By Dr. Piyush Goel
Poor air quality is filling most of our lungs as pollution has become one of our biggest concerns . It has become one of the sources of several respiratory and pulmonary diseases, some of which may continue for lifetime, such as chronic obstructive pulmonary disease (COPD). The disease kills about 1 million people in India, largely because this progressive disease can remain hidden for a long time and there is no curative treatment. Hence, the importance of vitamin D and respiratory health assumes significance.
Over time, such chronic pulmonary diseases can cause lung cancer and similar fatal diseases. However, recent research shows that one very unlikely panacea-treating vitamin D deficiency will not only strengthen the bone but may also help prevent lung diseases.
Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is found naturally in a few foods — including some fish, fish liver oils, and egg yolks — and in fortified dairy and grain products.
Vitamin D and lung function
Our lungs are made of thin blood vessels and air sacs which help in transfer of pure air to blood and extract carbon di-oxide-filled air from blood. When we inhale, the air travels down the windpipe (trachea) into your lungs through two large tubes known as bronchi. These tubes divide many times inside the lungs into many smaller tubes that end in clusters of tiny air sacs known as alveoli.The air sacs have very thin walls full of tiny blood vessels or capillaries. The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream and exhales carbon di-oxide. The natural elasticity of the bronchial tubes and air sacs help lungs to force air out of the body. COPD causes them to lose elasticity and expand more than required, and leaves some air trapped when you exhale.
The 'sunshine vitamin', known to protect bones, can also guard you against colds, flu and asthma attacks. According to the recent findings, COPD patients, who were severely deficient in vitamin D, benefitted to a great extent by the use of vitamin D supplements-it led to a 45 per cent reduction in lung attacks among such patients. Prescribing and orally administering vitamin D supplement is safe and it costs less than any other treatment –the treatment is potentially highly cost-effective for those who have low vitamin D levels following routine testing.This is probably because vitamin D is also known to increase neuromuscular and immune function, and reduce inflammation. COPD is characterized by lung inflammation, and possibly that is where vitamin D acts as a remedy.
Vitamin D deficiency: Who are at risk?
Some of the following types of people are more likely to experience vitamin D deficiency and hence, when living in polluted surroundings, are more likely to develop COPD:
- Older adults: As they age, skin cannot synthesize vitamin D as efficiently. Besides, they are likely to spend more time indoors, and they may have inadequate intakes of the vitamin.
- Breastfed infants: Vitamin D requirements cannot be met by human milk alone as the vitamin D content of human milk is related to the mother's vitamin D status.
- People with limited sun exposure or more melanin in skin: Dark skinned people or those who cover themselves extensively may suffer from vitamin D deficiency and therefore may have extra risk of developing COPD when living in a polluted environment.
Vitamin d deficiency treatment
People can boost their vitamin D levels by:
- Spending 15 minutes a day in summer sunlight without sunscreen
- A diet that includes fatty fish and fortified dairy products
- Supplements should also be considered for people with vitamin D deficiency or those wishing to avoid direct sunlight.
- Vitamin D supplements, given by mouth, reduced the rate of moderate/severe COPD exacerbations in patients with low vitamin D levels.
- Doses of vitamin D ranged from 30 micrograms daily to 2500 micrograms monthly.
Note that supplementation did not influence the proportion of participants experiencing serious adverse events, indicating that it was safe.
The author is Pulmonologist, Columbia Asia Hospital, Gurgaon. Views expressed are the author's own.