Role of vitamin D, in combination with calcium, indisputable
January 27, 2014 – Despite the current debate surrounding vitamin D, its role in maintaining good bone health and protecting against osteoporosis, in combination with calcium, is indisputable.
While evidence of the potential role vitamin D may play in non-skeletal conditions mounts, the New Zealand Self Medication Industry (SMI) agrees with recent editorial comments in The Lancet that large clinical studies would help to properly assess the effects of vitamin D for health conditions such as heart diseases, diabetes, cancer, dementia and inflammatory diseases.1
According to SMI executive director, Tim Roper, vitamins and supplements are not a panacea for preventing chronic disease, however, they do have a legitimate place in the wider health system and remain important for many people.
“SMI recognises that robust evidence is essential if we want to demonstrate vitamin D’s role in preventing a range of non-skeletal conditions. In the meantime, we don’t want to see people with brittle bones, as well as those at high-risk, cutting vitamin D out of their supplement routine and making themselves vulnerable to future fractures.”
Mr Roper added that for people who aren’t obtaining adequate calcium or vitamin D from natural sources, supplementation is known to be a highly effective way to fill the gap and to reduce fracture risk by up to 24 per cent.2
SMI’s recommendation is for people who are at risk of osteoporosis to speak to a qualified healthcare professional. If they are found to be calcium or vitamin D deficient, supplementation may be recommended as preventative action.
At-risk populations include: Three quarters
• People with naturally very dark skin
• People with little or no sun exposure – e.g. people who are hospitalised, living in an aged care facility or working jobs that prevent sun exposure such as shift workers, miners, or even office workers working particularly long hours
• People who cover up with long robes/head coverings because of religious or cultural reasons
• People with a malabsorption conditions
• Older adults who, due to age, cannot synthesise vitamin D as efficiently
• People who are overweight or obese.
Osteoporosis is one of New Zealand’s most debilitating and costly health problems. The condition affects one in every two women over the age of 60 and nearly one third of all men in New Zealand. For people who aren’t obtaining adequate calcium or vitamin D from natural sources, supplementation is known to be a highly effective way to fill the gap.3
In New Zealand, the recommended daily intake of calcium is between 1000 and 1300 mg per day for adults. For vitamin D, the National Health and Medical Research Council (NHMRC) consider that doses of up to 80 mcg are safe.5 Most supplements that are available in New Zealand are 25 mcg or less.
Mr Roper added that SMI, alongside several other healthcare stakeholders, is awaiting feedback on the current MBS review into vitamin D testing.
“SMI looks forward to the outcome of the MBS review into vitamin D testing. In our view, testing for vitamin D deficiency provides an opportunity for informed discussion on treatment options – that is, appropriate sun exposure versus supplementation, and their respective risks and benefits,” Mr Roper said.