India gets plenty of sunshine, so why are millions still deficient in vitamin D? Expert explains.
Vitamin D deficiency in sunny India: Why it’s still so common
For a country blessed with sunlight almost throughout the year, India's vitamin D story sounds almost contradictory. Step outside on a bright afternoon and it is easy to assume that people are naturally getting enough of the "sunshine vitamin." But doctors across the country are seeing the opposite. Vitamin D deficiency has emerged as a silent epidemic. It often stays unnoticed until people start complaining of persistent tiredness, body aches, muscle weakness or frequent fractures. A systematic review has estimated that nearly six out of ten Indians may have low vitamin D levels, making it one of the most common micronutrient deficiencies in the country.
Why a sunny country is struggling with vitamin D
Dr Ramkinkar Jha, Director - Orthopaedics, CK Birla Hospital, Gurugram, said, "Even though India enjoys sunshine year-round, vitamin D deficiency has become one of the most common nutrient deficiencies in the country. The problem is worrying since vitamin D is a crucial component for strong bone health, muscular development, and musculoskeletal well-being." The reasons are surprisingly modern. Office jobs have replaced outdoor work. Children spend more time indoors with screens. Long commutes, air-conditioned workplaces and apartment living mean many people hardly spend time in direct sunlight. Dr Jha explained, "A significant majority of individuals spend their days either working in offices, attending school, or just staying at home; hence, not getting exposed enough to the sun. Even when outdoors, they are likely to use sunscreens, umbrellas, or wear clothing that covers most of their bodies, thus preventing the synthesis of vitamin D in their skin. Air pollution in cities blocks out UVB radiation needed by the body to produce vitamin D." Ironically, living in a sunny country does not automatically guarantee enough vitamin D. The body needs proper exposure to ultraviolet B rays, and modern lifestyles often stand in the way.
Skin colour, obesity and biology also play a role
Not everyone produces vitamin D at the same rate. According to Dr Jha, "Darker-skinned individuals require more exposure to sunlight in order to synthesize the same quantity of vitamin D produced by light-skinned people. Besides, obesity also leads to vitamin D deficiency due to the fact that excess body fat stores more vitamin D than the organism needs." This means that even people who spend some time outdoors may still fall short.
Why Indian diets often don't fill the gap
Unlike iron or calcium, vitamin D is naturally present in very few foods. Dr Jha said, "Sources of vitamin D through natural food are rare and comprise fatty fish, eggs, and milk with vitamin fortification. However, because many Indians do not eat these foods on a daily basis, their dietary requirement might go unmet." Many vegetarian diets contain limited vitamin D. Food fortification is improving, but it is still not universal. Experts have long suggested that fortifying staple foods could help address the problem on a larger scale. These reports underline that vitamin D deficiency is not a niche problem. It is a public health concern.
The body often sends signals, but they are easy to ignore
Persistent fatigue is often blamed on stress. Aching muscles are dismissed as ageing. Bone pain gets ignored. But these symptoms can sometimes point towards low vitamin D. Dr Jha warned, "Consequences of vitamin D deficiency are grave. They range from experiencing bone pains and muscle weakness to fatigue, slow bone fracture healing, and an increased risk of osteoporosis and bone fractures among older patients." He added, "In children, deficiency leads to rickets, but osteomalacia may occur in adults. Osteomalacia is a condition where the bones are fragile and weak due to poor mineralization of vitamin D and calcium in the body." Older adults, postmenopausal women and people with obesity are especially vulnerable.
Small everyday habits can make a big difference
Fixing vitamin D deficiency does not mean chasing endless supplements or sitting in the sun for hours. Dr Jha said, "Measures to prevent vitamin D deficiency involve moderate sunbathing, balanced meals that are rich in both calcium and vitamin D, regular exercise, and supplements, as recommended by the health practitioner." He further advised, "People at risk of developing bone problems, such as those above 60 years of age, postmenopausal women, obesity, and lack outdoor contact should be tested periodically for vitamin D levels."
Medical experts consulted
This article includes expert inputs shared with TOI Health by Dr Ramkinkar Jha, Director - Orthopaedics, CK Birla Hospital, Gurugram. Inputs from specialists helped shed light on the surprising rise of vitamin D deficiency in sunny India, the factors driving it, and the importance of proper testing and doctor-guided treatment rather than self-medication.
