The best food sources are fish liver oils. At this time within the U.S., approximately 98 percent of all fluid milk and evaporated milk are fortified with Vitamin D. Most dried whole milk and evaporated milk are fortified as well as some margarines, butter, selected cereals and some infant products. The milk used to make cheese is usually not Vitamin D-fortified. Vitamin D deficiency in adulthood may result in osteomalacia. It is characterized by pronounced softening of the bones, which leads to deformities, especially of the limbs, spine, thorax and pelvis.
Typical symptoms are a rheumatic type of pain and general weakness.
There may also be a waddling gait and tetany manifested by facial twitching. Although osteomalacia is seen occasionally in men, it is most often observed in women of child-bearing age who have become depleted of calcium because of multiple pregnancies and inadequate diet. Osteomalacia is frequently confused with a disease having similar symptoms, osteoporosis. Prevention of osteomalacia typically relates to an adequate supply of Vitamin D, calcium and phosphorus in the diet. Vitamin D must be assured from either sunshine, ultraviolet lamp, natural food source, fortified food source, or a concentrated supplement.