THE importance of vitamin D in our diets has been highlighted by health experts in the past few months as they raised concerns about the growing incidence of vitamin D deficiency amongst the UK population.
Despite the recent summer heatwave, our diets and the lack of year-round sunlight means the UK has been described by health professionals as being in the midst of a vitamin D epidemic.
In fact, the situation has worried the Royal College of Paediatrics and Child Health (RCPCH) so much that the organisation recently set up a campaign to tackle the levels of deficiency in the UK.
Vitamin D is a vitamin and pro-hormone which our bodies naturally produce by synthesising ultraviolet light from the sun. It is required in the body to make proper use of calcium for stronger bones and teeth and maintain a healthy immune system.
A recent global study of more than 155,000 people by University College London scientists found a direct link between vitamin D deficiency and hypertension, which raises the likelihood of stroke and heart attacks.
Researchers used genetic variants known as single nucleotide polymorphisms, or SNPs, to reflect an individual’s vitamin D status in order to test for an association with hypertension.
The research found that for every 10% increase in vitamin D concentrations, there was a 8.1% decrease in the risk of developing hypertension, leading to a strong suggestion that some cases of cardiovascular disease could be prevented through vitamin D supplementation.
The RCPCH has said that steps needed to address the problem included widely available and low-cost vitamin D supplements, fortification of foods, greater knowledge amongst healthcare professionals and better public awareness.
In fact, according the RCPCH, recent figures suggest a four-fold increase in incidents of rickets over the last 15 years. Vitamin D deficiency is a particular problem amongst children and young people and pregnant women.
Professor Mitch Blair, officer for health promotion at the RCPCH, said: “We know vitamin D deficiency is a growing problem – and localised research reveals startling high levels of vitamin deficiency amongst certain groups including children.
“People can only get a fraction (10%) of their recommended daily amount of vitamin D through food and very little from sunlight. So getting out in the sun more or eating more oily fish isn’t going to solve the problem. Lack of vitamin D is related to a plethora of serious illnesses in children and adults that could be prevented through relatively simple steps such as taking supplements.”
Professor Blair said it was vital that the uptake of vitamin D supplements improved.
He said: “Ensuring people are aware that they’re available is crucial – and there is some evidence to suggest we need to make these supplements more readily available for the wider population, which is already happening in some countries.
“And equally as important is making sure that all healthcare professionals can spot the signs of vitamin D deficiency in children; aches and pains, poor growth, muscle weakness and seizures – and make sure they get appropriately treated.”
Just last month, health experts in Wales warned they were seeing rising numbers of rickets – linked to vitamin D deficiency –as a result of poor diets.
Specialist dietician Sioned Quirke said reliance on fast food was leading to poor nutrition and a lack of essential vitamins, causing a rise in conditions last commonly seen during the early 20th century.
Ms Quirke, who is based in the Rhondda Valley, said: “Definitely for some population groups, diet has reverted back to being as poor, certainly when it comes to nutrition, as it was 100 years ago.
“If you think about a typical family 100 years ago in Wales, then they would have had very poor diets in minerals and nutrition as fruit and vegetables were not readily available and if they were, it was not very affordable. They would only be able to have the cheaper cuts of meat, but convenience foods also use poor quality meat.
“The difference between now and then is that this is out of choice. People say that fruit and vegetables are not affordable, when in fact they are.
“We are starting to see increasing numbers of childhood diseases, which we had thought had gone, making a return.
“Rickets and scurvy are coming back. When I was training 10 years ago we were told about these as past conditions and thought we would not come across it, but we’re now seeing more cases.
“These conditions are long-term. If the bones are affected by vitamin deficiency then they are affected for life. If that does not improve people’s quality of food, I don’t know what will.”
Studies have revealed that vitamin D supplementation in the elderly is associated with reductions in the risk of falls (19%) in doses above 800 units daily, while another study indicated a reduction of hip fractures of 30%.
Last year, Dr Steve Davies, a consultant endocrinologist at University Hospital of Wales in Cardiff, led a study to produce the first ever treatment guidelines for the condition in the light of more than 30% of the population being recorded as being deficient in the hormone.
He said that there could be a “huge economic benefit” to the NHS in Wales and the rest of the UK if the problem was tackled.
The first all-Wales medical guidelines by the Welsh Endocrine and Diabetes Society – produced by Dr Davies with Dr John Harvey, of the North Wales Clinical School, Dr David Price, from Swansea University, and Dr Carol Evans, from Cardiff University – is aimed at helping diagnose and treat the swelling number of patients with vitamin D deficiency.
“Currently, hip fractures in the elderly costs the NHS approximately £1.1bn,” he said.
“If we could reduce that by 30% through the use of vitamin D – which in medical terms is quite inexpensive – that is a significant cost benefit to the NHS. We are trying to create a consensus from the current chaos with regards to the management of vitamin D deficiency. The condition is common and presents considerable problems in the young and elderly.
“As a consequence, we wanted to develop a commonsense approach that would guide health professionals in diagnosis and appropriate treatment.”
He said that increased awareness of exposure to the sun – while welcome – had a likely impact upon the development of vitamin D deficiency.
“Now we are looking at the 30% of the population that are deficient – because the public health campaign with regards to exposure to sunlight has been so successful,” Dr Davies said.
“It has taught us to avoid excessive sun exposure – but, we also manufacture less vitamin D and this can cause vitamin D deficiency particularly in certain groups like the elderly or those with dark skin.
“Also we now appreciate that at our latitude, sunlight is often inadequate to generate sufficient vitamin D between September to May, so there is only a small summer window to produce vitamin D.”