Special considerations for vitamin D in the south Asian population in the UK

Abstract

The human requirement for vitamin D is achieved primarily through the synthesis of this prehormone in the skin during exposure to ultraviolet B (UVB) radiation, with only a minor contribution from the diet, year round. Achieving optimal vitamin D status is therefore largely dependent upon adequate exposure of the skin to sunlight, however, the length of exposure required varies with latitude and season, and is also dependent upon skin pigmentation, with darker skin requiring greater exposure than fair skin due to the protective effects of melanin against UVB radiation. In northern European latitudes, where UVB radiation between the months of October and March is of insufficient intensity for the synthesis of vitamin D via this route, vitamin D deficiency is a public health concern, particularly for south Asian diaspora and other dark-skinned ethnic minority communities. The consequences of vitamin D deficiency include poor bone health, including rickets and osteomalacia. In addition, there is increasing awareness of an important role for vitamin D in the development and progression of chronic diseases, including type 2 diabetes, which is prevalent in south Asian populations. The aim of this review is to examine some of the most recent reports of vitamin D status in south Asian diaspora communities, and to explore its impact on bone health. In addition, we will examine the putative association between type 2 diabetes and vitamin D deficiency in south Asian populations and the current guidelines for treatment of vitamin D deficiency of south Asians in primary care settings.