Vitamin D deficiency remains a key nutrition issue Feb 2012

Vitamin D remains high on the nutrition agenda as confirmed by recent communication from the UK’s Chief Medical Officer, Dame Sally Davies, raising awareness of the problems of vitamin D deficiency with health professionals and encouraging them to take appropriate action.

Vitamin D is essential for healthy bones through its role in promoting the absorption of calcium, which together with phosphorus and other nutrients, forms and maintains a healthy bone structure.   The classic symptom of a lack of vitamin D in children is rickets, a condition that was common in the post-war years and whilst its incidence decreased in later years, it is once again appearing as a health issue in children.

Vitamin D is found in a limited number of foods such as oily fish and egg yolk and also in fortified foods such as breakfast cereals, margarines, and infant and follow-on formula and growing-up milks.  However, a main source of vitamin D for most individuals is through the action of sunlight on the skin, which enables the body to produce vitamin D. 

Concern has arisen in recent years because vitamin D levels are being found to be at worryingly low levels and rickets has re-emerged as a childhood problem.  The reasons for these changes are that children are not being exposed to sunlight in adequate quantities, as a result of limited outdoor play, clothing that fully covers the body and use of high intensity sun screen.  Concerns about the damaging effects of intense sunlight increasing risks of skin damage and potentially skin cancers have led to a reduction in direct exposure to sunlight which in turn has limited vitamin D production in the skin.

The NHS recommends that Vitamin D supplements should be given to all pregnant and breastfeeding women, children aged six months to five years, people aged 65 and over, and people with darker skin (such as people of African-Caribbean and South Asian origin). They should be given to people who are not exposed to much sun, for example people who cover up their skin for cultural reasons, or people who are housebound for long periods of time.

Research from the Feeding for Life Foundation in its report ‘MIND THE GAP: Are the current vitamin recommendations meeting the needs of the under-5s in the UK?’ confirmed that the awareness of the recommendations for vitamin supplementation in children is low amongst both parents and healthcare professionals. These supplements are recommended for children aged 6 months to 5 years unless they are drinking 500ml (a pint) of infant or follow-on formula a day as vitamin D is added by law to these products. 

Feeding for Life Foundation Research Results

Currently the UK’s Scientific Advisory Committee on Nutrition is reviewing the Dietary Reference Values (DRVs) for vitamin D and will make recommendations.

The SACN Working Group on Vitamin D will require a risk assessment of the vitamin D status of the UK population and consideration of the:

•  biochemical indicators of vitamin D status and the validity of the threshold concentrations/ranges used to assess risk of deficiency and excess;
• association between vitamin D status and various health outcomes at different life stages and in different population groups and the effects of biological modifiers      
• contribution of cutaneous vitamin D synthesis to vitamin D status in the United Kingdom taking account of the effects of modifiers of skin exposure to sunlight; the risks of skin damage and other adverse health outcomes associated with sunlight exposure
• potential adverse effects of high vitamin D intakes;
• relative contributions made by dietary vitamin D intake (from food sources, fortified foods and supplements) and cutaneous vitamin D synthesis to the vitamin D status of the UK population.

BSNA welcomes the communication from the Chief Medical Officer and the research review being undertaken by the UK’s Scientific Advisory Committee to continue to keep vitamin D on the nutrition agenda and help to raise awareness of the issues of low vitamin D levels in certain groups of infants and young children. 

References

Advice from Chief Medical Office on Vitamin D

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_127420

Healthy Start advice on vitamin D for young children

http://www.healthystart.nhs.uk/food-and-health-tips/vitamins/

NHS advice on vitamin supplementation

http://www.nhs.uk/chq/pages/1122.aspx?categoryid=51&subcategoryid=168

Feeding for Life Foundation

 http://www.feedingforlifefoundation.co.uk/home.aspx

Scientific Advisory Committee on Nutrition Working Group on Vitamin D

http://www.sacn.gov.uk/meetings/working_groups/vitamin/index.html