Black People and Vitamin D Deficiency
We Are Reading S.T.E.M. #2 Last updated 4th January 2024
Greetings people, here are the notes and references from the Black People and Vitamin D Deficiency video. Please subscribe so you receive these in your inbox as soon as they are compiled. And please do share this far and wide so as many of our people as possible can gain a better understanding of this very important topic for our health and wellbeing.
Defining Vitamin D Deficiency
“deficiency”… does not necessarily connote clinically explicit disease (as would the term “deficiency” for nutrients such as vitamin C [scurvy] or thiamin [beriberi]). Rather it connotes an increase in risk for certain untoward outcomes, such as… in Vitamin D and Chronic Disease. This explains the seeming paradox that individuals who are ostensibly healthy today may nevertheless be “deficient.” (Heaney, 2008)
Vitamin D Status is determined by circulating 25 Hydroxyvitamin D aka Calcidiol:
The total serum 25(OH)D level (the sum of 25(OH)D that is bound to carrier proteins and is free in the circulation) is the currently accepted marker of choice for defining vitamin D status in any given individual. Its preferential use is based on (i) analysis of the existing body of clinical research, (ii) assay advances that confer easy and accurate measurements and (iii) the fact that it is the most abundant and stable of the various vitamin D metabolites in serum; 25(OH)D has a relatively long half-life (15 days) compared to 1,25(OH)2D (15 h). (Chun et al, 2019)
Two Different units of measuring Vitamin D in blood
Nanograms per millilitres (Ng/ml)
Nanomoles per litre (nmol/l)
1 ng/ml = 2.5 nmol/l
No international consensus on what deficiency is
health organizations across the globe differ significantly in their definition of what level of total circulating 25(OH)D constitutes sufficiency and deficiency for a “normal” population without evidence of active bone disease (e.g., osteoporosis, hyperparathyroidism, etc.). In North America, the Institute of Medicine has recommended the value of ≥20 ng/ml 25(OH)D (50 nmol/L) for sufficiency (45), whereas the Endocrine Society recommended for ≥30 ng/ml (75 nmol/L) (46). The Vitamin D Council states that individuals should strive for levels above 40 ng/ml (100 nmol/L) (47). In contrast to this, the UK Science Advisory Council on Nutrition defined vitamin D deficiency as serum levels of 25(OH)D <10 ng/ml (25 nmol/L), but did not recommend an optimal level for human health (48). Although the 10 ng/ml level is held by some other European nations, some have recommended higher levels.” (Chun, et al, 2019)
Bringing this all together, levels less than 20ng/ml are considered seriously deficient, between 20ng/ml and 30ng/ml are considered still too low, between 30ng/ml and 60 ng/ml are considered optimal:
The further Black People live from the equator, the lower our Vitamin D status
In the West, Black people are routinely found to have lower levels of circulating Vitamin D
Melanin is essential for protection against UV radiation which causes skin cancer. Black skin blocks out twice as much UV radiation as White skin. But the skin also relies on UV light to synthesise Vitamin D. Thus, you would expect Vitamin D levels to be lower among Black people the further away from the equator (i.e. where the Sun shines strongest and for the longest time). And that’s exactly what the data show:
African Caribbeans
Impacts on Black Health
In the video we covered a number of connections between low health outcomes for Black people, and low vitamin D status. Most were taken from Ames et al 2021, and we also read an article from the UK entitled “BAME babies at highest risk of Vitamin D deficiency, highlighting need for improvements to UK antenatal supplementation programme, new study suggests.”
Finally, we noted a study which found that Black people with low Vitamin D were more likely to get Sars-Cov-2, but this did not apply to White people:
Conclusion
For me, there is more than ample evidence that low vitamin D status is closely correlated with poor health outcomes, though as we’ve covered previously, causal connections have not yet been conclusively demonstrated in the scientific literature for most of these.
The next instalment in this series will be entitled How Can We Get Enough Vitamin D. Please do subscribe here on Substack and YouTube so you get notified when the live stream is coming up. And please do share to help spread the word.
Peace
Ely
Sources
Ames, Bruce N., William B. Grant, and Walter C. Willett. 2021. Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities? Nutrients 13, no. 2: 499. https://doi.org/10.3390/nu13020499
Heaney, R.P., 2008. Vitamin D in health and disease. Clinical journal of the American Society of Nephrology: CJASN, 3(5), p.1535. https://doi.org/10.2215%2FCJN.01160308
Mogire, R.M., Mutua, A., Kimita, W., Kamau, A., Bejon, P., Pettifor, J.M., Adeyemo, A., Williams, T.N. and Atkinson, S.H., 2020. Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis. The Lancet Global Health, 8(1), pp.e134-e142. https://doi.org/10.1016/s2214-109x(19)30457-7
Chun, R.F., Shieh, A., Gottlieb, C., Yacoubian, V., Wang, J., Hewison, M. and Adams, J.S., 2019. Vitamin D binding protein and the biological activity of vitamin D. Frontiers in endocrinology, 10, p.718. https://doi.org/10.3389%2Ffendo.2019.00718
Meltzer, David O., et al. Association of vitamin D levels, race/ethnicity, and clinical characteristics with COVID-19 test results. JAMA network open 4.3 (2021): e214117-e214117.: https://doi.org/10.1001/jamanetworkopen.2021.4117
BAME babies at highest risk of Vitamin D deficiency, highlighting need for improvements to UK antenatal supplementation programme, new study suggests: https://www.birmingham.ac.uk/news-archive/2020/bame-babies-at-highest-risk-of-vitamin-d-deficiency-highlighting-need-for-improvements-to-uk-antenatal-supplementation-programme-new-study-suggests