Question:

Is vitamin D deficiency a public health problem in Australia? What action is currently being taken in Australia to address Vitamin D deficiency at a population level?What strategies are recommended for future focus to reduce the burden from Vitamin D deficiency in Australia?

Answer:

Q1- Is vitamin D deficiency a public health problem in Australia? 

Vitamin D deficiency can be considered as a public health problem in Australia, particularly in recent times. Approximately one third of the adult population of Australia adults are discovered to be affected by vitamin D deficiency, as per a study that took into consideration above 11,000 adult citizens from various parts of the nation. This was then regarded as being the foremost national study to assess the vitamin D levels of Australian residents. The sections that were at the highest risk of such a deficiency included women, the aged, the overweight, people who are involved in fewer than 2.5 hours of bodily activity on a weekly basis, and individuals who belong to a non- European lineage. One of the primary reasons for this recent pandemic has been the stress on avoiding being in the sun for too long for fear of developing serious health problems such as cancers. It is for this reason that people, over the years, have been advised to work indoors or to shield their skin from the sun when working outdoors in the sunlight.(1)

The outcomes indicated vitamin D deficiency as being a significant public health concern for the nation of Australia that needs prompt consideration. Vitamin D deficiency is soon becoming a significant health problem all over the world as well. It is evident from the outcomes of the research carried out that, even though there is no dearth of vitamin D enriched sunlight, the residents of Australian are far from being immune to such a deficiency.(2)

Reduced amounts of vitamin D can give rise to a range of grave, possibly life-threatening, ailments including softened bones; ailments that give rise to progressive muscle weakness causing a heightened threat of falling, osteoporosis, cardiovascular sickness, and various kinds of cancer as well as type 2 diabetes. A condition such as Rickets could be tracked down to approximately the 1600s, during which a pandemic broke out among children all over the world due to Vitamin D deficiency.

The insufficient absorption of UV rays eventually causes children to develop a range of health conditions like growth impedance, muscle feebleness, skeletal malformations, hypocalcaemia, and a range of other disorders. In the later part of the 19th century, autopsies that were carried out in the region of the Netherlands reached the conclusion that 80-90 per cent of infants were victims of Rickets. The cases of people suffering from rickets noted in the case of Sydney hospitals between the 2003 and 2004 have risen to practically double. This considerable increase could be accredited to the rising number of migrants in the nation of Australia, a number of whom can be assessed as being at a greater risk of the deficiency of vitamin D as compared to others.(3)(4)

Due to the increase in the occurrence of the deficiency of vitamin D, afflictions like osteoporosis in Australia's elderly residents has become the cause of numerous Australians above sixty years of age being affected by such a rapidly spreading condition in the case of aged residents. Osteoporosis is primarily a condition of excessively fragile and delicate bones, due to which major fractures can take place with a minor bump or tumble. An organisation named Osteoporosis Australia has projected that one half of all the women, along with one third of the total number of men all men above the age of sixty years will bear the destructive consequences of osteoporosis.(3)

Osteoporosis is also considered to be a silent ailment, as in a majority of cases, the sufferers are unaware that they are afflicted with it till the time they suffer a fracture to any of their bones due to a fall. The country’s vitamin D deficit amounts in current times has been steadily increasing, primarily because of factors like the long term accomplishment of government initiatives such as like Cancer Council Australia which have boosted the overall population’s consciousness of the threats and dangers linked with prolonged exposure to the sun, along with a range of skin cancers.(4) In the year 1988, the 'sun smart' initiative was launched, which considerably affected the population’s attitude and actions concerning exposure to the sun. The accomplishment of this initiative minimised the sunburn proportion by 50 per cent, which is also what researchers feel has given rise to an increase in the number of vitamin D deficiencies all over the nation of Australia.(5)

Along with the lessening of sun exposure in the case of Australia people, there has also been a reduction in terms of dietary intake. This is primarily due to the fact that a huge majority of residents have stopped consuming fatty fish oil, in the form of tablets, as a means of stabilising the amount of vitamin D in the body.(5)

Q2- What action is currently being taken in Australia to address Vitamin D deficiency at a population level?

Given the fact that vitamin D deficiency is continually on the rise in Australia, it is vital that the government and other health authorities take the necessary steps to ensure that this pandemic is brought under control. The drastic rise of vitamin D deficiencies in Australia has alarmed the government, which is why a compulsory fortification of the necessary vitamins and minerals. Primarily due to the rise in cases of vitamin D deficiency all over the nation of Australia, the federal government has initiated a range of such fortification of the necessary vitamins as well as minerals (including vitamin D). This has been done in the case of a range of food items such as eatable oil spreads as mentioned in the Australian Standard. Additionally, it has also been considered necessary for every food production unit manufacturing table spreads like butter and margarine must have nothing less than 55 mg of vitamin D per kilogram, as a reaction to a rising public health necessities.(5)(6)

In reply to current advances, a range of public strategies are being looked into once again so as to make sure that vitamin D is unmistakably being assessed. Due to the deficiency of this vitamin resurfacing, the reference value rules for each nutrient were recognised, which then resulted in the creation of the prescribed dietary vitamin D references. These dietary vitamin D strategies are taking into consideration restricted exposure to UVB sun rays, which is 5 µg/day for babies and young children, the same for adults till the age of fifty years, 10 µg/day for adults older than fifty years of age, and 15 µg/day for adults older than seventy years of age.(7)

As far as treatment is concerned, the everyday necessities of this vitamin are roughly an approximate 800-100IU so as to ensure health. In a majority of cases, this cannot be obtained from sun exposure. Additionally, a greater amounts is necessary for those individuals who have already been identified as being deficient. In the case of average deficiencies, supplements can be taken orally along with the diet at amounts of 3000 to 5000 IU on a daily basis for anywhere between six to twelve weeks, after which an extended minimised amounts of 1000 to 2000 IU on a daily basis so as to stabilise reserves in the human body.(7)(8)

In cases of extreme deficiencies, the government has come forth with treatment procedures that involve ‘megadoses’ in which a patient is given doses approximately 100 000 IU in strength so as to help in boosting stores at a rapid rate. This helps in ensuring that physical wellbeing in re-established to avoid additional illnesses or ailments.(8)