By Marc Sorenson, EdD Sunlight Institute…
Research from Singapore, a very sunny country, demonstrated that 57% of older adults with hip fractures were vitamin D deficient. The researchers note that in Western countries with seasonal winters, D deficiency is common due to the reduction in sunlight. But on measuring serum vitamin D in fracture patients in sunny Singapore, they found that 57.5% were suffering deficiency and 34.5% were suffering insufficiency. Only 8% of the patients had normal vitamin D levels.
One might ask why people residing in a sunny, predominantly tropical climate would have such a high degree of vitamin D deficiency and consequently high fracture risk. Further study found the answer: Most of the people who suffered fractures had been housebound and had little sun exposure. The authors of the paper made the following statement: “Another factor was Malay ethnicity (dark skin, which inhibits vitamin D production), and clothing habits that prevented sun exposure.”
The authors of the paper concluded with this statement: “Vitamin D deficiency and insufficiency are common in patients with hip fracture in Singapore. Vitamin D deficiency was associated with being housebound and those of Malay ethnicity. Clothing habits resulting in reduced sunlight exposure may increase the risk of vitamin D deficiency.”
The same pattern of high D deficiency also exists among youth in some sunny countries; in Qatar deficiency is common.  Sixty-eight percent of the children there are deficient and the girls are especially likely to be deficient. Low duration of time spent outdoors is a major predictor of deficiency, and the children who are deficient suffer a greater incidence of rickets, fractures, and gastroenteritis.
And finally, I would like to remind the readers of research from Spain that I have cited on various occasions. Women who spend their time indoors are about 11 times more likely to have a fracture as those who regularly seek the sun.
A major message is this: If the sunlight is all around you and you don’t expose yourself to it, it will do you no good. You may a well live in the Arctic Circle.
Carefully embrace the sun and save your bones.
 Ramason R, Selvaganapathi N, Ismail NH, Wong WC, Rajamoney GN, Chong MS. Prevalence of vitamin D deficiency in patients with hip fracture seen in an orthogeriatric service in sunny Singapore. Geriatr Orthop Surg Rehabil. 2014 Jun;5(2):82-6
 Bener A, Al-Ali M, Hoffmann GF. High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatr. 2009 Feb;61(1):15-22.
 Larrosa M, Casado E, Gómez A, Moreno M, Berlanga E, Ramón J, Gratacós J. Vitamin D deficiency and related factors in patients with osteoporotic hip fracture. Med Clin (BARC) 2008;130:6-9.