An estimated 10 million people are deficient in vitamin D
The NHS board urges more people to take a supplement
Newly released research from the NHS advisory board, The National Institute for Health and Care Excellence (NICE) states that 10 million people across England are vitamin D deficient!
A deficiency in vitamin D can lead to many health problems, including rickets and brittle bones.
The health risks associated with vitamin D deficiency are far more severe than previously thought – yet the demands of modern life mean we’re getting less than ever before. Adriaane Pielou sheds some light on the issue and explains why we all need to get out more
It’s been known since the 1930s, when vitamin D was discovered, that vitamin D is crucial to the creation of strong bones, and that without its vital assistance in the absorption of calcium, they don’t grow properly. This can result in conditions such as rickets, which has seen an upsurge in the UK in the past 15 years. But more recently it has been discovered that there are receptors for vitamin D in cells throughout the body, including the brain, confirming it plays a much wider role than that.
Three of the largest studies ever undertaken, published earlier this year, carried out by the Karolinska Institute in Stockholm, the Erasmus University Medical Centre in the Netherlands in conjunction with the University of Oxford and Harvard, and by researchers at Stanford University in the US, provide an overwhelming body of evidence linking a lack of vitamin D with a range of conditions, illnesses and diseases.
We now know that babies born to women deficient in vitamin D are considerably more likely to develop diabetes or schizophrenia. Adults with low levels of vitamin D have a significantly greater propensity to die early from big killers such as cancer (particularly breast, prostate and colorectal), high blood pressure and heart disease, and to suffer from autoimmune conditions such as multiple sclerosis and rheumatoid arthritis (with the world’s highest recorded incidence of MS in the sun-starved Orkneys, where one woman in 150 suffers from it).
How to increase your D
Exposure to the sun
‘No one is saying throw away your sunscreen,’ says Dr Graeme Close, a vitamin-D specialist at Liverpool John Moores University. ‘But we need to expose unprotected skin to the midday sun for ten to 20 minutes [depending on your colouring], three days a week, from April to October, to get a UVB hit. That should create about 10,000iu of vitamin D in your body.’ Bare about 40 per cent of your skin, if possible, but take care to protect your face and other thin-skinned areas; children should only have a few minutes unprotected.
Eat the right foods
‘One of the best natural sources of vitamin D is oily fish, such as sardines. Others include egg yolks and liver,’ says dietician Jacqui Lowdon, spokesperson for the British Dietetic Association. ‘But food alone is unlikely to provide you with adequate levels. One portion of fresh salmon or tuna, say, will give you about 600iu and an egg yolk 40iu, whereas 15 minutes of sun at noon will give you about 10,000iu. Currently there’s a lot of debate surrounding vitamin D-fortified foods. We’ve been aware for decades of the importance of vitamin D in preventing bone diseases such as rickets. That’s why cod liver oil – a good source of vitamin D – was given out free during the war.’
Take a vitamin D supplement
Dr Jonathan Berg runs the City Assays Clinic at the NHS Sandwell and West Birmingham Hospital, which provides vitamin D tests (vitamindtest.org.uk). ‘The NHS can’t afford to test everyone for free, so we set up the clinic as a way of providing the service at £25 a go. We’ve tested about 80,000 people so far and 80 per cent show inadequate levels. The figure is so high there’s an argument for saving your money and taking supplements instead, as it’s likely you’re deficient.’
There seems to be no consensus, however, on how much you should take. ‘Many believe the official recommendations are overly cautious,’ says Dr Berg. He takes 1,000iu a day of vitamin D3 (vitamin D comprises D2 and D3; as a supplement, D3 is much better utilised in the body than D2), but warns that vitamin D can be toxic when levels get too high. In the US, a leading authority on vitamin D, Dr Michael Holick of the Boston University Medical Center, recommends children take 400iu to 1,000iu a day, and teens and adults, 1,500iu to 2,000iu.
Find out more
For more information on vitamin D, go to the websites of the National Institute for Medical Research; the Health Research Forum; the NHS; Nice; Cancer Research/Sunsmart; Vitamin D Council; Dr Michael Holick, and alternative practitioners Dr Andrew Weil and Dr Joseph Mercola.
Researchers were confounded when they discovered that the vitamin-D effect is so marked that people born in October and November, to mothers pregnant in sunny months, are less likely to suffer a slew of diseases and to die prematurely than those born in early spring to mothers pregnant during the dark winter months, but the statistics are incontrovertible.
Increasing levels of vitamin D have been shown to improve psoriasis, lift depression, boost recovery times of people receiving chemotherapy, increase the effectiveness of IVF and significantly decrease the incidence of breast cancer. Certain smaller studies have also shown it to be useful in protecting against Alzheimer’s.
So the message is simple: you have to have enough D. Recent studies have shown that D-ficiency is now widespread in Britain, with half the population estimated to have an inadequate level. That’s partly because of location – the further one travels from the equator, the less sunshine there is – and partly because of behaviour. Fear of skin cancer has led to many of us slathering ourselves in sunscreen every time we venture outdoors – something that is happening less and less now that so many of us spend a good portion of our lives inside, tethered to screens.
Perhaps unexpectedly, however, a low level of vitamin D isn’t just a problem in sunless northern- or remote southern-hemisphere countries. Thanks to the success of repeated warnings about the risk of skin cancer, plus high temperatures deterring people from going outside and local customs of covering up from head to toe, widespread low levels of vitamin D have been discovered in even the sunniest climes, from Gambia to India and Qatar.
In Australia, it’s now such a problem that the famous ‘slip, slop, slap’ slogan that got a generation slipping on a shirt, slopping on the sunscreen and slapping on a hat before stepping outside, has been modified to encourage people to get a daily dose of sun on bare skin. Back home, Cancer Research UK has amended its advice on unprotected sun exposure and now recommends a few minutes in the summer sun each day without sunscreen.
Interestingly, we probably wouldn’t be in this situation if it hadn’t been for a series of experiments with vitamin D carried out in the 1940s and 50s that went horribly wrong, in which patients who were fed 150,000iu to 500,000iu vitamin D supplements every day for several months died of toxicity, frightening a generation of doctors and effectively putting further research into vitamin D out of bounds for decades.
But now we do understand the benefits of vitamin D. So this year, as we pack our holiday suitcases with the usual sunscreens and protective clothing, perhaps it’s time to change the habits of lifetime and give our bodies a chance to absorb those crucial UVB rays. The cheering thing is, the remedy for D-ficiency is completely free.