New vitamin D guidelines

- and an alarming need to establish responsibility

Vitamin D deficiency is a widespread problem, which increases the risk of complicated COVID-19 infections, muscle weakness, cancer, and a lot of other problems. The Danish Veterinary and Food Administration now recommends that both children and adults take vitamin D supplements throughout the entire winter period and that particularly vulnerable groups take high-dosed vitamin D supplements all year round. However, the new recommendations have not yet been included in the Danish Health Authority’s awareness campaigns for fighting COVID-19 because vitamin D appears to have ended up in a legal gap between being a foodstuff on one side and medicine on the other. According to a British study that was published earlier, there is currently an alarming need to establish responsibility in order to make sure that nursing home residents and other exposed groups get their vitamin D supplements, just like they receive their prescription medicine.

The sun during the summer period is our main source of vitamin D. Unfortunately, many people do not expose themselves to enough sunshine, and because the liver is only able to store limited quantities of the nutrient, vitamin D deficiency is a problem during the winter period. According to a press release issued by the Danish Veterinary and Food Administration, one in five Danes who is not in the habit of taking vitamin D becomes vitamin D-deficient in the spring time. Therefore, the Danish Veterinary and Food Administration has started recommending that all adults and children from the age of four years supplement with vitamin D throughout the entire winter period (from October to April). Both the Danish Veterinary and Food Administration and the Danish Health Authority also recommend supplementary vitamin D all year round for children until they reach an age of four years. The Danish Veterinary and Food Administration still recommends high-dosed vitamin D supplements all year round for pregnant women, people with dark skin, nursing home residents, and individuals who are unable to get enough sun exposure.
The new guidelines for vitamin D follow in the wake of a study of vitamin D status among Danes that was conducted by the Danish Cancer Society. An advisory working group with participants from the Danish Cancer Society together with experts and researchers from leading Danish universities and hospitals concluded that there is an urgent need to correct the population’s inadequate vitamin D status with help from supplements. Nonetheless, many people are unaware of the problem, which increases the risk of many diseases and new COVID-19 waves, and makes it more likely that the virus infections become complicated and potentially life-threatening.

Vitamin D supplements: An alarming need to establish responsibility and introduce a shift of paradigm

A British survey study of nursing home managers, private practitioners, and health professionals tried to find out where the responsibility lies for ensuring that nursing home residents have adequate levels of vitamin D in the blood. The study showed that the residents were not given supplements on a routine basis. Most of the participants in the study assumed it was the responsibility of the physicians. The nursing home managers did not feel properly equipped to make decisions regarding vitamin D or administering supplements with prescriptions. Based on their findings, the researchers behind the study concluded that there is a gap between the official vitamin D guidelines issued by the health authorities and what the nursing home residents who need the nutrient actually get. What is needed here is a shift of paradigm to make it possible to view vitamin D both as an essential nutrient and medicine for protecting the nursing home residents.
The researchers claim that the widespread vitamin D deficiency among old people may contribute to increasing the spread of COVID-19 and the likeliness that it becomes much more severe. It is a fact that nursing home residents are much more vulnerable, which is why there is an alarming and urgent need for a solution for this serious problem. The British study is published in BMJ Nutrition, Prevention & Health.

Official recommendations, actual need, and safe upper intake limit

Many experts believe that the actual need for vitamin D is a lot greater than the official recommendations in terms of optimizing blood levels of the nutrient. It depends on a number of factors such as diet habits, genes, sun exposure, age, skin type, BMI, use of cholesterol-lowering drugs, and chronic diseases like cancer and diabetes.
High-dosed vitamin D supplements with 20-80 micrograms of vitamin D are available on the market.
EU’s Scientific Committee on Food has established a safe upper intake levels for vitamin D that is 25 micrograms daily for infants aged 0-6 months, 50 micrograms daily for children aged six months to 10 years, and 100 micrograms for children from the age of 11 years and all adults, including pregnant and breastfeeding women. Vitamin D is a lipid-soluble vitamin, which means that you benefit the most from the nutrient by taking it in oil-filled gelatin capsules.

References:

Fødevarestyrelsen. Nye D-vitamin-anbefalinger til børn og voksne. Pressemeddelelse 21. december 2020

Joseph Williams and Carol Williams. Responsibility for vitamin D supplementation of elderly care home residents in England: falling through the gap between medicine and food. BMJ Nutrition, Prevention & Health. 2020

Northwestern University. Vitamin D levels appear to play role in COVID-19 mortality rates. Science Daily. May 2020

Ali Daneshkhah et al. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. medRxiv April 30, 2020

JoAnn E. Manson. Commentary. Eliminating vitamin D deficiency during the COVID-19 pandemic. A call to action. Metabolism Clinical and Experimental. July 23, 2020