ABM Zubair :
Sunlight is the primary source of vitamin D. However, despite being a tropical country, Bangladesh has a high prevalence of vitamin D deficiency. Discussions have recently begun on addressing this crucial micronutrient deficiency, while fortification of edible oil with vitamin D is being considered as a possible solution.
A lack of vitamin D can cause rickets in children and osteoporosis in adults. It may also lead to maternal complications such as pre-eclampsia and neonatal issues like hypocalcemic seizures. Additionally, long-term non-communicable diseases such as heart disease, diabetes, high blood pressure, and even cancer may become more prevalent due to vitamin D deficiency. According to the World Health Organization (WHO), 71 per cent of all deaths in Bangladesh are caused by non-communicable diseases. The deficiency of vitamin D is making this situation even more dangerous.
According to the Bangladesh National Micronutrient Survey 2019-20, one in four (22 per cent) children under the age of five and two in three (70 per cent) non-pregnant, non-lactating women suffer from vitamin D deficiency. Many believe that urban dwellers are more prone to vitamin D deficiency due to reduced sun exposure. However, research has shown that severe vitamin D deficiency are also found among rural populations. Given that a large portion of the population is at risk due to vitamin D deficiency, it is incomprehensible why this issue remains overlooked by policymakers.
Although the human body primarily produces vitamin D from sunlight, certain natural foods can partially meet this requirement. These foods include milk and dairy products, egg yolks, fatty fish, red meat, liver, mushrooms, etc. Traditionally, the people of our country consume these foods in low quantities and eat more rice and carbohydrate-rich foods. Moreover, public awareness regarding the importance of vitamin D and known methods to prevent its deficiency is relatively low. Most people are still not aware of the right time, duration, and ways to get healthy sun exposure. Additionally, increasing air pollution has reduced the human body’s ability to produce vitamin D from sunlight. Public awareness is crucial to obtaining this free natural source of vitamin D, which is a long-term process.
Vitamin D deficiency is not only a problem in Bangladesh; but also a global issue. South Asian countries like India and Pakistan have severe vitamin D deficiency, and even developed European nations are not free from this problem. According to WHO, when 20 per cent or more of a population suffers from vitamin D deficiency or other micronutrient deficiencies, public health interventions must be undertaken.
Diagnosis and treatment for vitamin D deficiency are quite expensive, considering Bangladesh’s socio-economic conditions. Measures that can be taken to prevent vitamin D deficiency include public awareness campaigns on the importance of getting healthy amount of sun exposure, encouraging the consumption of vitamin D-rich foods and making them more accessible, providing free vitamin D supplements for women and the elderly, and fortifying commonly consumed foods with vitamin D-a process known as fortification. Fortifying food products to combat vitamin deficiencies has been effectively implemented in countries such as the United States, Canada, Saudi Arabia, India, Pakistan, and Finland.
Food fortification with vitamins and minerals is not a new concept in Bangladesh. Iodine fortification in salt and vitamin A fortification in edible oil have been made mandatory. Since edible oil is widely consumed in Bangladesh and vitamin D is fat-soluble, it could serve as a suitable carrier for vitamin D fortification. Moreover, fortifying edible oil with both vitamin A and vitamin D is more cost-effective than fortifying it with only vitamin A. This approach would allow people to obtain both vitamins through their daily consumption of edible oil.
The high prevalence of vitamin D deficiency must be taken seriously, and its prevention should be considered as a public health priority. If ignored, the burden of diseases will continue to rise. Therefore, the government, policymakers, health experts, and individuals must all take action now. Implementing vitamin D fortification in edible oil would be beneficial for both the government and the general public.
(The writer is Public Health Expert and Executive Director, PROGGA).
