Vitamin D deficiency is common in the older population who often have less sun exposure. In fact around 50% of UK adults have a vitamin D deficiency, which can cause osteoporosis amongst other outcomes. Here, GM editor Alison Bloomer looks at NICE's public health guidelines can provide an important step forward for health professionals tackling the condition:
Women are more prone to low vitamin D than men and due to differing weather conditions, concentrations vary in populations across the world. This means they have less than 25nmol/litre of the active form of vitamin D in their body—25 hydroxy vitamin D.
Vitamin D deficiency has been linked to a number of health issues in the past few months alone. A recent paper in the British Medical Journal found that people with very low levels of vitamin D appear to be at higher risk of death from all causes (including cancer) and it suggests that vitamin D could play an important role in cancer prognosis.1 Data were taken from seven population-based cohorts from the US and across Europe. All study participants were aged 50–79 years. Results show that there was no clear trend of vitamin D by age, but average levels were consistently lower among women than men. Average levels increased with education, were lowest in obese individuals and higher among subjects who exercised. During 16 years of follow-up, there were 6,695 deaths in 26,018 patients—2,624 from cardiovascular diseases and 2,227 from cancer.
Also last month a study presented at the British Society for Rheumatology annual meeting suggested that low levels of vitamin D in the body are linked to chronic widespread pain.2 After a follow up of 4.3 years, the researchers found that one in 15 men who had no symptoms at the start of the study developed chronic widespread pain, and these men were more likely to be obese, physically inactive, depressed and experience other health conditions.
Lead researcher Paul McCabe, said: “Musculoskeletal pain is a recognised symptom of severe vitamin D deficiency states. What is less clear is whether vitamin D deficiency has a role in explaining more common chronic pain symptoms including chronic widespread pain.”
In addition, researchers at the University of California, San Diego School of Medicine have also found that persons with lower blood levels of vitamin D were twice as likely to die prematurely as people with higher blood levels of vitamin D.3
Add to this the results of a new study published in the journal Clinical Cancer Research in May that suggested that vitamin D deficiency may be an indicator of aggressive prostate cancer.4
It is welcome news that NICE is therefore currently developing a public health guideline on vitamin D to prevent deficiency. It focuses, in particular, on advice for at-risk groups to take a vitamin D supplement including older people aged over 65 years.5
Draft recommendations include clarifying existing guidance on groups at-risk of vitamin D deficiency, increasing access to vitamin D supplements and developing a national campaign. This campaign would be to emphasise the importance of a daily supplement for identified at-risk groups and to let people know where they can get vitamin D supplements.
Along with winter flu jabs and health screens, this will be an important step forward for older patients especially as draft guidance suggests health and social care professionals should recommend a daily vitamin D supplement to people from at-risk groups at every available opportunity.