Many of us are lacking a nutrient that could be vital to protect the body against a range of illnesses. Could you be at risk too?
FOR YEARS we’ve been told to cover up, stay out of the sun and slap on factor 50 to protect ourselves against skin cancer but now some experts are admitting that overdoing the “safe-sun” message could contribute to a new health epidemic – vitamin D deficiency.
As well as osteoporosis, low levels of vitamin D have been linked to a range of serious conditions from heart disease to diabetes.
To find out the truth, Good Housekeeping magazine asked 12 randomly chosen staff members to undergo a blood test to check their levels. The tests were carried out by Harley Street GP Dr Richard Cooper. To his and their disbelief every one of these apparently healthy women had low blood levels of vitamin D and nearly half of them were clinically deficient.
Experts consider a blood level of 75 and over (measured in nmol per litre) to be the optimal level of vitamin D. Anything below 25 is classified as clinically deficient.
None of the volunteers, aged from 24 to 63, had vitamin D blood levels even approaching 75. The two with the highest scores had just returned from sunny holidays and some of the volunteers had scores below 25.
Good Housekeeping’s Dr Sarah Jarvis was stunned when she discovered her own level was low.
“I was absolutely horrified and really shocked, particularly by my own results,” she says. “I actively avoid sunbathing and burning but I don’t avoid being outside. I’ve been aware for a while there is an issue with vitamin D and that it could be a ticking time bomb for osteoporosis in later life.
“It has made me rethink the way I look at my patients. On a personal level I am so deficient that I am now having injections to get my vitamin D levels back to normal. Then I will think seriously about taking supplements.”
There’s growing evidence these results are a snapshot of what is happening among women in general.
Studies show that around half of us have inadequate vitamin D levels and during winter and spring one in six is severely deficient even at the very low minimum level set by UK authorities.
For the first time in many years cases of childhood bone disease rickets, which is caused by vitamin D deficiency, are on the rise. So what’s the explanation?
Unlike other nutrients where our intake comes almost exclusively from food we get around 90 per cent of our vitamin D from the action of sunlight on our skin.
For a variety of reasons we’re not getting nearly enough, says professor of endocrinology at Newcastle University Simon Pearce.
“Appropriate sunlight exposure is key for vitamin D synthesis and the sun-safe message has been overstated,” he says.
“Other important factors are that women in particular are unlikely to work outside and people are eating far less fish which is a good source of vitamin D.”
It’s hardly surprising levels are low when sunlight is so scarce, especially in the north of Britain.
Scotland gets only a little more sun than Eskimos inside the Arctic Circle but without the same vitamin D-rich fish diet.
Vitamin D
Anthony Norman, professor emeritus of biochemistry at the University of California, says: “Vitamin D has been shown to play an important role in the immune system, the heart and blood vessels, the pancreas, muscle development and brain development.”
A study last year funded by the Medical Research Council (MRC) found vitamin D has a direct influence on 229 genes involved in disease, particularly those associated with multiple sclerosis, Crohn’s disease and type 1 diabetes. Scientists at the University of Copenhagen found the vitamin plays a crucial role in activating our immune defences.
Who is at risk?
The Government already recommends supplements for pregnant and breastfeeding mothers, children under four, people over 64 and those with darker skin or whose skin is not exposed to the sun very much.
People of African or Asian origin are particularly vulnerable as they need more sun to make the same amount of vitamin D.
Older people have a reduced ability to make vitamin D and people who are obese are also at greater risk.
What we don’t know
There are still many unanswered questions. How much vitamin D we need on a daily basis is a complex issue. Age, weight and skin colour can all affect the amount that we might need.
Unlike other countries the UK has no recommended daily intake level for people aged four to 65.
The Government’s Scientific Advisory Committee on Nutrition’s working group is reviewing the evidence and this will form the basis for new UK recommendations which are expected later this year.
Professor Pearce thinks we need to add vitamin D to food, particularly milk and orange juice.
How much sun is enough?
The current advice is to spend a few minutes outside in the middle of the day regularly without sunscreen.
Again there is no standard answer as the level of sun exposure needed to make enough vitamin D depends on your skin type, amount of skin exposed, time of day, latitude, altitude and cloud cover.
However our need for vitamin D isn’t a green light to fry in the sun.
Vitamin D production stops well before the skin starts to become red so never allow your skin to redden or burn.
Darker-skinned people will be able to spend more time in the sun than those with fairer skin who burn more easily.
What is now needed are large-scale clinical trials that use high doses of vitamin D to raise blood levels while measuring the impact on disease. The good news is that it’s starting to happen around the world.
What it means for you
“While we shouldn’t overreact, the impact of vitamin D on bone health is a certainty and on that basis alone those with lower levels need to address the issue,” says Dr Cooper.
Although vitamin D is found in fortified margarines, oily fish, eggs and some breakfast cereals, food is only a small part of the equation and anyone who gets very little sun should consider supplements.
Current UK advice is that taking up to 25mcg of vitamin D3 daily is safe. It can also be taken in liquid form.
- Similar posts
- New skin cancer treatment on the way (11.6%)
- Vitamin D and diabetes (9%)
- Friends & family can detect Alzheimer's better than testing (8.8%)
- Fish oils (8.8%)
- British black raspberry benefits (8.8%)
All UK schools should be required to have a comprehensive sun safety policy to protect children from skin cancer, a charity campaigner says.
A recent survey of 1,000 parents, commissioned by MPs on the All-Party Parliamentary Group on Skin, found almost 40% of pupils have suffered sunburn while at school.
Richard Clifford of Skin Cancer UK says this is “entirely unacceptable” and wants mandatory sun rules for schools.
Current guidelines are not compulsory.
The call comes as parents of a 10-year-old girl who attends a school near Swansea complained their daughter had suffered severe sunburn at a sports day.
Pennard Primary School said parents could come in at lunch-time to apply cream, but that it would be impossible for teachers to apply suncream to the 200 children attending the school.
Advice from the National Institute for Health and Clinical Excellence (NICE) says schools should encourage children to seek shade whenever possible, particularly when out playing in the midday sun.
And it says sunscreen (of at least SPF 15 strength) should be applied liberally half an hour before and after going out in the sun and reapplied every two hours thereafter.
Nurseries and pre-schools have higher staff-child ratios to deal with such demands.
But what is not clear is exactly how schools are expected to deliver this.
Mr Clifford said: “Admittedly teachers cannot be expected to apply sunscreen due to simple time pressures.
“There is also the inevitable question regarding their concerns over child abuse and the strong advice they receive from local authority education departments and trade unions.
“However, there is no reason whatsoever why they should not supervise the application, perhaps with the assistance of the school nurse or indeed parents who attend on a pre-arranged rota system.”
NICE suggests parents could provide sunscreen for their children who could, in turn, be taught how to apply it for themselves and their school-friends.
The guidelines also recommend schools run awareness campaigns to alert children to the harms of too much sun exposure.
But Mr Clifford says in reality too few do.
“Instead, it is left to the individual teacher to decide as to whether or not to introduce the subject of UV awareness. This is simply not good enough.”
Cancer Research UK has produced information to help schools develop a sun safe policy, but so far only 621 English primary schools have registered to receive this sun protection policy pack.
Dr Claire Knight, health information officer at Cancer Research UK, said: “It’s important that children are protected from sunburn while at school.
“Children have delicate skin and getting sunburnt as a child increases the risk of skin cancer later in life.”
Prolonged over-exposure to the sun and episodes of sunburn under the age of 15 are major risk factors for skin cancer in later life.
The British Association of Dermatology estimates that four out of five skin cancer deaths are preventable.
Dr Knight said: “Cancer Research UK encourages schools to develop their own sun protection policy, and recommends that children should be allowed to bring sunscreen of at least SPF 15 with four or five stars into school and be supervised whilst applying it.
“Using shade and clothing is also crucial to any policy designed to promote the safe enjoyment of the sun.”
It’s no secret we’ve been somewhat starved of sunshine so far this summer.
Now a range of supermarket products aims to tackle the health problems caused by a lack of ‘sunshine’ vitamin D.
The line of fortified milk, yoghurt and fruit juices at Marks & Spencer is due to be extended across much of the country in time for autumn.
It contains other nutrients such as calcium and omega 3 and costs the same as equivalent products.
Vitamin D – found in fresh oily fish, liver and eggs – is the only vitamin produced by the body, but it is mainly formed by exposure to sunlight and many Britons do not have enough of it.
Deficiency leads to diseases such as rickets in children to brittle bones in the elderly. Low levels are also linked to a higher risk of heart disease, cancer and diabetes.
M&S says the Simply More range has proved a success since its launch in select stores in spring, with the prune-flavoured yoghurt outselling standard varieties.
Vitamin D strengthens teeth and bones, and studies suggest it may help to prevent Alzheimer’s. In England, half the population is low in vitamin D when winter ends. In Scotland the figure is as high as two-thirds.
Margarine has been fortified with vitamin D since 1940, and Government
scientific advisors last year proposed adding it to milk too.
M&S nutritionist Claire Hughes said: ‘We want to make it as easy as
possible for our customers to stay healthy and get their daily dose of
vitamin D without having to worry about getting out in the sunshine.’
Registered dietitian Ursula Arens said some breakfast cereals have been fortified with vitamin D for more than a century. She added: ‘There has been a wave of interest recently in vitamin D, and people who are being encouraged to increase their intake may well see health benefits from consuming these kind of products.’
A study has concluded that giving vitamin D3 (cholecalciferol) to predominantly elderly women, mainly in institutional care, seems to increase survival. These women are likely to be vitamin D deficient with a significant risk of falls and fractures.
Until now there has been no clear view on whether there is a real benefit of taking vitamin D.
“A Cochrane meta-analysis published only a couple of years ago found that there was some evidence for benefit, but it could not find an effect on mortality. We were, however, aware that more trials had been published and wanted to assess the effects of vitamin D when you added all the data together,” said Dr Goran Bjelakovic, who works at Department of Internal Medicine – Gastroenterology and Hepatology, at the University of Nis, in Serbia and at The Cochrane Hepato-Biliary Group at The Copenhagen Trial Unit in Copenhagen, Denmark.
The eight-strong international team of researchers identified 50 randomised trials that together had 94,148 participants.
“Our analyses suggest that vitamin D3 reduces mortality by about 6 pc. This means that you need to give about 200 people vitamin D3 for around two years to save one additional life,” said Bjelakovic.
The rate of men dying from malignant melanoma – the deadliest form of skin cancer – has doubled over the past 30 years, according to new research.
More men and women are being diagnosed with malignant melanoma than ever before, with over 10,000 new cases being diagnosed each year.
But whilst women are being diagnosed with the potentially life threatening skin cancer, more men are dying from it.
Since the 1970s, death rates for women have risen from 1.5 per 100,000 to 2.2 per 100,000.
But, according to figures released by Cancer Research UK, fewer than 400 men died from melanoma thirty years ago compared with more than 1100 men now, representing a bigger jump in death rates from 1.5 to 3.1 per 100,000 men.
However, the highest death rates have occurred in men over the age of 65 which have soared from 4.5 per 100,000 to 15.2 per 100,000 since the late 70s.
The figures suggest that men are either unaware of the early signs of malignant melanoma or are more reluctant to get them checked out by their GP.
Caroline Cerny, Cancer Research UK’s SunSmart manager, said: “To curb this huge rise in deaths from malignant melanoma it’s more important than ever that people are aware of the dangers of too much sun.
“Too often men leave it up to their partners or mothers to remind them to use sunscreen or cover up with a shirt and hat and even to visit the doctor about a worrying mole.
“It’s crucial that people go to their doctor as soon as they notice any unusual changes to their skin or moles – the earlier the cancer is diagnosed the easier it will be to treat.”