Vitamin D
I have presented in the past some articles on the importance and role of Vitamin D in our health. To emphasize the role of this vitamin D, i will share with you the lecture of Dr Masanobu Kawai of Japan during the 17th Asia Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APSPGHAN) held in Taipei Taiwan last October 16, 2026.
The speaker stated the reasons Vitamin D matters and these are:
1. Mineral balance
– maintains calcium-phosphate homeostasis through intestinal absorption, renal handling and bone mineralization
2. Skeletal strength
– protects against rickets, osteomalacia, bone pain and impaired peak bone mass acquistion
3. Extra skeletal function
– low levels of 25(OH)D is linked with immune, respiratory, inflammatory and cardio metabolic outcomes.
Dr. Kawai reviewed us on the biogenesis of Vitamin D3 in our skin. The provitamin D3 (7-dehydrocholesterol) through exposure to UVB at 280-315nm and through this the C9-C10 bond is broken thus the beta ring opens is transformed into previtaminD3. And through thermal isomerization, this previtamin D3 is transformed into vitamin D3 ( cholecalciferol).
The different factors that reduce vitamin D3 production include:
1. High latitudes
2. Winter
3. Darker skin pigmentation
4. Skin covering lifestyle/ clothing and
5. Excessive UV protection
Dr. Kawai said that in the Asia- Pacific regions the prevalence of Vitamin D deficiency varies but is very high.
The burden persists even where sunlight is abundant and that the risk of deficiency concentrates in infants, adolescents and children with chronic diseases.
It is important to know that babies are born with vitamin D deficiency. It is for this reason that we pediatricians are giving our newborns vitamin D supplementation. The prevention dose recommended for Vit D is 400 IU/day for the 0-12 Months old and 600 IU/ day for children and adolescents > 1 year old.
Screening for Vitamin D Deficiency (VDD) is not recommended in the general population due to its cost- effectiveness concerns, however, targeted screening should be conducted in individuals at high- risks like :
- children with signs of rickets or hypocalcemia
- chronic conditions affecting vitamin D metabolism or absorption
- exclusively breastfeed infants without vit D supplementation
- and in children with limited sun exposure or inadequate dietary intake.
The speaker, Dr. Masanobu Kawai ended his lecture by stating the four policy levels for prevention of Vitamin D deficiency and these are:
1. Education
2. Public awareness
3. Food fortification
4. Lifestyle and environment.
Since Vitamin D deficiency (VDD) is common among Asian Pacific children despite abundant sunlight, we should give importance to these 4 levels being mentioned above.