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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Endocrinol. | doi: 10.3389/fendo.2019.00493


 Chittari V. Harinarayan1* and H AKHILA2*
  • 1Sakra World Hospital, India
  • 2Other, India

Vitamin D and calcium are essential nutrients for bone health, to achieve peak bone mass and to preserve bone, as age advances. The deficiency of this twin nutrient casts long shadows in later life as short/long latency diseases–rickets/osteomalacia/osteoporosis. There is scant review available about the trend of these nutrients in India. For over past half a century, the intake of dietary calcium, milk, milk products and cereals has declined drastically in the background of upward revision of RDA/RDI in modern India. This is attributed to changing lifestyle, inadequate milk consumption across various socio-economic strata, and shift in dietary intake from cereals to rice and wheat. There is a clear rural–urban divide in consumption of milk, milk products and cereals, a change in dietary habits which magnify the calcium and vitamin D deficiency. Revisiting of RDA guidelines for calcium along with public health measures is required to tackle the morbidity arising due to twin nutrient deficiency. Any measure to addresses this issue in isolation, without achieving the desired benefits, is a disservice to the population. Population based educational strategies, government measures, leveraging technology, adequate sun exposure and food fortification help tackling the twin nutrient deficiencies in this diverse country.

Keywords: Vitamin D, Calcium, Rural & urban, Time trends, Way forward, India, Developing & transition countries

Received: 25 Mar 2019; Accepted: 08 Jul 2019.

Edited by:

Kate A. Ward, MRC Lifecourse Epidemiology Unit (MRC), United Kingdom

Reviewed by:

Jan J. Stepan, Charles University, Czechia
Suma Uday, Birmingham Women's and Children's Hospital, United Kingdom  

Copyright: © 2019 Harinarayan and AKHILA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mx. Chittari V. Harinarayan, Sakra World Hospital, Bangalore, India,
Mx. H AKHILA, Other, Bangalore, India,