The review, published in The Food and Nutrition Journal, shines a light on the mounting evidence pointing to the importance of the sunshine nutrient for our health and wellbeing.
The authors also find worrying gaps in the UK’s vitamin D levels, pointing to research showing that amongst 210,502 patients who had a vitamin D test, one third were deficient (with deficiency identified as a blood level below 30 nmol/litre).
“Closing the gap between vitamin D intakes and recommendations is an imperative to prevent deficiency, and maintain bone and muscle health, particularly to prevent nutritional rickets and osteomalacia,” says co-author of the review and HSIS nutritionist Dr Pamela Mason.
Amid the evidence, the researchers looked at the latest government findings derived from the National Diet and Nutrition Survey (NDNS) data, which reveal that one in five people in the UK are deficient in vitamin D including: 10% of children aged 4-10 years, 26% of 11–18-year-olds, 17% of adults aged 19-64 years, and 13% of adults 65+ years.
HSIS GP Dr Nisa Aslam, also a study co-author, adds: “It is crucial to prevent deficiency and ensure that 25(OH)D levels are at least 25 nmol/litre, and possibly even 50 nmol/litre. This can be achieved reliably only by vitamin D supplementation across the population.”
The UK recommends a dose of 10 mcg daily to achieve a serum concentration of 25(OH)D of at least 25 nmol/litre, but the authors argue that in Europe and the US, where the target level of 25(OH)D is more than 50 nmol/litre, data suggest that 10 mcg daily of vitamin D would allow only approximately 50% of the UK population to achieve the European target.
The authors say the research shows people need to take 25 mcg of vitamin D daily to achieve the European target level of more than 50 nmol/litre in 97.5% of the UK population.
Why the gap matters
“Vitamin D is essential for calcium absorption and bone mineralisation, which is positively associated with bone mineral density,” says Dr Mason, adding, “Good bone health is essential for consolidating bone mass in adulthood and reducing the risk of osteoporosis in later life.”
In fact, many of the vitamin D guidelines globally are based on vitamin D requirements for bone health.
Low vitamin D status (less than 50 nmol/litre) also speeds up bone turnover, bone loss and osteoporotic fracture (De Martinis et al, 2021).
Besides bone health, not getting enough vitamin D can negatively impact muscles, immune function, susceptibility to autoimmune conditions such as type 1 diabetes, systemic lupus erythematosus (SLE) and rheumatoid arthritis, gut microbiota, respiratory system and susceptibility to cardiometabolic disease.
The review notes the wide body of research on the impact of vitamin D supplementation on extra-skeletal functions such as gut, cardiometabolic and respiratory health has generated positive findings.
How to bridge the gap
Our bodies can most efficiently produce vitamin D when we expose our skin to sunshine but UK residents fail to get enough sun exposure to meet their needs and achieving the UK recommended daily intake of 10 mcg vitamin D from food alone is highly challenging.
Dr Mason explains: “Very few foods contain vitamin D and oily fish, such as salmon and mackerel, would need to be consumed several times a week if not daily to meet the daily 10 mcg recommendation. This isn’t acceptable to everyone, and only a few foods, such as some cereals and dairy alternatives, are fortified. Supplementation would therefore appear to be the best way to achieve recommended 25(OH)D levels."
The authors say that encouraging the whole UK population to take the 10-mcg recommended daily dose of supplement would allow most people to achieve 25(OH)D levels of 25 nmol/litre.
Dr Pamela Mason concludes, “Vitamin D is cost effective and easy to take. Additionally, supplementation offers potential cost savings to the NHS. Healthcare professionals are in a position to routinely advise patients to take a 10-mcg daily supplement and to increase their intake of vitamin D containing foods. Advice needs also to be reinforced through care homes, local parenting and community groups and via faith groups.”
HSIS
HSIS works with a panel of independent diet and nutrition experts to present the facts about food supplements in a simple, straightforward way.
HSIS experts are trained professionals working as nutritionists and dietitians. They also produce reports and publish research on nutrition and health. They regularly provide comment and information to journalists who are writing about food supplements issues and are available for interview on request.
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Source: Food & Nutrition Journal
https://doi.org/10.29011/2575-7091.100166
Vitamin D: The Challenge of Bridging the Gap and the Rationale for Supplementation
Mason P, Aslam N, Jenkins G