Vitamin D and sunlight: Are you in the dark about this deficiency?

Covering up from head to toe in black, synthetic fabric is leaving many women struggling for one essential nutrient.

KARACHI:

If you cover your hair, body and face with black synthetic fabric or use too much sun block every time you go out into the sun, you may be putting yourself at significant risk of a vitamin D deficiency, doctors are beginning to warn.

Vitamin D is produced by the skin when it is exposed to sunlight. It is also absorbed from certain foods, like fish. But if you don’t get enough of it, you experience symptoms like bone and limb pain, back and muscles aches, migraines.

Well-known consultant obstetrician and gynaecologist Dr Sadiah Ahsan-Pal has long been alarmed with the sheer number of her patients in Karachi who are testing deficient in Vitamin D. “There is nothing wrong with covering yourself,” she clarifies. “But women in Pakistan are using the wrong colour i.e. black and the wrong fabric i.e. synthetic to do so.” Instead it is recommended that they use light-coloured fabrics that breathe because they are made of natural fibres such as silk or cotton.

The problem is that more and more women in Pakistan are taking up the black-coloured abaya, a clothing whose tradition emanates in part from the Arab world and is not indigenous to South Asia. And for anyone who argues that women have been using this style in the Arab world for a long time, they just need to look at the slew of research on what is being called “the silent epidemic” on that region.

In fact, a number of studies have also been conducted on Arab women. The scope of this research ranges from women living in the United Arab Emirates to those of Arab descent living in various parts of Europe including Denmark. One such study is published in the Journal of Biosocial Science in which researchers conclude that after ‘adjusting for other confounding variables such as nationality clothing and UV sources...limited skin exposure to sunlight appears to be an important determinant to Vitamin D status’ in a person. Thus covering oneself with black cloth and rarely exposing the skin to sunlight does have a significant negative impact on the biological ability to synthesise vitamin D for the body.

In Pakistan, many women add to the ensemble black gloves made of synthetic material and socks as a result of which not a single inch of skin is left visible with the exception of the eyes. “Synthetic is not the appropriate fabric for this weather, it doesn’t allow your skin to breathe or your perspiration to evaporate,” cautions Dr Sadiah. “It has also resulted in the development of many skin and fungal infections and irritations. What is worse is that many people do not even connect the dots as to why this is happening though it’s fairly common sense.”

Additionally, women who are restricted to staying indoors or within the boundary walls of their homes are also showing up vitamin D deficient. “Women observing pardah inside their homes because of male domestic help barely get any time in the sun furthering aggravating the deficiency” explains Dr Saadia Khan, who is the head of the department obstetrics and gynaecology at University Medical and Dental College in Faisalabad.

And a Vitamin D deficiency does not discriminate. It is not only surfacing in lower income groups - it equally affects members of the privileged socio-economic class. Many women from the high-income groups stay indoors for most of the day but when they go out, it is in a car and they usually just hop out of it to go indoors yet again, whether it is someone’s house, a café or shop. The result is that even they don’t get enough exposure to sunlight and when they do find themselves in ‘dhoop’ they cover up to prevent tanning.

Expecting mothers are advised to take particular care as they are at greater risk. In fact, according to Dr Sadiah Ahsan-Pal over 90% of her patients are testing positive for the deficiency. Khan in Faisalabad also presents similar statistics with her patients in the Punjab.

A vitamin D deficiency affects your immune and vascular systems and may also put you at risk during pregnancy, presenting severe complications such as diabetes, high blood pressure, and problems with the baby’s growth. Furthermore, it can cause infertility in men as well women and has been linked to some cancers such as that of the breast. Doctors are, however, still in the stage of trying to connect all the dots.

There are plenty of Vitamin D rich foods, especially oily fish or fish liver oils but in Pakistan this too poses a hitch. Many people don’t eat fish regularly during the week. And the fish we do have access to are not high in Vitamin D. Examples of the varieties that are rich in Vitamin D are salmon, sardines and tuna - which are generally not easily available in Pakistani markets or are too expensive because they are imported. Outside Pakistan many companies sells cereals fortified with supplements but just like eating fish, this is not necessarily part of our culinary culture.

Vitamin D is also essential for the absorption of calcium in the body, which is in turn a crucial mineral for the healthy functioning of our cells. Khan points out that many young adults and children across the country are no longer drinking enough milk, if any at all, to provide their growing bodies with their much-needed nutrients. Children don’t play enough outside where they can also get their daily dose of Vitamin D.

Doctors are also worried about the old obsession with skin whitening and fair skin. Many people apply excessive sun block, which is counter-productive as it limits much-needed absorption of the sun rays.

And so if you or someone you know has inexplicable aches and pains or recurring headaches, it is well worth consulting a doctor and getting a complete blood test to find out if a Vitamin D deficiency is at play. And then, in possibly what may be the quickest of fixes, just go get some sun.





Published in The Express Tribune, August 7^th, 2011.