scholarly journals Vitamin D Supplementation in Australia: Implications for the Development of Supplementation Guidelines

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kellie Bilinski ◽  
Peter Talbot

High rates of vitamin D deficiency and testing have been reported in Australia, yet there are few reports regarding vitamin D supplement use. Australian wholesale sales data was obtained for vitamin D supplements for the period 2000–2011. There has been a threefold increase in supplement sales over the past decade, whereby over A$94 million supplements containing vitamin D in Australia were sold during the year 2010. There were eighty-nine manufacturers that produce a variety of 195 vitamin D products. The amount of vitamin D in these products varies considerably, from 40 to 1000 IU per unit, although supplements containing only vitamin D had the highest amount of vitamin D. There was a trend for sales to increase in winter months. Given the potential public health benefits of vitamin D, there is an urgent need for a better understanding of supplementation use and for the development of supplementation.

2020 ◽  
Author(s):  
Joseph Williams ◽  
Carol Williams

AbstractIntroductionVitamin D supplements are recommended for elderly care home residents with little sunlight exposure. However, their use in care homes is limited and vitamin D deficiency in residents is widespread. This study aimed to understand perceived responsibility for the vitamin D status of residents and the determinants of current practice around supplementation.MethodsThirteen semi-structured interviews were conducted with key informants in two areas of Southern England including care home managers, general practitioners (GPs) and public health professionals. Interviews were audio recorded and transcribed verbatim.ResultsInductive thematic analysis identified four themes – medical framing; professional and sector boundaries; awareness of national guidance; and ethical and practical issues. Vitamin D supplements were not routinely given to residents, and most participants, including the GPs, believed the vitamin D status of residents was the responsibility of the GP. Care home managers felt unable to make decisions about vitamin D and vulnerable to suggestions of wrongdoing in administering over-the-counter vitamin tablets. This results in vitamin D requiring prescription by medical professionals and few care home residents receiving vitamin D supplements.ConclusionThe medical framing of vitamin D supplements in care homes is a practical barrier to residents receiving them and is out of step with public health recommendations. Vitamin D levels in care home residents could be improved through universal supplementation. This requires a paradigm shift so that vitamin D is understood as a protective nutrient as well as a medicine, and a public health as well as a medical responsibility. The failure to ensure vitamin D adequacy of residents may emerge as a factor in the spread and severity of COVID-19 in care homes and gives increased urgency to addressing this issue.KEY MESSAGESWhat is already known about the subject?Nutrition guidelines recommend elderly care home residents take vitamin D supplements as a preventative measure. This is rarely implemented in practice and vitamin D inadequacy is widespread.What are the new findings?Medical framing of vitamin D in the care sector puts elderly residents at risk of vitamin D deficiency. Vitamin D supplements are perceived as medicines requiring an individual prescription and diagnosis by a medical professional. This is out of step with public health recommendations. The system’s failure to protect the vitamin D status of the elderly in care homes may have implications in the context of COVID-19.How might these results change the focus of research or practice?Prompt a review of current guidelines and regulations in England to establish responsibility for implementing public health recommendations on vitamin D supplementation in care homes. Further research on feasibility of implementation strategies is needed.


2020 ◽  
pp. bmjnph-2020-000129
Author(s):  
Joseph Williams ◽  
Carol Williams

IntroductionDaily vitamin D supplements are recommended for elderly care home residents; however, they are rarely given and vitamin D deficiency in care homes is widespread. This study aimed to understand the determinants of current practice and perceived responsibility for the vitamin D status of residents.MethodsThirteen semi-structured interviews were conducted with key informants in two areas of Southern England including care home managers, general practitioners (GPs) and public health professionals. Interviews were audio recorded and transcribed verbatim.ResultsInductive thematic analysis identified four themes: framing of vitamin D supplements as medicines; professional and sector boundaries whereby GPs are perceived as responsible for the vitamin D status of residents and care home managers felt unable to administer over-the-counter vitamin tablets; low awareness of national guidance; and ethical and practical issues. This results in vitamin D supplements requiring prescription by medical professionals and few residents receiving them.ConclusionThe medical framing of vitamin D supplements in care homes is a practical barrier to implementation of longstanding nutrition guidelines. A paradigm shift is needed so that vitamin D is understood as a protective nutrient as well as a medicine, and a public health as well as a medical responsibility. Vitamin D is important for musculoskeletal health. Possible links with COVID-19 are still being investigated. The pandemic has drawn attention to conditions in care homes and there is an opportunity to revise current guidance on vitamin D supplementation which will have lasting benefit for this vulnerable group.


2019 ◽  
Vol 34 (4) ◽  
pp. 253-257
Author(s):  
Kimberly Lowe ◽  
Khadija Tul Kubra ◽  
Ze Yang He ◽  
Katherine Carey

For the past 15 years, cardiovascular disease (CVD) has been the leading cause of death for both men and women in the United States and worldwide. With an aging population, there has been increasing use of statin therapy to reduce the risk of CVD. However, statin-associated muscle symptoms (SAMS) remain an obstacle to this treatment, leading to discontinuation and nonadherence to statin therapy. Signs and symptoms of SAMS include muscle pain, tenderness, and increased serum creatine kinase. Despite the idiopathic pathophysiology of SAMS, some studies have shown an association between vitamin D deficiency and SAMS; the use of vitamin D supplements can lead to relief of these symptoms. The purpose of this review was to critique evidence for the association between low serum vitamin D and SAMS and the use of vitamin D supplementation for treatment.


2019 ◽  
Vol 105 (8) ◽  
pp. 791-793 ◽  
Author(s):  
Rebecca J Moon ◽  
Elizabeth M Curtis ◽  
Cyrus Cooper ◽  
Justin H Davies ◽  
Nicholas C Harvey

BackgroundPublic Health England advises 400 IU/day vitamin D supplementation for children over 1 year. Commercially available children’s multivitamin and vitamin D supplements were surveyed to determine the vitamin D content.MethodsMultivitamins and vitamin D supplements marketed at children <12 years and sold by nine UK supermarkets and health supplement retailers were surveyed. Vitamin D content was determined from manufacturer’s websites and product packaging.Results67 multivitamins were surveyed, containing 0–800 IU/day vitamin D. Only 25%–36%, depending on the child’s age, provided ≥400 IU/day vitamin D. Supplements containing only vitamin D or labelled as for ‘healthy bones’ typically had higher vitamin D content (57%–67% contained ≥400 IU/day).ConclusionsFew multivitamin products supply the recommended 400 IU/day vitamin D. Clinicians need to be aware of this when recommending vitamin D supplementation and advise parents/carers to choose a product that contains ≥400 IU/day vitamin D.


2019 ◽  
Vol 18 ◽  
pp. 153473541882205 ◽  
Author(s):  
M. Robyn Andersen ◽  
Erin Sweet ◽  
Shelly Hager ◽  
Marcia Gaul ◽  
Fred Dowd ◽  
...  

Background: Vitamin D supplements may prevent recurrence, prolong survival, and improve mood for women with breast cancer, although evidence for these effects is preliminary. Methods: This report describes vitamin D supplement use by 553 breast cancer patient/survivors (193 who used a naturopathic oncology [NO] provider and 360 who did not) participating in a matched cohort study of breast cancer outcomes. Results: We found that more than half of breast cancer patients reported using vitamin D supplements. Women who received care from NO providers in early survivorship may be more likely to use vitamin D supplements ( P < .05). Approximately 30% of breast cancer patients with blood levels recorded in their medical chart were potentially vitamin D deficient (<30 ng/mL). Vitamin D supplement use at study enrollment was associated with higher levels of self-reported health-related quality of life (HRQOL) at enrollment ( P < .05) and predicted better HRQOL at 6-month follow-up ( P < .05). Sufficient blood levels of vitamin D recorded between enrollment and follow-up were also associated with better HRQOL at follow-up ( P < .05). Conclusions: Vitamin D supplementation by breast cancer patients is common both during and after treatment for breast cancer, but deficiency may also be common. NO and conventional providers may be able to promote vitamin D sufficiency through vitamin D supplementation and by encouraging healthy solar exposure. Further studies should be undertaken examining whether vitamin D supplementation and higher blood levels might improve HRQOL among women with breast cancer in early survivorship.


2015 ◽  
Vol 20 (10) ◽  
pp. 1746-1754 ◽  
Author(s):  
Chunfeng Yun ◽  
Jing Chen ◽  
Yuna He ◽  
Deqian Mao ◽  
Rui Wang ◽  
...  

AbstractObjectiveTo evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women.DesignA descriptive cross-sectional analysis.SettingChina National Nutrition and Health Survey (CNNHS) 2010–2013.SubjectsA total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses.ResultsThe median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9–20·0, range 3·0–51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D <20 ng/ml). According to the multivariate logistic regression analyses, vitamin D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (P<0·001). In the autumn months, vitamin D deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (P<0·001). In the winter months, vitamin D deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (P<0·001) and lack of vitamin D supplement use (P=0·007).ConclusionsVitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.


2016 ◽  
Vol 76 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Aoife Hayes ◽  
Kevin D. Cashman

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.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1304-1304
Author(s):  
Norliyana Aris ◽  
Hamid Jan Bin Jan Mohamed ◽  
Wan Mohd Izani Bin Wan Mohamed

Abstract Objectives Known as ‘sunshine vitamin’, sun exposure is a major and natural source of vitamin D. This study aimed to investigate the effects of moderate sun exposure and vitamin D supplementation on vitamin D concentration among Malay women in Kelantan, Malaysia. Methods A quasi-experimental study design was carried out among female indoor workers with vitamin D deficiency (serum 25-hydroxyvitamin D &lt; 50 nmol/l) for 12 weeks to evaluate the effects of moderate sun exposure (n = 19; 15 minutes sun exposure biweekly on face, lower arms, hands and feet), vitamin D supplementation (n = 15; 50 000 IU cholecalciferol weekly) and placebo (n = 15) on serum 25-hydroxyvitamin D (25(OH)D) levels. Data was collected twice from each respondent, firstly during baseline and secondly during endpoint. Body composition measurements (body fat percentage and body mass index), fasting blood test (serum 25(OH)D level) and questionnaire (socio-demographic, physical activity and dietary vitamin D intake) were conducted. The vitamin D classification was based on the 2011 Endocrine Society Clinical Practice Guidelines. Repeated measure ANOVA within group analysis was applied. Results The baseline characteristics did not differ significantly among study groups except for age (F = 6.15, p = 0.004). After 12 weeks, serum 25(OH)D levels increased significantly in sun exposure (mean difference (MD) = 14.27 nmol/l, p &lt; 0.001) and vitamin D supplement group (MD = 14.30 nmol/l, p &lt; 0.001) but not in the placebo group (MD = 1.63 nmol/l, p = 0.067). Conclusions The 12-weeks intervention with moderate sun exposure and vitamin D supplementation showed a similar significant increment in serum 25(OH)D levels. However, no changes in serum 25(OH)D was observed in the placebo group. These results showed that sunlight exposure and vitamin D supplement were equally helpful in improving serum 25(OH)D levels in participants with vitamin D deficiency. Funding Sources Short Term Research Grant, Universiti Sains Malaysia.


2020 ◽  
Vol 8 (B) ◽  
pp. 798-801
Author(s):  
Winra Pratita ◽  
Karina Sugih Arto ◽  
Nindia Sugih Arto

BACKGROUND: Many studies have shown low Vitamin-D level as a risk factor for autoimmune diseases, especially multiple sclerosis and thyroid disease. Graves’ disease (GD) is an autoimmune disease caused by autoantibodies that stimulate thyroid-stimulating hormone (TSH) receptors by increasing thyroid hormone synthesis and secretion. Several studies report that many patients with autoimmune thyroid disease including GD have low Vitamin-D status. AIM: The objective of the study was to evaluate the effect of Vitamin-D supplement on GD patients on improvement in thyroid hormone levels. METHODS: Open random clinical trial was conducted in GD patients to determine changes in thyroid hormone to achieving normal levels between those receiving methimazole plus Vitamin-D supplementation compared with those who only received methimazole. Patients were checked for TSH receptor antibody, thyroid profile and Vitamin-D level before treatment and rechecked for thyroid profile and Vitamin-D level 3 months after treatment. t-test used to compare the drug efficacy (p < 0.05) in two groups. RESULTS: From 25 children with GD accompanied by Vitamin-D deficiency with an average value of Vitamin-D was 16 ng/mL. GD children who receive methimazole with Vitamin-D supplement had elevated TSH levels in the 3rd month of therapy that was significantly different compared to GD children who received methimazole only (p = 0.00), and the increase of TSH was also followed by an increase in Vitamin-D levels. CONCLUSION: All children with GD had Vitamin D deficiency, and the addition of Vitamin-D supplement to GD therapy would improve TSH faster than children who did not receive Vitamin-D supplement.


Author(s):  
Kaveh Tabrizian ◽  
Reyhane Shokouhinia ◽  
Fatemeh Davari Tanha ◽  
Marjan Ghaemi ◽  
Mahsa Ghajarzadeh ◽  
...  

Objective: Uterine myoma is the most common benign tumor however with significant distress and reduced quality of life in affected women. Besides, vitamin D deficiency may be a risk factor for uterine myoma. This study aimed to evaluate the effect of vitamin D supplements on the size of myoma in women with vitamin D insufficiency or deficiency. Materials and methods: This clinical trial was conducted in a teaching hospital from 2019 to 2020. According to baseline vitamin D level, participants were assigned into two interventional equal groups (vitamin D deficiency or insufficiency) to receive either 1000 IU daily or 50000 IU weekly vitamin D for 12 weeks. The size and location of the uterine myoma were compared before and after the intervention. Results: Totally, 137 women with uterine myoma were enrolled. Based on baseline vitamin D level, 52 cases had vitamin D insufficiency and 85 cases had vitamin D deficiency. No significant difference was observed in age and BMI in both groups. The location of the subserosal and intramural myoma did not differ, otherwise, the percent of the submucosal myomas were increased significantly (p=0.020) after the intervention. In both groups decreased myoma size otherwise not significant was seen after the intervention (p=0.148 and p=0.664 respectively). Conclusion: Vitamin D supplementation may not be effective in women with vitamin D insufficiency or deficiency in the short term to reduce myoma size.


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