Vitamin D deficiency in patients with inflammatory bowel disease.

There are over 300 000 people in the UK affected by inflammatory bowel disease (IBD). Though vitamin D deficiency is common in patients with IBD, National Institute for Health and Care Excellence (NICE) guidance regarding vitamin D supplementation does not address the needs of patients with chronic inflammatory diseases. However, there is growing evidence that vitamin D plays an important role in the management of IBD. Nurses caring for patients with IBD should have an understanding of the causes and consequences of vitamin D deficiency in this patient group. This article looks at the role vitamin D plays in the body and the challenges of treating deficiency. Consideration is given to diet, sun exposure and supplementation as possible treatments and acknowledges the limitations of treatments for patients with IBD. With a lack of clear national guidance, it is hoped that raising awareness of these issues will inform nursing practice and ensure a holistic approach to care.

Primary care management of vitamin D deficiency and liver disease.

PURPOSE: Vitamin D deficiency is one of the most common medical conditions. Up to 96% of patients with liver disease have this deficiency. The purpose of this manuscript is to educate primary care nurse practitioners (NPs) of vitamin D deficiency and its proper management in patients with liver disease. DATA SOURCES: Information was compiled by reviewing the scientific literature on cirrhosis, liver disease, and vitamin D deficiency (CINAHL, MEDLINE, PubMed search engines). CONCLUSIONS: While the usual supplement dose for vitamin D deficiency is 1000 international units (vitamin D3 ) daily, vitamin D2 supplementation at doses of 50,000 international units can be given for correction. Primary care NPs can assist patients with liver disease with optimal nutrition and vitamin supplementation. IMPLICATIONS FOR PRACTICE: Primary care NPs should be aware of vitamin D deficiency in patients with liver disease. Vitamin D supplementation may be required in high doses in those patients with a moderate to severe deficiency. Repeat 25-hydroxyvitamin D levels should be checked after supplementation is completed and yearly thereafter.

Vitamin D: new implications for mood and blood pressure.

This article reviews the 2011 guidelines for the evaluation, treatment, and prevention of vitamin D deficiency as well as the research literature evidencing an association between vitamin D, blood pressure and depression. Studies reveal an association between vitamin D levels and both systolic blood pressure and depression.

Dietary intake of vitamin D is not enough.

The National Diet and Nutrition Survey (Bates et al 2011) show adult females have low levels of vitamin D. Many women in midwives' care may be vitamin D deficient. The aim of this article is to update midwives' knowledge of vitamin D in line with their statutory role as a midwife, so they can recognise deficiency and make women aware of the consequences for themselves and their baby.

Improving protein and vitamin D status of obese patients participating in physical rehabilitation.

PURPOSE: Sarcopenia and vitamin D deficiency increase risk of disability outcomes associated with a million hip and knee replacements annually. The purpose of the present study was to identify protein and vitamin D inadequacy in arthroplasty patients, and observe the effect of supplementation on metabolic markers on protein and vitamin D status. METHODS: One hundred and eighty obese arthroplasty patients admitted for inpatient rehabilitation, positive for protein and vitamin D insufficiency, received supplemental protein and vitamin D. RESULTS AND CONCLUSION: Following supplementation, normalization of protein and vitamin D status was achieved. Nutrient supplementation during physical rehabilitation provided an efficient and effective means to reverse nutrient deficiency in an obese, orthopedic population. CLINICAL RELEVANCE: Inpatient physical rehabilitation is an opportune environment for nurses to provide education and intervention of nutrient supplementation, which may lessen consequences of sarcopenic obesity and related frailty disorders.

Vitamin D deficiency in at-risk groups.

There has been a lot of public health interest in vitamin D since the documented resurgence of rickets in children, the identification of widespread vitamin D deficiency and the growing understanding of the role vitamin D plays in the immune system. Some people are at greater risk of vitamin D deficiency than others, including babies and individuals of Asian and Black origin. This article looks at two particular aspects of vitamin D deficiency risk: skin colour and the relationship with regards to vitamin D status between the mother and infant at birth and through breastfeeding. The aim of this article is to enable the practitioner to confidently identify mothers and babies at increased risk of vitamin D deficiency.

The sunshine vitamin.

The musculoskeletal function of vitamin D has been well defined, prompting the population to supplement with vitamin D and calcium to maximise bone growth. However the role of vitamin D in pregnancy has not been systematically studied and is permeated with continuing controversy regarding the cause and effect relationship of vitamin D and pregnancy outcomes. Although further research is needed, the National Institute of Health and Clinical Excellence (NICE) (2008) recommend that all pregnant and breastfeeding women supplement with 10 microgrammes of vitamin D daily. Furthermore midwives and health visitors are asked to educate women about the importance of vitamin D supplementation, at booking and throughout antenatal care. Each appointment presents an opportunity to address concerns and explore options to increase levels through diet and supplementation and address any difficulties in obtaining supplements.

Relationship between vitamin D during perinatal development and health.

Vitamin D deficiency is a highly prevalent condition that is present in 40% to 80% of pregnant women. There is emerging evidence that vitamin D deficiency may be a risk modifying factor for many chronic diseases, including osteomalacia, rickets, multiple sclerosis, schizophrenia, heart disease, type 1 diabetes, and cancer. Heightened susceptibility to these diseases may originate in early life during the development of tissue structure and function. It is suspected that biologic mechanisms can "memorize" the metabolic effects of early nutritional environment through fetal and neonatal imprinting. Inadequate vitamin D nutrition during perinatal life may establish a poor foundation that may produce long-term threats to human health. This review summarizes the risks of vitamin D deficiency for human health and provides the current vitamin D recommendations for mothers and their newborns.

Falls in the nursing home: a collaborative approach.

Problem solving using a collaborative approach may reduce the risk of falls in the nursing home. Interventions need to be tailored to the individual's cognitive and physical impairments as well as be feasible in the particular long-term care setting. Polypharmacy, Vitamin D deficiency, delirium, and urinary incontinence are among several risks for falls that are discussed in this article.