HQ Team
April 9, 2025: One in five Indians are Vitamin D deficient, a silent epidemic affecting 46% of children aged 0-10 years, with policymakers having no comprehensive roadmap to address the issue, a study finds.
The Indian Council for Research on International Economic Relations and Anvka Foundation’s report ‘Roadmap to Address Vitamin D Deficiency in India’ stated that between 80 and 90% of the elderly suffer from osteoporosis putting them at risk of fractures and long-term disability.
Researchers did a Meta-analysis on the subject, key informant interviews, and stakeholder consultations to find a regional variation in the prevalence of Vitamin D deficiency, ranging from 9.4% in northern India to as high as 38.81% in east India.
“Children, adolescents, pregnant women and the elderly are the most vulnerable to Vitamin D deficiency in India,” according to the report. “Women across all age groups are more vulnerable than men.”
The indoor lifestyle of urban Indians is contributing to the rising prevalence of Vitamin D deficiency. Initiatives, like milk and edible oil fortification and the inclusion of Vitamin D in the list of essential medicines, have been taken by the government.
Pollution levels, urbanisation
The Indian Council of Medical Research – National Institute of Nutrition released the “Dietary Guidelines for Indians” in 2024, which specifies the requirement and need for adequate sun exposure.
Despite the popular belief that India receives ample sunlight throughout the year, existing studies and consultations show that rising pollution levels, urbanisation and modern lifestyle changes have reduced sun exposure, according to the report.
High air pollution in cities blocks ultraviolet B radiation from reaching the skin, hindering natural Vitamin D synthesis. Additionally, regions with extreme climates, such as intensely hot summers or cold winters, discourage outdoor activities, reducing sun exposure.
The modern lifestyle has further reduced sunlight exposure, as most people spend long hours indoors, it stated.
Social norms
Cultural and social norms also play a significant role in increasing the prevalence – these include the preference for fair skin and the use of umbrellas, sunscreen and full-body coverings to avoid tanning.
The naturally higher melanin content in Indian skin further reduces the efficiency of Vitamin D production, requiring prolonged sun exposure to synthesise adequate levels.
Studies suggest that individuals with darker skin may require three to six times longer exposure to produce the same amount of Vitamin D as those with lighter skin tones.
Diet further compounds the issue, as there are few foods, such as green vegetables, fish, eggs, mushrooms, beef liver and cheese, with high Vitamin D content. These are also often expensive and out of reach for the poor.
Traditional cooking
Additionally, traditional cooking methods, such as prolonged boiling of milk and other dairy-based beverages like tea and coffee, may reduce the Vitamin D content.
A significant proportion of the Indian population, particularly in the southern and eastern regions, is lactose intolerant, limiting their milk consumption and reducing both calcium and Vitamin D intake.
“There is a lack of awareness among the population on how to address the deficiency and there are no clear guidelines or package of practices to address it through the public food procurement and distribution system. Further, policy initiatives are voluntary rather than mandatory.”
The report called for mandatory fortification of food products with Vitamin D, building awareness through mass media campaigns and setting dietary requirements.
Vision document
It urged the government on regular data collection to monitor and evaluate the Vitamin D status of a population and to examine the impact of government initiatives such as supplementation programmes targeted at different population groups to increase Vitamin D intake.
The absence of a comprehensive treatment package implies that patients with Vitamin D deficiency with the same symptoms may receive different treatments depending on the healthcare provider they consult. The prices of supplements, despite being on the national list of essential medicines, are very high.
The report laid out nine key recommendations to address the deficiency, starting with a coordinated multistakeholder effort towards developing a comprehensive Vision Document to eradicate Vitamin D deficiency, outlining clear targets, goals, funding and strategies.
