In this review, reports were retrieved in which vitamin D status, as assessed by serum
25-hydroxyvitamin D [25(OH)D] levels, was measured in South African population groups with
varied skin colours and ethnicities. Healthy children and adults were generally vitamin D-sufficient
[25(OH)D level >50 nmol/L] but the majority of those aged above 65 years were deficient. A major
role for exposure to solar ultraviolet radiation (UVR) in determining 25(OH)D levels was apparent,
with the dietary contribution being minor. Limited data exist regarding the impact of recent
changes in lifestyles on vitamin D status, such as urbanisation. With regard to disease susceptibility,
11 of 22 relevant publications indicated association between low 25(OH)D levels and disease, with
deficiency most notably found in individuals with tuberculosis and HIV-1. Information on the
relationship between vitamin D receptor variants and ethnicity, disease or treatment response in the
South African population groups demonstrated complex interactions between genetics, epigenetics
and the environment. Whether vitamin D plays an important role in protection against the range
of diseases that currently constitute a large burden on the health services in South Africa requires
further investigation. Only then can accurate advice be given about personal sun exposure or dietary
vitamin D supplementation.