Vitamin D is a fat-soluble vitamin and is important for the growth and development of bones and improving resistance to various diseases, apart from facilitating absorption of calcium and phosphorus. The human body produces it naturally when it’s directly exposed to sunlight but it is also found in limited foods, like oily fish, liver and egg yolk.
The latest report, released Tuesday, draws attention to significant gaps in addressing public health challenges linked to Vitamin D deficiency in India. It calls for a multi-pronged strategy including the expansion of mandatory fortification of milk and oil with Vitamin D. It has also recommended fortifying staple foods distributed through the public distribution system and improving accessibility and affordability by including its supplements in the National List of Essential Medicines (NLEM).
“The report aims to highlight the urgent need for coordinated action against Vitamin D deficiency. By addressing policy gaps, funding research, and implementing large-scale interventions, the country can work towards eliminating malnutrition and micronutrient deficiencies,” Dr Arpita Mukherjee, a professor at ICRIER and lead author, told ThePrint.
Dr Aashish Chaudhry, managing director, Aakash Healthcare and co-author of the study stressed that Vitamin D deficiency is a silent epidemic affecting millions, yet it remains largely overlooked.
“Its impact extends beyond weak bones—it weakens immunity, increases the risk of chronic diseases, and imposes a significant economic burden on families and the healthcare system,” he told ThePrint.
The report notes that several systemic challenges—including the absence of reliable government data, limited public awareness, inadequate information dissemination, insufficient food fortification initiatives, and the high cost of supplements—have further intensified the burden of Vitamin D deficiency.
“While one in five Indians suffer from this deficiency, core ministries such as the Ministry of Health and Family Welfare, Ministry of Women and Child Development and the Ministry of Ayush are yet to launch any programmes or campaigns targeting the deficiency,” it says.
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Gaps identified, key measures suggested
Vitamin D status in blood is currently assessed using the biomarker 25-hydroxy vitamin D (25(OH)D) test, which measures the amount of this Vitamin D metabolite in the blood.
In the Indian context, guidelines set by the All India Institute of Medical Sciences (AIIMS), a level below 12 ng/ml (or below 30 nmol/litre) is considered indicative of deficiency.
The absorption of ultraviolet B (UVB) rays from the sun is the primary source of Vitamin D. But the report stressed that while 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.
High levels of air pollution in urban centres not only deteriorate air quality but also block UVB radiation from penetrating the atmosphere, thereby limiting the skin’s ability to synthesise Vitamin D.
Additionally, regions with extreme climates—such as intensely hot summers or cold winters—discourage outdoor activities, reducing sun exposure. Urbanisation and rapid population growth have resulted in densely packed residential areas, where many individuals reside in high-rise buildings or overcrowded tenements with limited sunlight.
The report emphasises that contemporary lifestyle patterns have significantly curtailed outdoor movement, with most people spending prolonged periods indoors due to work and leisure habits. Cultural and social norms also contribute significantly to this deficiency—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. It has further noted 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.
Dietary limitations also exacerbate the crisis, 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.
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.
Furthermore, 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.
The report by researchers associated with ICRIER and Anvka Foundation notes that in India, food fortification efforts may be strengthened with fortification of staples such as wheat and rice, along with dairy products other than milk and edible oils, and to ensure that fortified foods reach the vulnerable through government programmes and the public distribution system.
Currently, the Food Safety and Standards Authority of India (FSSAI) permits only plant-based sources of Vitamin D for food fortification on a voluntary basis.
The document recommends permitting the use of Vitamin D derived from animal by-products—such as lanolin (wool grease)—to reduce dependence on expensive imports of plant-based sources. It suggests that such use should be permitted under strict mandatory labelling to maintain transparency for consumers.
Targeted supplementation programmes can also be integrated into maternal health initiatives, childhood immunisation schedules, and geriatric healthcare services to protect high-risk groups.
Additionally, to improve affordability, the goods and services tax on Vitamin D supplements should be reduced, it has suggested.
The report proposes that the current 10 percent import duty on Vitamin D supplements (D2 and D3) and testing kits be lowered to five percent to make them more affordable and accessible. It also calls for increased investment in domestic research and development for the production of low-cost testing solutions. These innovations, along with product reformulation, can be incentivised through subsidies, the researchers have noted.
(Edited by Radifah Kabir)
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