scholarly journals Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health

2011 ◽  
Vol 106 (11) ◽  
pp. 1617-1627 ◽  
Author(s):  
Kevin D. Cashman ◽  
Mairead Kiely
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
National Policy ◽  
Population Level ◽  
Institute Of Medicine ◽  
Knowledge Gaps ◽  
Public Health Perspective ◽  
The Public ◽  
Adverse Health Effects ◽  
The North

The North American Institute of Medicine (IOM) recently published their report on dietary reference intakes (DRI) for Ca and vitamin D. The DRI committee's deliberations underpinning this most comprehensive report on vitamin D nutrition to date benefited hugely from a much expanded knowledge base in vitamin D over the last decade or more. However, since their release, the vitamin D DRI have been the subject of intense controversy, which is largely due to the persistence of fundamental knowledge gaps in vitamin D. These can be identified at the levels of exposure, metabolism, storage, status, dose–response, function and beneficial or adverse health effects, as well as safe and effective application of intake recommendations at the population level through sustainable food-based approaches. The present review provides a brief overview of the approach used by the IOM committee to revise the DRI for vitamin D and to collate from a number of authoritative sources key knowledge gaps in vitamin D nutrition from the public health perspective. A number of research topics are outlined and data requirements within these are identified and mapped to the risk assessment framework used by the DRI committee. While not intended as an exhaustive list, it provides a basis for organising and prioritising research efforts in the area of vitamin D, which may offer a perspective on the major areas in need of attention. It is intended to be of use to researchers, national policy makers, the public health community, industry groups and other relevant stakeholders including funding institutions.

scholarly journals Food-based solutions for vitamin D deficiency: putting policy into practice and the key role for research

2016 ◽  
Vol 76 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Aoife Hayes ◽  
Kevin D. Cashman
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Population Distribution ◽  
Population Level ◽  
Vitamin D Supplementation ◽  
Public Health Perspective ◽  
Vitamin D Intake ◽  
Dietary Reference Values ◽  
High Degree

Recent re-evaluations of dietary reference values (DRV) for vitamin D have established intake requirements between 10 and 20 µg/d. National nutrition surveys indicate that habitual mean intakes of vitamin D in the population are typically in the range 3–7 µg/d. As vitamin D supplementation will not be effective at a population level because the uptake is generally low, creative food-based solutions are needed to bridge the gap between current intakes and these new requirement values. The overarching aim of this review is to highlight how food-based solutions can have an important role in bridging this gap and counteracting vitamin D inadequacy in Europe and elsewhere. The present review initially briefly overviews very recent new European DRV for vitamin D and, while not in agreement on requirement estimates, how they point very clearly to the need for food-based solutions. The review discusses the need for traditional fortification of foods in the dairy and other sectors, and finally overviews recent advances in the area of biofortification of food with vitamin D. In conclusion, increasing vitamin D intakes across the population distribution is important from a public health perspective to reduce the high degree of inadequacy of vitamin D intake in Europe. Fortification, including biofortification, of a wider range of foods, which accommodate diversity, is likely to have the potential to increase vitamin D intakes across the population distribution. Research has had, and will continue to have, a key role in terms of developing food-based solutions and tackling vitamin D deficiency.

Legal Preparedness for Obesity Prevention and Control: The Public Health Framework for Action

2009 ◽  
Vol 37 (S1) ◽  
pp. 9-14 ◽  
Author(s):  
William H. Dietz ◽  
Alicia S. Hunter
Keyword(s):  
Public Health ◽  
Obesity Prevention ◽  
Prevention And Control ◽  
Care Delivery ◽  
Integrated Approach ◽  
Public Health Approach ◽  
Institute Of Medicine ◽  
Public Health Perspective ◽  
The Public ◽  
And Control

The Centers for Disease Control and Prevention (CDC) has focused its obesity prevention and control efforts on improving population-level health. A recent Institute of Medicine report identified systems that affect population health, to include health care delivery systems, schools, businesses and employers, communities, and governmental public health infrastructure. CDC uses the public health model to engage these systems, and this process coordinates multiple settings, sectors, and jurisdictions to develop an integrated approach to identify, prevent, and control obesity. The public health approach goes beyond medical care to prioritize policy and environmental strategies that can be implemented across jurisdictional levels, in collaboration with traditional and nontraditional partners. The process ultimately produces tools, guidelines, and interventions that can be used to prevent and control obesity. In this manuscript, we provide an overview of the public health perspective on obesity, outline the public health framework for addressing obesity, and discuss the rationale for leveraging law-based efforts as a tool to accomplish the public health mission.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

The public health approach to suicide prevention in Ireland

2021 ◽  
pp. 1-6
Author(s):  
S. Rochford ◽  
P. Dodd ◽  
C. Austin
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
Population Level ◽  
Prevention Strategy ◽  
Public Health Approach ◽  
National Strategy ◽  
Extended Phase ◽  
The Public ◽  
National Implementation

Abstract This article provides an overview of the public health approach to suicide in Ireland. The authors provide detail on the current suicide prevention strategy in Ireland, Connecting for Life, which is a whole-of-government, systemic, multicomponent national strategy. As the strategy enters its final extended phase of implementation over the period 2020–2024, the public health elements of Connecting for Life are presented, including the population level and more targeted approaches. The findings of an interim review of the strategy are discussed, in addition to the local and national implementation structures which are in place to assist implementation and monitoring of the strategy.

The role of the internet in suicide prevention from the public health perspective

2021 ◽  
pp. 683-698
Author(s):  
Michael Westerlund ◽  
Karolina Krysinska
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
The Internet ◽  
Special Focus ◽  
Public Health Perspective ◽  
Web Based ◽  
Practical Applications ◽  
The Public ◽  
Social Media Platforms

An overview of research on suicide and the internet, as well as the practical applications of online interventions in suicide prevention efforts is given. The text presents how much material about suicide is available online and what are the contents, with a special focus on pro-suicide and harmful online material and communication, and how people at risk of suicide use the internet. The topic of advantages and dangers of suicide-related material available on social media platforms will be covered. The range and effectiveness of online and web-based crisis interventions are discussed, along with support available online for people bereaved by suicide. The text also presents existing efforts on regulation and legislation in relation to suicide-related websites and content.

scholarly journals Future perspectives in addressing the global issue of vitamin D deficiency

2020 ◽  
Vol 79 (2) ◽  
pp. 246-251 ◽  
Author(s):  
M. M. Mendes ◽  
K. Charlton ◽  
S. Thakur ◽  
H. Ribeiro ◽  
S. A. Lanham-New
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Health Outcomes ◽  
Vitamin D Deficiency ◽  
Public Health Problem ◽  
Population Level ◽  
The Body ◽  
Global Public Health ◽  
Global Issue ◽  
Wide Range

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

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