4 minute read
Vitamin boost
Find a balance
When it comes to vitamin D, many of us are not getting enough. In fact, it’s one of our most common nutrient deficiencies. So how much do you need and what can you do to up your intake?
Vitamin D deficiency affects one in four Australians. It is linked to many diseases such as cancer, bone loss, depression, diabetes, heart disease and autoimmune conditions such as multiple sclerosis. It is present in only a few foods and almost completely missing from our food intake. Yet its deficiency is underdiagnosed.
To understand the vitality of vitamin D for optimal health, we need to understand how it works in the body.
Humans obtain vitamin D from their diet or we synthesise it in the skin after exposure to UVB light.
Vitamin D on its own is inactive in the body and must undergo a series of metabolic processes to activate. Classically, we know it for its bone-building properties.
However, there are many other tissues that also express the vitamin D receptor including bone marrow, brain, colon, breast and immune cells.
These give rise to vitamin D’s non-classical actions.
One of its wonders is its ability to halt cancer growth, through reduction of cellular growth and improved cellular differentiation. As such, vitamin D deficiency is being linked to colon, prostate, breast and ovarian cancer.
Moreover, we also see these protective effects of vitamin D on our immune system. This became especially well-known in light of the Covid-19 pandemic.
It is essential to turn to dietary sources of vitamin D during the winter months when sun exposure is scarce and difficult to obtain.
We have started to learn more about vitamin D’s protective effects on our immune systems due to the increasing data linking deficiency with immune disorders such as multiple sclerosis, type 1 diabetes and Crohns disease.
We are also learning more about the mechanisms which link our immune system with vitamin D. Our immune cells can also convert vitamin D into its active forms and furthermore, they can respond to it by enhancing antimicrobial responses to diseases that enter the body.
This begs the question: to tap into vitamin D’s goodness effects, how much vitamin D do we need and where can we get it from?
At least 80 per cent of the vitamin D we need comes from sun exposure.
When your skin goes red after sun exposure, it produces the equivalent of 10,000 to 25,000 international units (IU) of vitamin D in our bodies. To put this in perspective, the vitamin D available on pharmacy and supermarket shelves contains 1000 IU per capsule.
You would need to ingest 10 capsules to get the same amount of vitamin D as you would from the sun. Sun exposure sounds like the winner here! However, most Australians don’t get enough sunlight exposure. There are many reasons for this, but one factor that has been suggested is the overuse of sunscreen.
Caution! The keyword here is “overuse”. The literature tells us that most people don’t
Jala Moushi
Melbournebased community pharmacist
use sunscreen religiously and generously enough to cause a complete block of vitamin D absorption in the skin. Nevertheless, we need a balance due to sunscreen’s protective ability against skin cancer.
The Cancer Council recommends obtaining adequate vitamin D levels in the summer just by spending a few minutes outdoors on most days of the week, when the UV index is 3 or above. After those few minutes, seek sun protection. Those with darker skin may need more time in the sun for maximal vitamin D absorption.
In winter, 2-3 hours per week is the requirement. It is essential to turn to dietary sources of vitamin D during these months when sun exposure is scarce. Dietary sources include fatty wild fish such as mackerel, herring and cod liver oil.
If sun exposure and dietary intake of vitamin D do not suffice for optimal levels, then supplements are the next option. Australian Therapeutic Guidelines recommend supplementation only for those with a confirmed vitamin D deficiency (via a blood test). Vitamin D supplementation for non-deficiency is not recommended as there is not enough evidence that it prevents long-term disease.
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