Addressing vitamin D deficiency in Canada: A public health innovation whose time has come

• Published in: Public health (London) Vol. 124; no. 6; pp. 350 - 359
• Main Authors: Schwalfenberg, G.K, Genuis, S.J, Hiltz, M.N
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2010
• Subjects: Canada; Canada - epidemiology; Epidemiology; Humans; Infectious Disease; Internal Medicine; Morbidity-Mortality; Mortality; Nutrition; Public health; Risk assessment; Risk Factors; Sunshine; Vitamin D; Vitamin D - immunology; Vitamin D - physiology; Vitamin D - therapeutic use; Vitamin D deficiency; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - ethnology; Vitamin D Deficiency - therapy; Vitamin D insufficiency; Vitamins; Canada; Canada; Vitamin D; Nutrition; Sunshine; Vitamin D insufficiency; Epidemiology; Public health
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2010.03.003

Summary There is disturbing evidence of widespread vitamin D deficiency in many population groups, particularly within nations at high latitude. Numerous recent studies in the scientific literature associate vitamin D deficiency with a colossal increase in morbidity and mortality. Since Canada is at higher latitude, this review assesses the vitamin D status within the Canadian population. This review was prepared by assessing available medical and scientific literature from Medline, as well as by reviewing several books and conference proceedings. A standard 25(OH)D level of 75–80 nmol/l or more was used to indicate vitamin D sufficiency. Between 70% and 97% of Canadians demonstrate vitamin D insufficiency. Furthermore, studies assessing 25(OH)D levels of vitamin D at 25–40 nmol/l reveal that many Canadians have profoundly deficient levels. Repletion of vitamin D3 with 2000 IU/day for those not receiving judicious sun exposure and those with no contra-indications would likely achieve normalized levels in more than 93% of patients, without risk of toxicity. Explicit directives regarding vitamin D assessment and management are urgently required.