Vitamin D Adequacy and Improvements of Comorbidities in Persons with Intellectual Developmental Disabilities

Abstract

The prevalence of vitamin D deficiency is alarmingly high among people with developmental disabilities. In addition to enhancing mineral metabolism, vitamin D affects neuro-modulation, muscle coordination, immunity, infections and autoimmune disorders. Peer-reviewed papers from PubMed, Medline, and other research databases were searched using key words to collate relevant evidence in preparation of this evidence-based review. Per the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), general interpretations of results are included taking into consideration the risk-benefits, broader evidence, and implications for practicing clinicians. Many clinicians consider the minimum level of serum 25-hydroxy vitamin D [25(OH)D] required for optimal health in the normal population to be 30 ng/mL (75 nmol/L), whereas a lesser number consider the level to be 20 ng/mL. However, evolving data suggest that for vulnerable populations, such as those with autoimmune disease, cancer, cardiovascular diseases, metabolic syndrome, and persons with developmental and intellectual disabilities, 40 ng/mL (100 nmol/L) might be considered the minimum level. To reach this level, most people requires adequate sun exposure and/or a daily oral supplementation of between 1,000 and 5,000 International Units of vitamin D. This review explores vitamin D requirements for the musculoskeletal and non-skeletal systems and its adequacy in relationship to common disorders affecting persons with intellectual disabilities.

Physiology of Vitamin D—Focusing on Disease Prevention

“…However, the mere existence of policies is insufficient; these policies must be accompanied by effective measures to ensure individuals reach the target vitamin D status. This includes recommendations for safe sun exposure, food fortification strategies, and vitamin D supplementation guidelines [ 14 , 19 , 290 , 291 , 292 ]. Adhering to practical public health guidelines makes eliminating vitamin D deficiency cost-effectively feasible.…”

Vitamin D as an Immunological Factor in Combating COVID-19

“…Some evidence points to the fact that Vitamin D supplementation and higher concentrations of 25 (OH) D may be linked to a reduced risk of several chronic diseases such as cancer, diabetes mellitus, among others. A higher level of vitamin D is inversely associated with infection caused by viruses such as dengue, hepatitis, HIV, influenza, rotavirus, among others [9,11,43].…”

Disease prevention strategies using vitamin D

“…Some individuals cannot rely on orally administered vitamin D (those with gastrointestinal absorption abnormalities) or even sun exposure (e.g., those with disor-ders such as lupus, or who take medication that increases sensitivity to the sun's rays, or have insufficient generation of vitamin D in the skin) to achieve target vitamin D status. Thus, guidelines and recommendations must also encompass modes of safe sun exposure, food fortification strategies for communities, and supplementation guidelines for those who with special needs, as well as, when appropriate, the measuring of serum 25(OH)D concentration [5][6][7][8] . 6 The need for vitamin supplements For people living in the west and some affluent people living in other parts of the world consumed balanced diets and getting some exposure to sunlight; For them, it is a waste of material and money and unlikely needing vitamin or herbal supplementation.…”