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. All of the dairy products here at Delamere Dairy are a source of calcium, including our milk, yogurt and cheese products, so by incorporating these products into your diet you can be assured that your calcium requirements can easily be met. 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:
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, some cereals, yogurts, 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 about to enter 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.
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