William Tsiaras, Martin A. Weinstock
The steroid hormone vitamin D is required for normal calcium and phosphorus metabolism and is thus an important contributor to musculoskeletal health. Recent data have linked low vitamin D levels to a wide range of diseases, including cancer, cardiovascular disease, autoimmune disease and infection. Adequate levels of vitamin D are maintained through its cutaneous photosynthesis and oral ingestion. By some estimates, one billion people worldwide have vitamin D deficiency or insufficiency.
A number of factors influence the photosynthesis and bioavailability of vitamin D and contribute to risk of impaired vitamin D status. These factors include
- variation in sun exposure due to
- time of day,
- atmospheric components,
- sunscreen use and
- skin pigmentation, as well as
- obesity and the
- incidence of several chronic illnesses.
This review will focus on factors that influence vitamin D status and contribute to the prevalence of low vitamin D levels.
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