Vitamin deficiency in adults
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Prevalence and Risk Factors of Vitamin Deficiency in Adults
Vitamin deficiencies, particularly of vitamin D and B vitamins, are common among adults worldwide and can have significant health impacts. Studies show that vitamin D deficiency affects a substantial portion of the adult population, with prevalence rates varying by country, age, ethnicity, and lifestyle factors. For example, 20% of Australian adults were found to be vitamin D deficient, with an additional 43% classified as insufficient. Risk factors include being born outside the main English-speaking countries, living in higher latitudes, winter or spring season, obesity, low physical activity, and not taking supplements. In China, 70.3% of older adults were vitamin D deficient compared to 17.4% in the US, with risk factors differing between countries but including age, gender, ethnicity, income, health status, and physical activity levels 57.
B vitamin deficiencies, especially among the elderly, people with alcoholism, those with heart failure, recent obesity surgery, and vegetarians/vegans, are also prevalent. Multiple B vitamin deficiencies often coexist, increasing the risk of neurological impairment and disability .
Health Consequences of Vitamin D and B Vitamin Deficiency
Vitamin D is essential for bone health, and its deficiency can lead to osteomalacia and increase the risk of fragility fractures. There is also evidence linking vitamin D deficiency to extra-skeletal conditions, including low mood, cognitive impairment, and possibly neurodegenerative diseases such as Alzheimer's and Parkinson's 38. B vitamin deficiencies are strongly associated with neurological symptoms and can contribute to neurodegenerative diseases, anemia, and hyperhomocysteinemia. Prompt therapy can reverse many of the symptoms associated with B12 deficiency, but some disorders may not respond as quickly 410.
Screening and Diagnosis of Vitamin Deficiency in Adults
Vitamin D status is best assessed by measuring serum 25-hydroxyvitamin D levels. However, routine screening for vitamin D deficiency in asymptomatic adults is not universally recommended, as current evidence is insufficient to assess the balance of benefits and harms of such screening. Instead, targeted screening is advised for individuals at higher risk, such as those with bone, liver, or kidney diseases, obesity, malabsorption, pregnancy, lactation, or advanced age 126.
For B vitamins, diagnosis often relies on clinical presentation and laboratory testing, especially in populations at risk or those presenting with neurological or hematological symptoms 410.
Treatment and Prevention Strategies for Vitamin Deficiency
Vitamin D deficiency can be prevented and treated through safe sun exposure, dietary intake, and supplementation. Supplementation should be tailored to the individual's needs and risk factors, with oral vitamin D2 or D3 being effective and safe for most adults. Routine monitoring during treatment is generally not necessary due to the wide safety margin of vitamin D, but may be considered in special cases 136.
For B vitamin deficiencies, supplementation and dietary adjustments are effective, and early intervention is crucial to prevent irreversible complications, especially neurological ones 410.
Vitamin D Deficiency and Obesity in Adults
There is evidence suggesting an association between vitamin D deficiency and obesity in adults and the elderly. Some studies indicate that vitamin D deficiency may contribute to the development of obesity, while others find a borderline or null association. More prospective studies are needed to clarify the direction and causality of this relationship .
Conclusion
Vitamin deficiencies, particularly of vitamin D and B vitamins, are common in adults and can lead to significant health problems, including bone disorders, neurological impairment, and mood disturbances. Risk factors include limited sun exposure, poor diet, certain health conditions, and lifestyle factors. Targeted screening and individualized supplementation are recommended for at-risk populations, while routine screening in healthy adults remains controversial. Early diagnosis and treatment are essential to prevent long-term complications.
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Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults.
Vitamin D deficiency is associated with low mood and impaired cognitive performance in older adults, but not with physical performance.
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