ARGUMENTS FOR AND AGAINST WHOLE POPULATION SUPPLEMENTATION WITH VITAMIN D IN SCOTLAND
ARGUMENTS FOR AND AGAINST WHOLE POPULATION SUPPLEMENTATION WITH VITAMIN D IN SCOTLAND
by Catriona Lawson
1. ISSUES WHY NOT GETTING ENOUGH
1.1. Geography
1.2. Strength of sunlight
1.3. Season - less sunlight in Scotland in Autumn/Winter
1.4. Malabsorption - coeliac disease
1.5. Diet is not sufficient
1.6. Skin colour
2. DIET SOURCES
2.1. Oily fish
2.2. Cod liver oil
2.3. Milk
2.4. Egg yolk
2.5. Fortified cereal products
3. EVIDENCE THAT THERE IS A DEFICIENCY OF VITAMIN D IN THE UK
3.1. Bone mineral density measurements
3.2. Measure 25 (OH) Vit D blood serum
3.2.1. Various methods - get different results
4. VITAMIN D DEFICIENCY DISEASES
4.1. Rickets - becoming more of a problem in the UK - prevalence increasing in last 20 years. Prevalence in Nigeria.
4.2. Osteomalacia - in adults, demineralisation of bones
5. VITAMIN D2 V VITAMIN D3 - WHICH IS BETTER?
5.1. Vit D2 - ergocalciferol - plant sources
5.2. Vit D3 - cholecalciferol - animal sources
5.3. Vitamin D2/D3 studies by Tripkovic
5.4. Still ongoing Vit D2 v D3 studies - D2/D3 in biscuits
6. GROUPS AT RISK OF VITAMIN D DEFICIENCY
6.1. Pregnant women
6.2. People with dark skin from African, Afro-Caribbean & South Asian backgrounds
6.3. People confined indoors i.e. in care homes
6.4. People who habitually cover up their skin while outdoors
7. FAT SOLUBLE
7.1. Could accumulate
7.2. Problem with toxicity
8. STAKEHOLDERS
8.1. Government
8.2. Health Professionals
8.3. Food Industry
8.4. Dermatologists
8.5. Public
8.6. Pharmacological companies
8.7. Non government organisations
8.8. Media
9. EVIDENCE IN UK
9.1. Bone mineral density
9.2. Normal level of Vit D 75 ug/ml
9.3. Deficient in Vit D 25ug/ml
9.4. Insufficient level of Vit D 21-29 ug/ml
10. METABOLISM OF VITAMIN D
10.1. Sun exposure
10.2. Skin
10.3. Liver
10.3.1. 25 (OH) Vit D
10.4. Kidney
10.4.1. 1, 25 (OH) Vit D
10.4.2. Hydloxylation