scholarly journals Feasibility of Phototherapy as a Community-Based Solution for Vitamin D Deficiency

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 240-240
Author(s):  
Mary McCarthy ◽  
Evelyn Elshaw ◽  
Barbara Szekely ◽  
Tom Beltran

Abstract Objectives 1. Determine acceptability and feasibility of a phototherapy kiosk designed as a self-care intervention for low vitamin D; 2. Demonstrate that narrow spectrum ultraviolet (UV) B delivered by the kiosk is equivalent to recommended daily D3 supplementation to raise or maintain serum 25-hydroxyvitamin (OH)D levels at or above 30 ng/mL; and 3. Examine the relationship of demographic variables, including age, gender, body mass index, physical activity, ethnicity, skin type, season, and sun exposure to serum 25(OH)D levels in both treatment arms. Methods Participants were randomized to either the phototherapy kiosk (PK) for a treatment every other week or 600 IU D3 oral supplement (OS) daily, for 10 weeks. PK exposure was based on response to previous treatment and Fitzpatrick Skin Type category; subjects wore undergarments only and eye protection for treatments of 2–6 minutes duration. OS group received a one-time prescription of 70 capsules, dispensed by a research pharmacist. Primary outcome was serum 25(OH)D level. Results Final sample 88 adults; OS group n = 45 and PK group n = 43. Demographics: median age 35 years, mostly female (66%), no difference observed between groups for age, race/ethnicity, or marital status. No difference seen in skin type, birth location, sun exposure, or use of sunscreen. OS group had higher BMI and %body fat. Baseline 25(OH)D level were similar, P = 0.25. At 12 weeks median OS 25(OH)D 25.5 ng/mL and PK 30 ng/mL; P = .01. At 16 weeks, OS group 25(OH)D level 21 ng/mL and PK 27 ng/mL; P = .04. Adherence: OS 92% vs PK 100%. There were no reportable adverse events. Conclusions Use of PK every other week achieved higher serum levels of 25(OH)D than usual care vitamin D3 600 IU/day for 10 weeks, although both groups returned to baseline levels 30 days post-treatment. At a time when self-care measures are highly valued for health promotion, programmed UVB delivered via PK in the community appears to be a safe, efficacious alternative to oral D3 supplementation but requires recurring use. Results from this study suggest a need for early intervention in preventable health conditions impacting Warfighter performance and readiness, particularly pre-deployment when optimizing long-term wellness for duty in austere environments. Funding Sources Benesol, Inc.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ehsan Hejazi ◽  
Reza Amani ◽  
Naser SharafodinZadeh ◽  
Bahman Cheraghian

Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS) and 25(OH) D3 and dietary intake of multiple sclerosis (MS) patients with those of normal subjects.Method. Thirty-seven MS patients (31 women) and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH) D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire.Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH) D3 and TAS between the study groups. Both groups had low serum levels of 25(OH) D3 and total antioxidants.Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.


2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Elena C. Castillo ◽  
Carlos Rodríguez-López ◽  
José R. Villarreal-Calderón ◽  
Merit Gómez-Carmona ◽  
...  

Vitamin D deficiency is present even in sunny regions. Ageing decreases pre-vitamin D production in the skin and is associated with altered cytokine profile. We performed a multivariate analysis considering lifestyle factors, anthropometric, and inflammatory markers according to seasonal variation in Mexican healthy older adults. The same cohort was followed during 12 months. Vitamin D deficiency/insufficiency was found in 91.3% of the subjects despite living in appropriate latitude (25°40′0″N). 25(OH)D levels remained below <30 ng/mL through all seasons. Vitamin D deficiency did not correlate to sun exposure or dietary intake. Gender was the strongest associated factor, explaining a variance of 20%. Waist circumference (WC) greater than 88 cm was a risk factor for vitamin D deficiency. Age (>74 years) combined with WC (>88 cm) and BMI (>32.7) showed a high probability (90%) of vitamin D deficiency. Remarkably, an increase in one centimeter in WC decreased 25(OH)D by 0.176 ng/mL, while an increase in one point BMI decreased 25(OH)D by 0.534 ng/mL. A cutoff point of 74 years of age determined probability of vitamin D hipovitaminosis. Vitamin D deficiency was correlated with TNF-αserum levels, possibly increasing the susceptibility of older adults to a proinflammatory state and its related diseases.


2007 ◽  
Vol 9 (2) ◽  
pp. 117-129 ◽  
Author(s):  
Patricia T. Alpert ◽  
Ulfat Shaikh

Individuals are capable of producing vitamin D with proper exposure to sunlight. However, several factors can interfere with the effectiveness of this process. Most sunscreens filter out UVB light, thus inhibiting vitamin D production. Individuals with more darkly pigmented skin have greater difficulty producing vitamin D because melanin acts as an effective natural sunscreen, requiring longer sun exposure to produce an adequate daily allotment of vitamin D. Additionally, solely breastfed infants whose mothers suffered from vitamin D deficiency or insufficiency when pregnant have smaller reserves of the nutrient and are at greater risk of developing nutritional rickets. Vitamin D deficiency leads to rickets, osteomalacia, and osteoporosis. Long-term vitamin D insufficiency can lead to paracrine effects such as type 1 diabetes, cancer, and multiple sclerosis. This article reviews the current literature on vitamin D deficiency and insufficiency and their relation to different disease states. Potential areas for research are discussed.


2005 ◽  
Vol 11 (3) ◽  
pp. 266-271 ◽  
Author(s):  
M Soilu-Hänninen ◽  
L Airas ◽  
I Mononen ◽  
A Heikkilä ◽  
M Viljanen ◽  
...  

Past sun exposure and vitamin D supplementation have been associated with a reduction in the risk of MS. We measured the serum concentration of 25-hydroxyvitamin D (25[OH]D) at the time of MS diagnosis in 40 MS patients and 40 controls. We found no difference in the serum levels of 25(OH)D between MS patients and controls when all samples or samples obtained during winter months were compared, but MS patients had significantly lower serum 25(OH)D concentrations in June to September than the controls. The vitamin D stores were adequate for bone metabolism (> 37 nmol/L) in 70% of MS patients throughout the year and within the hypovitaminosis level (< 37 nmol/L) in 30% of MS patients at some time of the year. During MS-relapses, 25(OH)D levels were lower than in remission, but mostly within the reference range observed in relation with normal bone metabolism. We conclude that the vitamin D stores in most MS patients are adequate for their normal bone metabolism. However, lower vitamin D levels during MS relapses than in remission suggest that vitamin D could be involved in the regulation of the clinical disease activity of MS. The optimal serum levels of vitamin D for the regulation of immune responses remain to be determined.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Stefan Pilz ◽  
Katharina Kienreich ◽  
Daniel Stückler ◽  
Andreas Meinitzer ◽  
Andreas Tomaschitz

Sunlight-induced vitamin D, synthesis in the skin is the major source of vitamin D, but data on the relationship of sun-related behaviour with vitamin D and parathyroid hormone (PTH) levels are relatively sparse. We evaluated whether habitual sun exposure is associated with 25-hydroxyvitamin D (25[OH]D) and PTH levels and whether there exist seasonal variations. We examined 111 hypertensive patients in Austria (latitude 47° N). Frequent sunbathing at home and outdoor sports were associated with higher 25(OH)D levels (P<0.05for both). Red or blond scalp hair as a child, memory of sunburns, preferring sunbathing, frequent stays on the beach or in open-air pools, and solarium use were associated with lower PTH levels (P<0.05for all). Multiple linear regression analyses including age, sex, and body mass index showed that sun exposure score was significantly associated with 25(OH)D (betacoefficient=0.27;P=0.004) and by trend with PTH (betacoefficient=−0.16;P=0.09). These associations were more prominent in summer in which 25(OH)D levels were significantly higher compared to winter. Translation of these findings into recommendations for the prevention and treatment of vitamin D deficiency remains a challenge for the future.


2013 ◽  
Vol 22 (4) ◽  
pp. 597-606 ◽  
Author(s):  
Carolina Bonilla ◽  
Rebecca Gilbert ◽  
John P. Kemp ◽  
Nicholas J. Timpson ◽  
David M. Evans ◽  
...  

2017 ◽  
Vol 47 (3) ◽  
pp. 409-422 ◽  
Author(s):  
Maria Marina Serrao Cabral ◽  
Angelo Jose Goncalves Bos ◽  
Hidemori Amano ◽  
Satoshi Seino ◽  
Shoji Shinkai

Purpose This paper aims to observe the possible relationship between skin color, sun exposure level, UV protection and food intake and serum levels of 25(OH) D in Japanese older adults. Design/methodology/approach Elderly (n = 131; 65-93 years old), followed by the Tokyo Metropolitan Institute of Gerontology in the Kusatsu (36°N) received a self-applicable questionnaire about the quantity and quality of the daily sun exposure and behavior to avoid the sun. A color analyzer measured each red (R), green (G) and blue (B) component of skin color, and dietary vitamin D was estimated by food frequency questionnaire. Serum 25(OH) D levels were collected and categorized as sufficiency (>30 ng/mL), insufficiency (between 20 and 30 ng/mL) and deficiency (<20 ng/mL). Findings High proportion of participants had insufficiency (53 per cent) and deficiency (25 per cent) levels of 25(OH) D. Insufficiency levels were more prevalent in women (57 per cent, p = 0.048) and in participants that use gloves (49 per cent, p = 0.054) and sunscreen on face (76 per cent, p = 0.003) as a sun protection way. Participants with sufficiency levels of 25(OH) D presented lower values of R (p = 0.067), G (p = 0. 007) and B (p = 0.001) of skin color (what is meaning darker skin) and a higher fish intake (12 times per week). Research limitations/implications The study is a cross-sectional design and brings a potential for measurement error in the recorded subjective variables. There is a memory bias in self-reported sun exposure and food consumption; however, in the multivariate analysis, it was demonstrated a significant association. Second, although the authors have sought to evaluate a number of variables that could affect the skin’s ability to synthesize vitamin D, there are many other factors that may affect this ability that could not be accounted for. Another limitation was the assessment of self-reported ultraviolet exposure data rather than direct measurement of exposure. Practical implications It was also concluded that darker skin color (a surrogate of longer-term sun exposure) participants had a lower prevalence of vitamin D insufficiency in this ethnic homogeneous population. When accessing patients’ skin color, the clinician must account for his or her ethnicity. Social implications Governments should regulate supplementation or food fortification with vitamin D, with special focus in countries with geographical location of insufficient solar radiation for skin synthesis of this vitamin. With this, it becomes a priority that a safe sun exposure ensures the sufficient serum levels of 25 (OH) D without the use of supplements. Originality/value This report was the first to analyze skin color components associated to vitamin D levels, finding that blue and green colors were significant. The clinical implication of this find is yet to understand. It was also concluded that darker skin color (a surrogate of longer-term sun exposure) participants had a lower prevalence of vitamin D insufficiency in this ethnic homogeneous population. When accessing patients’ skin color, the clinician must account for his or her ethnicity.


2015 ◽  
Vol 18 (1) ◽  
pp. 24-29
Author(s):  
Corina-Daniela Ene ◽  
◽  
Amalia-Elena Anghel ◽  
Alina Muşetescu ◽  
Ilinca Nicolae ◽  
...  

The relation between sun exposure, vitamin D synthesis and skin cancer is a complex one. Radiations from the sun stimulate the cutaneous vitamin D synthesis, one way, and promote the development of the skin cancer on the other way. A lot of epidemiologic and experimental studies revealed contradictory results regarding the relation between vitamin D and malignant melanoma. The vitamin D deficiency, accurate biochemical indicator of the vitamin D status in the body, could be implicated in promoting metastasis of the malignant melanoma by activation of the cellular proliferation, stimulation of the neutrophils chemotaxis and promoting angiogenesis. Identification of therapeutic strategies to normalise serum levels of the 25-OH vitamin D3 could represent useful tools in preventing melanoma metastasis.


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