Vitamin D supplements: We should all be taking them

The government says everyone over the age of one should have 10 micrograms of Vitamin D every day. Does that mean we should take supplements or can we get sufficient from the sun or the correct foods?

The simple fact is that, Vitamin D is not present in many foods, so it gets added to other foods and is available as a dietary supplement. It is also naturally created when the skin is exposed to the sun’s UVB rays.

What do the guidelines say?

Revised advice from Public Health England said that everyone over the age of one should have 10 micrograms (mcg) of Vitamin D every day - meaning that people should consider taking a supplement, particularly during autumn and winter months when it is difficult to get this amount from sunlight.

If your child is under one and exclusively breastfed or having less than 500ml of formula a day then need to have a vitamin supplement. If they are having 500ml formula a day then this is sufficient due to the fortification in formula milk, therefore a supplement is not required until a year old.

The guidelines recommend that children aged between one and four years should have a daily 10mcg supplement all year round. Additionally, in the UK, cow’s milk is generally not a good source of Vitamin D because it is not fortified as it is in some other countries.

Why do we need Vitamin D?

Vitamin D is an essential nutrient needed for strong bones and to help control the amount of calcium and phosphates in the blood, both of which are also vital for healthy muscles and teeth. Vitamin D is also said to help the prevention of many other diseases and adequate levels are also associated with other health benefits such as immunity and heart function.

It’s important at all stages in life, but particularly for growing infants, teens,  pregnant and breastfeeding women.

Vitamin D obtained from sun exposure so the problem for many British people is a lack of sunshine, particularly over the autumn and winter months. In the UK, even when the sun is out, the vast majority of us are confined to environments where there is simply not enough sunlight in which this vital vitamin can be absorbed.

In addition, people today are conscious of the risks of sun exposure and to harmful levels of UV rays, which means we spend far less time in the sun, thereby lowering the amount of Vitamin D we absorb.

We need to strike a balance between getting a safe amount of sun when the good weather does appear - and to consider taking a daily Vitamin D supplement when we’re not getting enough sunshine in our lives.

So why take a supplement?

The government says it issued the recommendations ‘to ensure the majority of the UK population has satisfactory Vitamin D blood levels throughout the year, in order to protect musculoskeletal health’.

Children aged five years and above may well get enough Vitamin D from sunlight in the summer (late March/early April to the end of September), so a supplement should not be required during these months.

However, the Scientific Advisory Committee on Nutrition (SACN) advises on nutrition and related health matters, found that from October to the end of March, the sun isn’t strong enough in the UK to produce Vitamin D and we rely on getting it from food.

Vitamin D is found naturally in foods like oily fish like salmon and mackerel, red meat, liver and some fortified cereals and spreads but it’s difficult to get the recommended amount from food alone. And it can also be difficult to get younger children to even taste oily fish and liver!

Can’t I just get enough Vitamin D from sun exposure?

It’s not known exactly how much time is needed in the sun to make enough Vitamin D to meet the body’s requirements. A number of factors that can affect how Vitamin D is made, such as your skin colour or how much skin you have exposed. It is not the same as sunbathing; the skin simply needs to be exposed to sunlight.

But, the sunlight has to fall directly onto bare skin (ie not through a window).

For a fair-skinned person, it is estimated that around 20-30 minutes of sunlight on the face and forearms around the middle of the day 2-3 times a week is sufficient to absorb enough Vitamin D in the summer months in the UK. However, for people with darker skin and the elderly, the amount of time needed exposed to sunlight to make enough Vitamin D can be much more than this. You don’t need to tan in order to get the Vitamin D you need. Exposing skin for just a short while is all that’s needed to make all the Vitamin D needed by your body in just one day. In less than the time it takes for the skin to turn slightly pink your body can produce 10,000 to 25,000 IU of Vitamin D.

Who is at risk of deficiency?

Official estimates suggest one in five adults and one in six children in England may have low levels of Vitamin D. However, it is important to know that low levels are not the same as deficiency. Although roughly one in five people have low levels, it is not accurate to say millions of people are at risk of deficiency.

People who are at risk of Vitamin D deficiency are being advised to take a supplement all year round. At risk groups include people whose skin has little or no exposure to the sun - such as the elderly, housebound and those living in a care home - or those who cover their skin when outside.

People from minority ethnic groups with dark skin, such as those of African, African- Caribbean or South Asian origin, may not absorb enough Vitamin D from sunlight – and should also consider taking a daily supplement all year round.

Can you take too much Vitamin D?

People who take supplements are advised not to take more than 100mcg of Vitamin D a day, as it could be harmful (100 micrograms is equal to 0.1 milligrams). Too much Vitamin D can lead to high levels of calcium in the blood which can cause heart and kidney problems.