Despite numerous scientific breakthroughs in healthcare, maintaining adequate physical health remains a challenge to human beings. Currently, there is a global wave that aims to raise awareness of the place of nature and healthy social habits in the prevention and management of chronic conditions, popularly known as non-communicable diseases. Among these preventable non-communicable diseases, those caused by Vitamin D deficiency have now become potential health threats in Africa that could join the likes of hypertension, diabetes and cancer, mainly due to the uncritical adoption of western lifestyles.
Urbanisation and the dangers of Vitamin D deficiency
The “modern” lifestyle and its unhealthy food consumption as well as a sedentary lifestyle deprived of outdoor activities comes with loads of consequences on the physical health of Africans, especially for children who are entirely dependent on adults for survival. According to the WHO, the burden of non-communicable diseases in Africa will surpass that of communicable diseases by 2030, a trend that has been attributed to lifestyle changes brought about by westernisation, itself characterised by rapid urbanisation.
One of the consequences of this lifestyle is Vitamin D deficiency, which is considered one of the most common non-communicable medical conditions worldwide. It is currently estimated that a whopping one billion people in the world suffer from Vitamin D deficiency. Scientists have advised that the best source of Vitamin D is exposure to sunlight, which is very limited for adults and children living in urban settlements. The sun’s ultraviolet B (UVB) rays interact with the cholesterol in the skin cells, providing the energy for vitamin D synthesis to occur. This is the reason why Vitamin D is often called the sunshine vitamin.
As far as Africa is concerned, it is worth noting that dark-skinned people have higher rates of Vitamin D deficiency compared to their lighter-skinned counterparts, mainly due to their higher melanin rates. The melanin acts as a protective layer against the sun reducing vitamin D production in the skin.
The most accurate way to measure the presence of Vitamin D in our bodies is by conducting the 25-hydroxy Vitamin D blood test. A level between 20 nanograms(ng)/millilitre(mL) and 50 ng/mL is considered adequate for healthy people, while any level below 12 ng/mL indicates Vitamin D deficiency.
Worse still, Vitamin D deficiency can cause permanent physical disability, if not corrected early. Moreover, research shows that Vitamin D deficiency has been increasingly associated with many serious diseases, including cancers, cardiovascular diseases, type 1 diabetes, osteoporosis in elderly people, and many other auto-immune diseases.
It is worth noting that Vitamin D allows calcium – whose most-known function is to build and strengthen bones and teeth – to be deposited in the bones, because of which it is considered essential in bone development. Consequently, the lack of it is understandably one of the most common causes of rickets in children and Osteomalacia in adults. Naturally, the most common signs of rickets and Osteomalacia are the softening and weakening of bones.
Moreover, case reports show that mothers who suffer from Osteomalacia prior to delivery are likely to give birth to newborns suffering from rickets. In other words, babies born from Vitamin D-deficient mothers are more likely to develop rickets. These babies are typically born with craniotabes, a typical finding in newborns suffering from rickets, which is characterised by an abnormal softening of the skull bones.
Obviously, rickets is a serious bone disease for children who are vulnerable because their bodies are still in a critical developmental process. The symptoms of rickets range from failure to grow, abnormally curved spine, bone deformities, dental defects to seizures, some of which might be devastating in the long term.
The importance of exposure to sun
A study on the role of the environment in rickets cases in the Middle East pointed out that vitamin D deficiency is usually the result of inadequate sun exposure of those living in mid- or high-latitude environments. Further, the study showed that while “there is generally abundant exposure to sunlight in tropical or subtropical climates, vitamin D deficiency may arise due to risk factors limiting sun exposure such as darker skin pigmentation, atmospheric pollution, and the covering of skin for religious and cultural reasons.”
The cumulative evidence of Vitamin D deficiency has led researchers to warn that it is already a significant public health problem with an increased association with metabolic syndromes, with rickets as one of the most common. The study specified that the deficiency is linked to the relatively recent changes in the workplace that has, over the past century, largely migrated from outdoors to indoors. The rise in digital attractions has also contributed to people spending more recreational time sheltered from the natural environment in which humans evolved for millenniums, and this affects specifically newborns and children.
A systematic review and meta-analysis reaffirmed that Vitamin D deficiency was higher in urban areas compared to rural areas where outdoor activities are the norm. In developing countries, the level of prevalence was high due to dark skin pigmentation, malnutrition, lack of sun exposure, dressing styles that cover most parts of the body, amongst other reasons, leading authors to recommend that national health systems develop specific policies to prevent, detect early, and treat Vitamin D deficiency.
Building healthier societies
Two significant conclusions can be drawn from the research. One, economic development in Africa must be imagined in a sense that does not depict urbanisation as the ultimate end goal. All aspects of community life have to evolve as a whole lest all efforts to improve our well-being in general and our health in particular would be in vain.
Two, most of these non-communicable diseases can be prevented with the implementation of nutritional policies and sensitisation around the dangers of imported and unhealthy social habits. Accordingly, adopting healthy social and nutritional habits should include ensuring sufficient calcium and vitamin D from food and supplements for pregnant women, ensuring 20 to 30 minutes of sun exposure each day, especially for children who depend on adults (exposing their forearms to the sunlight should be enough).
Therefore, building healthier societies starts with protecting the most vulnerable who happen to represent the next generations: From regular physical exercise to fasting, along with the importance of sunlight for health, the western world, keeps realising the impossibility of replacing healthy lifestyles with drugs.
But the key lesson is this: It is time for Africans to realise the dangers of adopting other people’s ways of life without deeper reflection around the consequences of these imports on African lives.