BNF annual lecture calls for greater focus on vitamin D deficiency in younger healthy populations

Today in London, Professor Susan Lanham-New, Head of the Nutritional Sciences Department at the University of Surrey, told an audience of over 100 that “there is a need to promote more awareness of vitamin D deficiency across the younger healthy populations within the UK.”

Delivering the British Nutrition Foundation’s (BNF) Annual Lecture 2019, Professor Lanham-New discussed new research that has been led by Dr Saskia Wilson-Barnes, University of Surrey, and which analyses the effects of vitamin D status on athletic performance in University-level athletes, and revealed that the results indicate that insufficient vitamin D negatively impacts predictors of jump height and aerobic fitness in these populations. Therefore, as well being related to poor musculoskeletal health, which means athletes are more susceptible to injuries like stress fractures, vitamin D deficiency may also affect athletic performance.

Vitamin D is important in bone health as it helps regulate the amount of calcium and phosphate in the body. However, it is estimated that around one in five people in the UK have low levels of Vitamin D. The body creates vitamin D from direct sunlight on the skin when outdoors but, between October and early March, the UK population will simply not get enough vitamin D from sunlight due the strength of the sun being of insufficient UV wavelength, and it is very difficult to get enough vitamin D to compensate for this from foods that are unfortified.

Professor Lanham-New explained: “There is a real need to promote more awareness of vitamin D deficiency across younger populations within the UK. It is established that vitamin D is beneficial for bone health and our studies demonstrate the importance of vitamin D for athletic performance within UK university students too. Good bone health ensures the consolidation of bone mass during adulthood and helps to prevent osteoporosis in later life – more attention needs to be placed on the importance of this.”  

During the Lecture, Lanham-New also discussed new research, that has been led by Dr Andrea Darling, University of Surrey, using data from the UK Biobank and which has shown, for the first time, extensive vitamin D deficiency in over 8,000 South Asians living in the UK – the largest dataset available on vitamin D status in ethnic minority groups.

Lanham-New continued: “Such low levels of vitamin D in this population group is extremely concerning. Due to darker skin pigmentation and lower sun exposure to the skin due to differing lifestyle habits and cultural dress style, this population is particularly susceptible to vitamin D deficiency, and this can lead to osteomalacia – the adult form of rickets. This disease presents itself through extensive bone pain, muscle ache and tiredness, and also presents a potential increased risk of diabetes. As such, ensuring an adequate intake of vitamin D through diet or supplements is essential.”

The government recommends that all adults and children over five should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter, and during the BNF annual lecture, Professor Lanham-New highlighted the importance of the different forms of vitamin D that can be used in supplements or in fortified foods.

Historically, it has been suggested that there is no difference between vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) in their effectiveness in improving vitamin D status. However, recent research led by Dr Laura Tripkovic and Dr Louise Durant (nee Wilson) from the Department of Nutritional Sciences, University of Surrey, has investigated whether vitamin D2 or vitamin D3 added to juice or food, at a relatively low dose of 15 mg/d, was effective in increasing serum total 25(OH)D, and compared the respective efficacy of these two forms of vitamin D in South Asian and white European women over the winter months.

Although both vitamin D2 and vitamin D3 increased 25(OH)D status and prevented the decline in 25(OH)D status during the wintertime, the results showed that at a low, but relevant, dose of 15 mg/d,

vitamin D3 was much more efficacious than vitamin D2 at increasing total 25(OH)D.

Speaking to the audience, Professor Lanham-New commented: “Our novel work on differences in vitamin D2 and vitamin D3 has highlighted some key issues with respect to the use of vitamin D2 fortification. This study is larger and more comprehensive than previous trials and backs up theories suggesting that, for the most effective supplementation, foods and drinks should be fortified with vitamin D3 – this finding is particularly key for vegetarians and vegans, since vitamin D3 is from an animal source. We are now working on a systems biology approach to vitamin D and we have some further exciting data in preparation on vitamin D2 and vitamin D3.”

Professor Susan Lanham-New’s research focuses on the area of nutrition and bone health, and also incorporates work on acid-base homeostasis and bone health. While this has been an area of media controversy, with unfounded suggestions that following an ‘alkaline diet’ can benefit conditions such as cancer and arthritis, there are real mechanisms by which dietary acidity and alkalinity can affect bone health. Research suggests that certain bone cells appear to be sensitive to acidity, resulting in increased levels of bone resorption – the breakdown of bone materials and loss of minerals, potentially resulting in reductions in bone mass.

Lanham-New explained: “Studies looking at the use of alkaline-based potassium supplements, (for example, potassium bicarbonate/potassium citrate), which can increase dietary alkalinity, have also shown significant reductions in bone loss.  Hence, dietary alkali supplementation or increased fruit and vegetable intake may be a beneficial strategy for improving bone health in the population, particularly for women going through menopause when bone resorption is particularly high due to the low oestrogen levels.”

Lanham-New has won a number of awards for her research, including the Nutrition Society Medal for her work on acid-base homeostasis and skeletal integrity, and the BNF Prize 2018. Each year, the BNF Prize is awarded by the BNF’s Council in recognition and celebration of a contribution of outstanding merit in the field of food, nutrition and health and the following year they are invited to deliver a speech at BNF’s annual day in November.

ENDS

High res images available on request

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BNF was established 50 years ago and exists to deliver authoritative, evidence-based information on food and nutrition in the context of health and lifestyle. The Foundation’s work is conducted and communicated through a unique blend of nutrition science, education and media activities. BNF’s strong governance is broad-based but weighted towards the academic community.  BNF is a registered charity that attracts funding from a variety of sources, including contracts with the European Commission, national government departments and agencies; food producers and manufacturers, retailers and food service companies; grant providing bodies, trusts and other charities. Further details about our work, governance and funding can be found on our website (www.nutrition.org.uk) and in our Annual Reports.