Vitamin deficiency
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Understanding Vitamin Deficiency: A Global Health Challenge
Vitamin deficiencies are a significant public health issue worldwide, affecting various populations and leading to severe health consequences. This article explores the prevalence, causes, and impacts of deficiencies in vitamins A, D, and B12, highlighting the need for effective prevention and management strategies.
Vitamin A Deficiency: Prevalence and Mortality
Prevalence in Low-Income and Middle-Income Countries
Vitamin A deficiency is a critical health issue, particularly in low-income and middle-income countries. In 1991, 39% of children aged 6-59 months in these regions were vitamin A deficient. By 2013, this prevalence had decreased to 29% 1. Despite this decline, the deficiency remains alarmingly high in sub-Saharan Africa and South Asia, with prevalence rates of 48% and 44%, respectively 1.
Mortality and Health Impacts
Vitamin A deficiency significantly increases the risk of mortality from measles and diarrhea in children. In 2013, it was responsible for approximately 94,500 deaths from diarrhea and 11,200 deaths from measles among children under five years old in low-income and middle-income countries 1. These deaths accounted for 1.7% of all deaths in this age group, with over 95% occurring in sub-Saharan Africa and South Asia 1.
Vitamin D Deficiency: A Global Epidemic
Global and Regional Prevalence
Vitamin D deficiency is recognized as a global pandemic, affecting people of all ages. From 2000 to 2022, 15.7% of the global population had serum 25-hydroxyvitamin D levels below 30 nmol/L, while 47.9% had levels below 50 nmol/L 2. The prevalence is higher in high-latitude areas and during winter-spring seasons 2. Women are particularly vulnerable to vitamin D deficiency 2.
Health Consequences
Vitamin D deficiency leads to bone diseases such as rickets in children and osteomalacia in adults. It is also associated with an increased risk of common cancers, autoimmune diseases, hypertension, and infectious diseases 5. To maximize health benefits, a circulating level of 25-hydroxyvitamin D above 75 nmol/L is recommended 5.
Vitamin B12 Deficiency: Causes and Diagnosis
Causes and At-Risk Populations
Vitamin B12 deficiency, also known as cobalamin deficiency, affects cellular metabolism, DNA synthesis, and mitochondrial function. It is relatively common, particularly among the elderly, infants, children, adolescents, and women of reproductive age in populations with restricted intake of B12-containing foods 34. Causes include inadequate intake, malabsorption, and impaired cellular uptake or metabolism 3.
Diagnostic Challenges
Diagnosing vitamin B12 deficiency involves measuring serum levels of total B12, holo-transcobalamin, homocysteine, and methylmalonic acid. However, the exact cut-offs for clinical and subclinical deficiency remain debated 310. Low serum B12 levels do not always indicate deficiency, and severe functional deficiency can occur even with normal or high serum B12 levels 10.
Conclusion
Vitamin deficiencies in A, D, and B12 pose significant health risks globally, particularly in low-income and middle-income countries. Addressing these deficiencies requires a multifaceted approach, including improved dietary diversity, supplementation, and fortification. Public health initiatives must prioritize these strategies to reduce the global burden of vitamin deficiencies and improve health outcomes.
Sources and full results
Most relevant research papers on this topic
Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys.
Vitamin A deficiency remains prevalent in south Asia and sub-Saharan Africa, but its mortality burden has decreased worldwide, with nearly elimination in regions other than these two regions.
Meta-Analysis
Rigorous Journal
Highly CitedGlobal and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants
Vitamin D deficiency remains prevalent globally, with high rates in high latitude areas, Eastern Mediterranean, and Lower-middle-income countries.
Meta-AnalysisHighly CitedVitamin B12 deficiency
Vitamin B12 deficiency affects individuals of all ages, particularly the elderly, and is caused by inadequate intake, bioavailability, or malabsorption, with management relying on B12 supplementation.
Highly CitedVitamin B12 deficiency
Vitamin B12 deficiency can lead to serious clinical consequences, and diagnosis and management require careful consideration of individual factors and dietary habits.
Systematic Review
Very Rigorous JournalHighly CitedVitamin D deficiency: a worldwide problem with health consequences.
Vitamin D deficiency is a global issue, leading to rickets, osteopenia, osteoporosis, and fractures, and increasing the risk of common cancers, autoimmune diseases, hypertension, and infectious diseases.
Very Rigorous JournalHighly CitedEvaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.
Vitamin D deficiency is common and often undiagnosed, so supplementation is recommended for patients at risk for deficiency and should be based on age and clinical circumstances.
Very Rigorous JournalHighly CitedVitamin D insufficiency.
Vitamin D supplementation reduces the risk of fractures and falls in adults, with potential benefits for other health outcomes, but more controlled clinical trials are needed.
Systematic ReviewHighly CitedVitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing
Vitamin D deficiency is prevalent in both low- and high-income countries, and addressing it through dietary strategies, such as increasing food diversity, fortifying, and supplementing, can help lower the risk of deficiency.
Literature ReviewRigorous JournalHighly CitedPublic Health Aspects in the Prevention and Control of Vitamin Deficiencies
Vitamin deficiencies are prevalent in low- and middle-income countries, with higher risks in pregnant women, children, adolescents, the elderly, and those with undernourished status.
Literature ReviewVery Rigorous JournalHighly CitedBiomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency
Current biomarkers of vitamin B12 status have limited diagnostic value, and even high serum levels may not always indicate deficiency.
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