D Վիտամինի Անբավարարությունը Որպես Հանրային Առողջության Արդի Խնդիր

In recent years, a significant amount of scientific materials has been accumulated on the low intake and insufficient status of vitamin D among population in various countries. Optimal vitamin D intake and levels are important not only for bone health and calcium-phosphate metabolism, but also for overall health and well-being. Vitamin D deficiency and insufficiency as a global health problem are likely to increase the risk of a wide spectrum of acute and chronic illnesses. Vitamin D deficiency is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% of the population in Western, Southern and Eastern Europe and in up to 80% of the population in Middle East countries. Pregnant women are a special risk group for vitamin D deficiency. A global systematic review conducted in 2016 found that the prevalence of 25(OH)D <= 50 nmol/L in pregnant women by WHO region was Americas (64%), Europe (57%), Eastern Mediterranean (46%), South-East Asia (87%) and Western Pacific (83%). Vitamin D plays an important role in epigenetic modifications in the fetus and in the processes of fetal programming. Vitamin D deficiency during pregnancy has been associated with several adverse outcomes for the mother and developing foetus gestational diabetes, preeclampsia and preterm birth. In addition, vitamin D deficiency in pregnant women has been associated with a higher risk of low birth weight, which can have long-term health consequences for the infant. A large number of epidemiological studies demonstrate associations between vitamin D deficiency and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. The majority of the human body’s vitamin D requirement is met through biosynthesis of this vitamin in the skin upon exposure to sunlight, with less than 30% of the daily requirement of vitamin D is obtained from dietary sources. Dietary intake of vitamin D is irregular, as some foods contain very little of the vitamin. The main dietary sources of this vitamin are oily fish, eggs, liver, and butter. Vitamin D deficiency can result from decreased endogenous synthesis and low dietary intake. High BMI and obesity can be risk factors for vitamin D deficiency. Creams, clothing, dust, smog, hypokinesia, and age can be other contributing factors. Endocrine Society Clinical Practice Guideline suggests empiric vitamin D (“empiric supplementation” as vitamin D intake that exceeds the Dietary Reference Intakes and is implemented without testing for 25(OH) D) for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. Due to the scarcity of natural food sources rich in vitamin D, empiric supplementation can be achieved through a combination of fortified foods and supplements that contain vitamin D.