Woods D R, Hoffman N B, Thomas W C
J Fla Med Assoc. 1989 Dec;76(12):1035-6.
Several years may be required for development of clinically evident osteomalacia in previously healthy subjects deprived of exposure to sunlight or enriched dietary sources of vitamin D. In a survey of residents of a 120 bed VA nursing home who had been patients there for two to six years, 17 were found to have x-ray or laboratory findings suggestive of the presence of vitamin D deficiency. Bone biopsy in eight of these 17 patients revealed definite osteomalacia in three patients. Thus, vitamin D deficiency may develop in confined, nonvitamin D fortified patients in Florida just as in more northern climes. Daily exposure for 30 minutes to sunshine or oral administration of 2.5 mg of vitamin D2 or D3 twice yearly has been recommended to prevent deficiency of this vitamin.