VIMS Journal: December 2015

Original Article

Study of Effect of Weight Reduction on Vitamin D Status in Obese and Overweight Subjects - A Pilot Study

Dr. Jayanta Chakraborty, Dr. Semanti Chakraborty, Dr. Rita Chakraborty, Dr. Dinabandhu Naga

Abstract :
Vitamin D deficiency- insufficiency is paradoxical in sunny India. More so in Bengal where majority of people consume fatty fishes. In the present study which is preliminary report of a larger population study weight reduction causes increase of Vitamin D from baseline level to a maximum of 9.51 ng/ml.

Introduction:
Vitamin D deficiency is in epidemic proportions worldwide. In one of our previous study vitamin D deficiency-insufficiency were 100% in type 2 diabetic subjects.[1]

In USA in a recent study the overall prevalence rate of vitamin D deficiency was 41.6%, with the highest rate seen in blacks (82.1%), followed by Hispanics (69.2%),[2]. This vitamin D deficiency is steadily increasing over decades in USA. In a report of Mayo clinic proceedings in 2006 - Vitamin D inadequacy has been reported in approximately 36% of otherwise healthy young adults and up to 57% of general medicine inpatients in the United States"[3].

In Saudi Arabia vitamin D deficiency was also substantial 78.1% in females and 72.4% in males[4].

In Pakistan when the studied population was premenopausal women it was 91.50%.[5]

So this global deficiency is sustained despite diverse food habit and varying exposure to the Sun.

There must be other causal relationship of this malady, besides the above two which have been widely addressed without any benefit.

The present study, which is an encouraging preliminary report of a larger study, gives a plausible insight into the problem.

Methods:
The present study is an excerpt of the parent study of vitamin D deficiency in India its cause and remedy. In an intervention of life style modification and weight reduction among 200 subjects randomized from a endocrinology clinic. The pilot study included 10 subjects. The target was weight reduction of minimum one kilogram (kg) over six months run over period. Maximum weight reduction permitted ten kilograms. 25 hydroxy Vitamin D (Vitamin D) was assessed initially and after six months. After three months those who did not lose weight, were treated with orlistat.

Results:
Among 10 subjects, only 6 subjects lost weight to target of 1kg or more. Minimum weight loss was 1kg and maximum was 10kg. Mean weight loss was 5.5kg. Minimum initial vitamin D was 11.04 ng/ml and maximum was 24.30 ng/ml.

Mean increase of vitamin D was 6.26 ng/ml.

Among these 6 subjects who succeded to lose weight. Vitamin D rose from 3.30 ng/ml to a maximum of 9.51 ng/ml, through weight loss without any vitamin D supplementation through diet or drugs.

Discussion :
The pandemic of vitamin D deficiency worldwide is a major global health concern. Not deficiency but sufficiency of diet and consequent obesity and metabolic syndrome is the principal causative factor. In another study we found that vitamin D deficiency is directly related to increased body mass index.[6] Obesity and metabolic syndrome causes inadequate active Vitamin D available to body, which we have discussed in details in another publication. So life style modification and reduction of body weight to ideal body weight is an important intervention for this Global epidemic.

Conclusion :
Body weight reduction in overweight and obese subjects normalizes vitamin D status, without requirement for vitamin D supplementation.

References
  1. Study of prevalence of Vitamin D deficiency in India, in diabetic and non diabetic population, along with its relationship with different variables like BMI, Calcium, Phosphate, PTH, FT4, TSH and PTH., Jayanta Chakraborty, Debdatta Kar, Semanti Chakraborty, Rita Chakraborty, Chanchal Samanta. Presented at Annual National Conference of Association of Physicians of India, Hyderabad, January, 2016.

  2. Forrest KY1, Stuhldreher WL, Prevalence and correlates of Vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54. doi: 10.1016/J.Nutres.2010.12.001.

  3. Michael F. Holick, PHD, MD, High Prevalence of Vitamin D Inadequacy and Implications for Health, Mayo Clin Proc. 2006; 81(3) : 353-373.

  4. Hanan Alfawaz, Hani Tamim, Shmeylan Alharbi, Saleh Aljaser and Waleed Tamimi, Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases BMC Public Health 201414:159. doi: 10.1186/1471-2458-14-159.

  5. Khan AH1, Iqbal R, Naureen G, Dar FJ, Ahmed FN. Arch Osteoporos. 2012;7: 275-82., Prevalence of Vitamin D deficiency and its correlates: results of a community-based study conducted in Karachi, Pakistan. Arch Osteoporos. 2012;7:275-82.

  6. Rk Marwaha*, N Tandon**, MK Garg***, Ratnesh Kanwar*, A Narang*, A Sastry, Vitamin D Status in healthy Indians Aged 50 Years and Above, J Assoc Physicians India 2011;59:703-70.

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