 85% of the transfer of calcium across the intestinal wall via the
calcium binding protein (CaBP).
• Vitamin D controls at least 40% of the active transfer of phosphorus across the
intestinal wall.
• Vitamin D controls re-absorption of calcium from bone
• Vitamin D controls re-absorption of calcium from the kidney.
• Vitamin D is involved in the immune system with most cells of the body having
vitamin D receptors (VDRs).
• Vitamin D helps control cell proliferation and differentiation (Cancer).
6. Definition of vitamin D status in human health
• Not deficient vitamin D = serum 25(OH)D3 greater than 50 nmol/L
• Mild deficiency vitamin D = serum 25(OH)D3 between 25 - 50 nmol/L
• Moderate deficiency vit D = serum 25(OH)D3 between 12.5-25 nmol/L
•
• Severe deficiency vit D = serum 25(OH)D3 less than 12.5 nmol/L
7. Vitamin D prevents bone disease
Classical role of vitamin D: bone health
• Improves bone mineral density through calcium absorption and deposition, necessary
to prevent rickets, osteomalacia and osteoporosis.
Healthy bone Osteoporotic bone
• Osteoporosis
A loss of bone mineralization caused in part by a Vitamin D
deficiency affects more than 200 million women worldwide.
8. Optimum vitamin D status may reduce the
risk of various health concerns
9. Vitamin D helps reduces Lung Cancer
• Lung Cancer is responsible for 19.4% of all cancer deaths. Lung cancer is increasing.
• The meta-analysis of 10 studies and 2227 lung cancer patients revealed a 5%
reduction in risk of lung cancer associated with each 10 nmol/L increase of or
vitamin D (25(OH)D) in the blood (Chen et al., 2015).
10. Scientific evidence supports vitamin D benefits
in different segments
Bone (14,605 publications)
Colon cancer (459 publications)
Immunity (1,001 publications)
Muscle (1,583 publications)
Multiple sclerosis (260 publications)
Blood pressure& CVD (2,721 publications)
Tuberculosis (493 publications)
Diabetes type I & II (1,287 publications)
Brain & cognition (1,123 publications)
~3,500 publications in 2011
11. Who in your community is at extra risk of
vitamin D insufficiency?
• Darker skinned people have reduced levels of Vitamin D
synthesis in their skin.
• Older people have a reduced ability to make Vitamin D in
their skin. They need more in their diet.
• Veiled people who are not exposed to sunlight.
• People who are obese.
• People who have liver or kidney disease.
12. Why do we need to increase intake of Vitamin D ?
Because there is a chronic deficiency of vitamin D in most countries of the world:
88% of the worlds population has suboptimal vitamin D levels
(<75 nmol/L)1,2
1. Bischo-Ferrari H.A. et al. Estimation of optimal serum concentrations of 25-
hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006 Jul;84(1):18-28
2. Zittermann A. et al. Vitamin D deficiency and mortality risk in the general population:
a meta-analysis of prospective cohort studies. Am J Clin Nutr. 2012 Jan;95(1):91-100.
doi: 10.3945/ajcn.111.014779. Epub 2011 Dec 14
13. Vitamin D status in India
• In India, several studies have demonstrated low serum levels of 25(OH)D3 (< 50
nmol/L) throughout the population (Arya 2004), (Vuppurturi 2006), ( Zargar
2007).
• One series of studies in northern India (27 ° N) has shown
- 96% of neonates (Sachen 2005),
- 91% of healthy school girls ( Puri 2008),
- 78% of healthy hospital staff (Arya 2004) and
- 84% of pregnant women (Sachen 2005) insufficient in vit D.
14. Vitamin D status in India
Vitamin D Status in India - Its Implications and Remedial Measures.
Harinarayan C.V. and S.R. Joshi JAPI vol 57 January 2009
18. Natural Good Sources of Vitamin D in Food
Extracted from U.S. Department of Agriculture, Agricultural Research Service. 2011.
USDA National Nutrient Database for Standard Reference
Food IU per serving
Cod liver oil, 1 tablespoon 1,360
Swordfish, cooked, 3 ounces ( approx 90 g) 566
Salmon (sockeye) cooked, 3 ounces (approx 90 g) 447
Tuna fish, canned in water, drained, 3 ounces (approx 90 g) 154
Sardines, canned in oil, drained, 2 sardines (approx 35g) 46
Egg, 1 large (vitamin D is in the yolk, (approx wt = 15 -18g) 41
Liver, beef, cooked 3 ounces (approx 90 g) 42
Cheese, Swiss, 1 ounce (30 g) 6
19. Research Project - Vitamin D in Eggs – PhD Thesis
A total of 162 ISA Brown laying hens of 58
weeks of age
9 treatment groups composed of 6 replicates
of 3 birds.
Fed for 9 weeks after which 30 eggs per
treatment analysed for both D3 and 25(OH)D3
content.
During the trial, eggs were collected at 0, 3 , 6
and 9 weeks to determine the rate of change
of vitamin D uptake by the hens.
24. USA Food & Nutrition Board recommended
Daily Vitamin D Allowance 2010
Age Daily Allowance
0 – 12 months 400 IU
1 – 70 years 600 IU
> 70 years 800 IU
25. Vitamin D in standard Eggs
One standard egg contains approximately
20 – 60 IU vitamin D
26. Vitamin D enriched Eggs
One 60g EGG could contain at least
250 IU vitamin D
27.
28. • Because they are
naturally rich in
vitamin D3 and
25(OH)D3.
• Eggs contain the
highest levels of 25-
(OH)D3 of any
animal food.
• 25-(OH)D3 has 5
times the vitamin D
potency of normal
vitamin D3 in human
nutrition
29. Eggs and cholesterol in the diet
Recent studies show eggs are safe to eat.
A major study was conducted by Hu et al., (1999) to examine the association between egg
consumption and risk of CHD and stroke in men and women.
A total of 37,851 men aged 40 to 75 years at study outset and 80,082 women
aged 39 to 59 years at study outset, free of cardiovascular disease, diabetes, high
cholesterol or cancer.
The finding was that the consumption of 1 egg per day is unlikely to have substantial
overall impact on the risk of coronary heart disease or stroke among healthy men and
women.
(Hu et al., JAMA. 1999; 281:1387-1394.)
30. Effect of cooking on the vitamin D content of eggs
Means in columns with no common superscript differ significantly
† Standard error mean. Each sample (n) is a blend of 10 egg yolks. Whole eggs were boiled for 10 mins in boiling water
31. Major Nutrients in 1 egg (weighing 60g)
Nutrient % r.d.a.*
Protein (g) 6.7 12
Energy (kcal) 78 11
Energy (kjoules) 324 11
Fat 6 n/a
PUFA (g) 1.17 12
MUFA (g) 2.46 20
Saturated fat 2 n/a PUFA=polyunsaturated fatty acids-
MUFA=mono-unsaturated fatty acids.
33. Albumen or Egg white – important fact
The protein in egg white or albumen is the best quality protein known to mankind. It has
a biological value (BV) of 100 and all other protein eaten by humans is inferior to egg
white.
34. CONCLUSION
• Vitamin D deficiency is a global issue affecting both developing and developed
countries.
• Specific groups like pregnant women, infants, elderly can be even more at risk.
• Especially, in Europe, India, S.E. Asia, Africa and Australia vitamin D deficiency is
widespread.
• Vitamin D deficiency and inadequacy has a detrimental health effect.
• By supplementing additional 25-OHD3 into a layer diet – vitamin D enriched eggs are
produced. Eggs enriched with vitamin D can help alleviate the chronic vitamin D
deficiency in the global human population.
35. Thank – you
for listening
Thank-you
DSM Nutritional Products
for sponsoring my talk here
in India today.