Sunlight robbery: A critique of public health policy on vitamin D in the UK

Abstract

The British Isles have a very cloudy climate and as a result receive fewer hours of clear sunlight than most other industrial regions. The majority of people in these islands have low blood levels of vitamin D [25(OH)D] all year round. Few food products are fortified with vitamin D in the UK and the government does not recommend any vitamin D supplement for most adults in the UK. Diseases associated with vitamin D insufficiency such as cancer, heart disease, diabetes (types 1 and 2) and multiple sclerosis are more frequent in the UK, and particularly in Scotland, than in many other European countries and some, such as multiple sclerosis and diabetes (types 1 and 2), are increasing in incidence. Present knowledge suggests that the risk of some chronic diseases could be reduced if vitamin D intake or sun exposure of the population were increased. Yet policy and public health recommendations of the UK government and its agencies (e.g. the Health Protection Agency, the Food Standards Agency) and of Cancer Research UK have failed to take full account of established and putative benefits of vitamin D and/or sunshine. The epidemic of chronic disease in the UK, which is associated with and caused at least in part by vitamin D insufficiency, has not been adequately recognized by these agencies, and too often measures taken by them have been misguided, inappropriate or ineffective.

An estimate of the global reduction in mortality rates through doubling vitamin D levels

“…However, the members of the review committee were largely dermatologists and made many errors and omissions in their review (Grant, 2009d). Gillie (2010) discussed the situation in the United Kingdom:…”

The effects of vitamin D3supplementation on serum total 25[OH]D concentration and physical performance: a randomised dose–response study

“…Inadequate vitamin D concentrations in developed countries have been attributed to the tendency to live a sun-shy lifestyle26 by living and working indoors for the majority of sunlight hours. In some countries, such as the UK, extreme cloud cover is experienced for many months of the year,27 which reduces the amount of UVB radiation reaching the earth's surface. At northerly lying latitudes (including the UK), the sun is at a more oblique zenith angle, which results in fewer photons striking the earth per area of land,28 resulting in less of a stimulus (ie, UVB radiation) for cutaneous vitamin D synthesis.…”

“…Zittermann30 defines ‘optimum’ 25[OH]D concentration as being between 100 and 250 nmol/l, whereas the US Institute of Medicine (IoM) defines inadequate 25[OH]D concentration as being less than 50 nmol/l and suggests that there are potential adverse events associated with levels greater than 125 nmol/l. The Scientific Advisory Committee on Nutrition (SACN) and the Food Standards Agency (FSA) of the UK define deficiency as a 25[OH]D <25 nmol/l, although these policies have been the subject of recent critique 27. It must be stressed that the recommended ‘optimum’ concentrations are defined in relation to adequate bone function/metabolism and there are currently no accepted guidelines to the optimum levels to maximise neuromuscular performance.…”

Nutrition, dental caries and periodontal disease: a narrative review

“…The aim of this review is not to suggest that dietary recommendations should focus on any single micronutrient such as vitamin D, but instead to point out that proper tooth mineralization is favourably influenced by foods rich in mineralizing factors such as darkgreen leafed vegetables, cheese, milk, cod-liver oil, oyster mushrooms, eggs and certain species of wild salmon (Lu et al 2007). It is true that vitamin D can be particularly challenging to obtain with whole foods for people who avoid the sun (Gillie 2010 Boonen et al 2007). The effectiveness of supplements as opposed to whole foods has not been adequately evaluated in this regard.…”