Sunshine & Gloom, Leaders’ Easters in The Daily Telegraph page 4 Monday 8th April 2012
Rain and gale force winds spoiled Bank Holiday plans for millions across the UK, including the Prime Minister David Cameron and his family who made the most of the overcast weather in North wales. The rainfall may have boosted water supply to gardens and reservoirs; however a nationwide lack of sunshine has deprived the UK workforce and their families, of the health benefits of topping up their vitamin D levels.1
Vitamin D is synthesised in the skin on exposure to sunshine, so it is not surprising that levels in the UK population are usually higher during the summer months and lower in the winter months, as body stores are depleted. However even during the summer months long office hours, indoor lifestyle, and overuse of sunscreens have contributed to an insufficiency of this key nutrient.1
According to Chief Medical Officer for England Professor Dame Sally Davies “A significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood.” Women who are pregnant or breastfeeding, those with darker skin tones, those that cover their skin for cultural reasons, together with the elderly, teenagers and those under 5 years may be at further risk of vitamin D deficiency.2
Why all the fuss?
Most of us feel better when the sun is shining. However we may not know that Vitamin D has multiple beneficial effects on the tissues, organs and systems of the body.3
Interest in vitamin D has broadened in recent years from a focus on bone health and the prevention of rickets and osteoporosis,4 to consideration of its role in cancer,5 cardiovascular disease,6 and autoimmune conditions such as multiple sclerosis.7,8 Moreover poor vitamin D status has been linked to increased mortality,9 infertility,10 diabetes,11 body weight,12 frequent infections,13 and mood disorders.14,15,16
There is some indication that vitamin D boosts performance in athletes17,18 which is newsworthy considering that London hosts the 2012 Olympics.
What can we do?
We can get more sun exposure perhaps in our lunch breaks and at weekends if the sun is shining. In the UK optimal synthesis of vitamin D occurs between May and September. Current guidelines are 20-30 minutes daily skin exposure to sunlight of the arms, legs and torso, before application of sunscreen. Sunscreen even as low as factor 8 will prevent 96% of vitamin D synthesis. Short breaks to sunny destinations are also advocated if possible. However sunbathing is not recommended and the photosensitive are advised to seek advice from GP or dermatologist.19
We can eat foods that contain vitamin D such as oily fish, dairy products, eggs and fortified foods such as breakfast cereals and fat spreads.
We can take vitamin D supplements, however since adverse effects may occur at high dosages it is advisable to seek expert advice from a healthcare professional. UK Dietary Reference Values for vitamin D are currently under review by The Scientific Advisory Committee on Nutrition (SACN) 20 and research to clarify the health benefits of vitamin D is on-going.
So now you really have a good excuse to take that short midday break outdoors when the sun is shining.
Pearce S. Diagnosis and management of vitamin D deficiency. BMJ 2010; 340:b5664.
Department of Health http://.dh.gov.uk/2012/02/vitamin-d/
Holick M. Vitamin D Deficiency N Engl J Med 2007; 357:266-281
Heaney RP The effect of vitamin D dose on bone mineral density. Osteoporos Int. 2012 Feb; 23(2):789-90.
Buttigliero C, Monagheddu C. et al Prognostic role of vitamin d status and efficacy of vitamin D supplementation in cancer patients: a systematic review. Oncologist 2011; 16(9): 1257-27.
Lavie CJ, Lee JH, Milani RV Vitamin D and cardiovascular disease will it live up to its hype? J Am Coll Cardiol. 2011 Oct 4;58(15):1547-56.
Shoenfeld N, Amital H, Shoenfeld Y. The effect of melanism and vitamin D synthesis on the incidence of autoimmune disease. Nat Clin Pract Rheumatol. 2009 Feb; 5(2):99-105.
Compston, A. Coles, A. Multiple sclerosis. Lancet. 2008 Oct 25; 372 (9648): 1502-17.
Schöttker B, Ball D, Gellert C, Brenner H. Serum 25-hydroxyvitamin D levels and overall mortality. A systematic review and meta-analysis of prospective cohort studies. Ageing Res Rev. 2012 Feb 17. [Epub ahead of print]
Lerchbaum E, Obermayer-Pietsch BR. Vitamin D and fertility-a systematic review Eur J Endocrinol. 2012 Jan 24.
Stivelman E, Retnakaran R. Role of vitamin d in the pathophysiology and treatment of type 2 diabetes. Curr Diabetes Rev. 2012 Jan 1; 8(1):42-7.
Soares MJ, Murhadi LL, et. al. Mechanistic roles for calcium and vitamin D in the regulation of body weight. Obes Rev. 2012 Mar 2. doi: 10.1111/j.1467-789X.2012.00986.x.
Khoo AL, Chai L, et.al. Translating the role of vitamin D (3) in infectious diseases. Crit Rev Microbiol. 2012 Feb 5. [Epub ahead of print].
Tariq MM, Streeten EA, et.al Vitamin D: a potential role in reducing suicide risk? Int J Adolesc Med Health. 2011; 23(3):157-65.
Cherniack EP, Troen BR, et.al. Some new food for thought: the role of vitamin D in the mental health of older adults. Curr Psychiatry Rep. 2009 Feb; 11(1):12-9.
Annweiler C, Schott AM, et.al. Vitamin D and ageing: neurological issues Neuropsychobiology. 2010 Aug; 62(3):139-50. Epub 2010 Jul 14.
Cannel J, Hollis B, et. al. Athletic performance and vitamin D. Medicine in Science & Sports Exercise 2009, 1102-1110.
Hamilton B. Vitamin D and Athletic Performance: The Potential Role of Muscle. Asian J Sports Med. 2011 December; 2(4): 211–219.
Holick M, Binkley N, Bischoff-Ferrari H, et.al. Controversy in Clinical Endocrinology: Guidelines for Preventing and Treating Vitamin D Deficiency and Insufficiency JCEM 2012 97: 1153-1158.
SACN Vitamin D http://www.sacn.gov.uk/meetings/working_groups/vitamin/index.html