The Vitamin D Warning – Could you be affected?
Over the last few years, vitamin D has become a
popular topic in the UK media and has had increased interest in the medical
world and there is a very good reason why.
Vitamin D deficiency has been on the increase for both adults and
children in the UK over the past decade. Even if an actual deficiency is not
present, 1 in 5 adults and 1 in 6 children in England, are still considered to
have inadequate / low vitamin D levels and this is concerning! Like all
vitamins and minerals, vitamin D is vital for optimum health. Its association
with healthy bones is well known, yet it plays just as critical a role in a
variety of other bodily processes and functions. Therefore if you are not
getting enough, your body will, over time, suffer the consequences. So how do you
know if you are low in Vitamin D or even deficient in it and what can you do to
help make sure you vitamin D levels are kept topped up throughout the year?
Read on to find out.
What is vitamin D?
Vitamin D is a vital nutrient and is one of the
thirteen vitamins required for good health. It is one of only four fat soluble
vitamins which, unlike water soluble vitamins, are ones which can be stored in
the body’s fatty tissues and liver. We therefore don’t need to consume it, or
be exposed to vitamin D sources daily as our body does have a reserve which can
be used as and when the body requires it. As you will read later though, these
reserves are generally not enough to get us through the winter months unless we
are lucky enough to get some winter sunshine holidays in too.
Why is vitamin
D so important?
One of the biggest roles of vitamin
D in the body is that it helps the absorption of calcium. Without vitamin D,
calcium from food and supplements cannot be absorbed and thus one of the most
well-known diseases associated with vitamin D deficiency is rickets (soft, thin
bones) and osteoporosis. Planted is fortified with
calcium to similar levels as dairy milk, so by incorporating Planted in your
diet you can be assured it will help maintain your calcium requirements. Over
the last few years however, scientists have discovered that vitamin D actually
plays a far greater role in our health than first realised and has shown to be
vital in healthy immunity, respiratory function and cardiovascular health. Vitamin
D deficiency has also been increasingly linked to some cancers, mental health
problems and diabetes as well as autism. It is therefore not hard to see why
this little vitamin is now currently in the spotlight.
Symptoms and signs of vitamin D deficiency
Not
everyone with a deficiency in vitamin D will experience symptoms and sometimes
the symptoms which can occur, can be very subtle so may not be noticed
immediately, but start to display themselves gradually over time. The most
common symptoms associated with vitamin D deficiency are joint, muscle or bone
pain which can lead to a feeling of weakness in the affected areas, as well as
general tiredness and fatigue. There is also a big link between vitamin D
deficiency and depression (including increased risk of suicide), so if
you are suffering from prolonged low mood or depressive symptoms this is
something that may be worth investigating further.
Hair loss can be another sign of
Vitamin D deficiency, especially in those people where levels have been low for
a greater length of time. Another lesser known symptom of low levels of Vitamin
D is an impaired immune system, which can lead to people being more susceptible
to illness and infection. In fact people with low Vitamin D levels and
deficiency can often suffer with reoccurring illness or illness that they just
can’t ‘shake’ off, they may also find that any wounds they get are slow to
heal. So if this describes you, it may be worth asking your GP for a vitamin D
test.
Who is most at risk of deficiency?
Although vitamin D deficiency can occur in anyone and
across all age groups, there are some people within the population who are at
an increased risk of deficiency. These include:
- Children under the age of 5
- People aged 65 and over
- Pregnant and breastfeeding women
- People who have minimal sun exposure, for example those people who are housebound, those who infrequently spend time outdoors and those people who cover up their skin with clothing.
- People with darker skin such as those from Asian, African or African- Caribbean origin have more melanin in their skin compared to those with fairer skin. This increased melanin slows down vitamin D production.
Where can we get vitamin D from?
An estimated 90% of our vitamin D requirements comes
from sunlight, which is certainly problematic for those of us living here in
the UK. The fact that our Vitamin D stores rely almost totally on our exposure
to sunlight, goes some way in explaining why deficiency rates of vitamin D are
high in the UK. With the increased awareness of skin cancer, people are now
more proactive in their sun cream usage especially with children. This of
course is vital and necessary, but is not great if used excessively or for just
small ten minute outings as it stops vitamin D production. A small amount of
sun exposure without sun cream protection is OK, but make sure you cover up and
use sun cream before you turn red or begin to burn.
British winters are particularly problematic due to
reduced sunlight and the fact that between October and April time, the sunlight
we do get is of the wrong wavelength to actually create vitamin D in the skin.
This is why vitamin D deficiency increases during the winter months, especially
in those already in the ‘at risk’ groups stated above. The recent cross-sectional National Diet and
Nutrition Survey reveals that 8.4% of UK white 19–64 years old have vitamin D
deficiency (< 25 nmol/L) in the summertime, which rises to 39.3% in the
winter months. Results of another recent study show that in the right
conditions white Caucasians in the UK need nine minutes of daily sunlight at lunchtime
from March to September for Vitamin D levels to remain ≥25 nmol/L throughout
the winter months. So this highlights the importance of stepping outside in
your lunchbreak during the summer months and soaking up those rays as much as
you can, or at least 9 minutes of it daily!
Can we get
vitamin D from food?
Most other vitamins and minerals can be gained
abundantly through the foods we eat, however this is sadly not the case when it
comes to vitamin D. We are not able to get all of the vitamin D we need from
food sources alone, which is why some sun exposure or even supplementation may
be necessary. However knowing which foods are good sources of vitamin D and
increasing these in your diet will definitely help. Here are the top four for
you to add to your shopping basket:
Eggs. Vitamin D in eggs is found only in the yolks so make sure you eat the entire egg!
Oily fish
such as salmon, herring, mackerel, sardines and trout. Wild fish has a higher
source of vitamin D than farmed fish, however, unfortunately it is farmed fish
that is most commonly sold in the UK, but do keep a look out for wild varieties
as it is increasingly available at all main supermarkets and far tastier too!
Portobello
mushrooms. Only mushrooms which are exposed to sunlight when growing are
good sources of Vitamin D and Portobello ones are the highest vitamin D source
in the mushroom world.
Fortified
Foods. These include milk and fortified milk alternatives, some cereals,
plant based products, cheese and spreads which often have vitamin D added to
them. However the amounts of vitamin D present in these types of products can
vary.
Do we need to
take a vitamin D supplement?
In 2016, Public Health England
(PHE) published new guidelines on vitamin D, which came as a direct result of
the increased incidence of low vitamin D levels in the English population. The
guidelines now state
that adults and children over the age of one should have 10
micrograms (mcg) of vitamin D EVERY day. This means that some people may want,
or indeed need, to consider taking a daily supplement.
For babies under the age of one year old who have more than 500ml (approx.
about one pint) of infant formula a day, no supplementation is required as this
formula milk is already fortified in vitamin D. For babies of this age who are
not on infant formula and are breastfed (which the government still recommends
exclusively until around 6 months of age if possible) then the new guidelines
also state that all babies under the age of one year of age should have a daily
8.5-10mcg vitamin D supplement to make sure they get their vitamin D
requirement. Vitamin D drops are available for this age group.
Remember that there is a difference
between a deficiency in vitamin D and low levels of vitamin D. With an actual
deficiency in vitamin D, over the counter supplementation will not be enough
and you will generally need prescription vitamin D from your GP, which is a
much stronger form. For people with low levels of vitamin D or those wanting to
follow the guidelines above as a precautionary measure, over the counter
vitamin D supplementation is available in a variety of formats, including
tablets, sprays and liquids.
If you
were looking for an excuse to book that early summer holiday in the sunshine
then this information will help you book it guilt free, reassuring yourself you
are doing it for the good of your health. As we are only just into April,
summer is still a little way off, so if you feel your body could have depleted
stores of Vitamin D, especially after this long winter, then book yourself an
appointment at your GP.
NOTE: If you think you
may be at risk of vitamin D deficiency then please contact your GP.
RESOURCES:
·
Meeting
Vitamin D Requirements in White Caucasians at UK Latitudes: Providing a Choice,
2018. Nutrients
·
Vitamin
D and the Immune System, 2011. Journal Investigative Medicine
·
The
Role of Vitamin D in Cancer Prevention and Treatment, 2010. Endocrinology
and Metabolism Clinics of North America
·
National Institute for Health and Care
Excellence, 2014. https://www.nice.org.uk/news/press-and-media/millions-of-people-at-risk-of-low-vitamin-d-need-better-access-to-supplements-to-protect-health-says-nice
·
Public Health England. Vitamin D: All you need
to know, 2014 https:// problems
www.gov.uk/government/publications/vitamin-d-for-healthcare-professionals-and-the-public
·
Scientific
Advisory Committee on Nutrition
·
Natural Vitamin D Content in Animal Products, 2013. Advances
in Nutrition. An International review Journal.
·
NHS