to be getting hot and bothered about the Vit D push?

[stinkingbishop]

I am prepared to be corrected but, having been hassled yet again by the HV about giving the twins Vit D because of the oft cited 'rise in Rickets', and saying, again, that they had a good diet, including oily fish, and play outside, and again being made to feel like I am stubborn/neglectful, I am getting rather worked up.

As I understand it, one of the main reasons we all have different coloured skin is because we have evolved to be able to absorb the optimum amount of Vit D from the sun (or rather for the sun to catalyse our absorption). Those in very sunny climes have darker skin so they don't overload; us peely wallies are that way because we have such brief windows. Interestingly, it's why Inuits have darker skin than, say, Scandinavians, because they eat so much fish. Very clever, Nature.

Vit D deficiency is caused by a mismatch between your current environment and what you evolved for. So someone whose ancestors lived in the Congo and is now in Stornoway really needs to eat a lot of herring. It's compounded by inner city living eg not having a garden, being inside most of the time. And also strikes some Asian populations because of vegetarian diets and processed flours used in eg chapatis, and because of a culture of covering up, especially girls, and staying at home.

I can't find anything online which shows the incidence of Rickets amongst caucasian children in Britain who play outside regularly (15 mins a day) and have a good diet. Is there anything? Have there been cases? Where should I be looking?

If it genuinely is a problem, I will calm down. But at the moment I just wonder to what extent this national, indiscriminatory push is motivated by the Government's desire not to be seen as racially profiling (but we SHOULD profile for some conditions, because your ethnicity does correlate with various issues and potential issues) and/or because they're using some research funded by whoever it is manufactures the supplements (I have no evidence of this because again I can't find anything).

So, do I calm down, or do I fire something off to whoever is in charge of briefing Health Visitors? It just seems yet another thing to beat nervous, unsure new Mums with. For the vast majority of whom, if I'm correct, this is a complete non-issue.

[WhoKnowsWhereTheTimeGoes]

I do agree about not wanting to give blood tests to children for Vit D level, when they could easily be supplemented. It would probably be a good idea for adults though as we have largely grown up without Vit D supplements, many of us spend most of our day indoors at work and if we have got a deficiency it is likely to be longstanding. Also it is just a pinprick of blood a bit like the one when you give blood to test for anaemia, not something that needs a whole vial of blood and a big needle, so it's easy to administer.

[WhyBeHappyWhenYouCouldBeNormal]

And also - it is a dependency, if without it we are susceptible to lots of diseases etc then a lot of us have become dependent on supplements... I think maybe we should be looking at our lifestyles and fixing what's wrong there instead...

It's scary to be popping tablets all your life

[TheRealAmandaClarke]

I think this highlights a more generalised problem with information about health. It is "better" to get your nutrients from food rather than from a crap diet with added pills. But that doesn't mean that common deficiencies cant occur, and that a supplement is needed.
The thing I find irritating surprising is that once its been explained, so many ppl choose to disbelieve what they're told, even though they have no background in medicine or biological dpscience, just because they think their gp or HV or nursery nurse or midwife is a bit of a thicky who can't possibly meet their quire nets for a detailed explanation. Life becomes a bit easier if youre not looking for trouble.
My dcs take their Abidec straight from a spoon. Mouths open like little baby birds. My friend gives hers to her dd in her breakfast drink. I decidede that if ds refused the drops I'd probably sneak them into a surgery petits filous wholesome yogurt.

[TheRealAmandaClarke]

Your explanation about dependency makes absolutely no sense whatsoever. You might as well be talking about astrology.

[Timeisawastin]

I reckon there's a good reason that early humans appear to be traced to the African equatorial area. Since we invented the wheel and managed to travel to the northerly area and the cold, cloudy climates we have suffered vitamin D deficiency. You might be able to change diets but the amount of sunlight we get is beyond our control (unless you emigrate). It makes sense to take supplements, it's nothing to do with 'dependency'.

[Thenapoleonofcrime]

I use a mouth spray that tastes minty, called DLux, the children really like it but we have only just started supplementing with D.

Whybe I think you need to stop thinking of 'vitamins' as a whole group and look into the benefits/disadvantages of them individually- I don't in general take extra vitamins for the reason you state, I don't think I'm deficient in them and they are mostly present in food- but D isn't one of these and babies are often covered up from the sun. If they are then breastfeeding, especially from a D-deficient mum, they will also be deficient. It's not a 'dependency' because you can go with out it!

In a lot of countries, they do seem a bit more clued up about this, either supplementing all children under a certain age, or my MIL (from anotehr country) used to say to do 'sun baths' with the children as babies, which is putting them in the sun for 10 min max (so no burning) with nothing on, then covering them up/putting them in the shade. Obviously in the UK this wasn't often possible (too cold) and I thought she was a bit strange, but now I see this is a natural way of ensuring D naturally.

[WhyBeHappyWhenYouCouldBeNormal]

I was just trying to make clear i wasn't talking about dependency as in addiction, but in the fact we have to trust in them - I was making my language clear.

I didn't trust anything my health visitor said and stopped seeing them soon after dd was 8 weeks old as they were insistent that i'd need to top up with formula which i did not want to do, so when they also suggested supplements I ignored them on that one too as I believed I was giving dd all I needed to in my milk.

So far no one has convinced me that it is impossible to get the vit d we need naturally - and when ever i've explained our diet and position, no health professional has challenged me...

I'm not trying to be confrontational - i'm just explaining that 'believing' all the advice the NHS gives it not always in best interests - a lot of the stuff on their website is out of date, and so wrong.

[WhyBeHappyWhenYouCouldBeNormal]

Thenapoleonofcrime thank you, that was a really useful post which explains it a bit more.

[TheRealAmandaClarke]

whybehappy I can see why you didn't trust your HV then tbh. I think I would have felt the same.

[Thenapoleonofcrime]

www.bmj.com/content/340/bmj.b5664

Whybe a quick google will take to you the more respected BMJ where you will see this has been a public health concern for over 10 years.

You seem to think this is something to have a 'position' on and that an 'anti' whatever drs/HV's suggest stance is required.

It's not really up to the NHS to argue you into doing it- it's a genuine choice.

[Thenapoleonofcrime]

Whybe I know what you mean- my HV wasn't great either on a couple of issues. On this one, I really think it's worth doing a bit of reading.

[RiverTam]

WhyBe - you are right about some vitamins, that we'd do better to get them from food, but vit D is the one vitamin that doesn't occur in food much at all, and it's exposure to sunlight that provides most if it, and so it is one vitamin where a supplement makes perfect sense.

As pps have said, in this country not everyone will get enough sun all the year round, and if you are darkskinned the situation is worse. Plus if you burn easily, like me, you'll not be keen on exposing yourself much to the sun at all.

DD is veggie and not keen on eggs, so apart from cereal won't get much vit D in her diet at all. I do try to get her in the sun, uncovered for a bit, but it's certainly not every day and I really don't want her to burn. So we supplement.

[SpeakerOut]

WhyBeHappyWhenYouCouldBeNormal - How do you make a child take a supplement anyway???
With my twins I pierce one of my liquid caps 10,000 IU with a needle 3 times in the end and just squirt it into their mouths. Very easy. I give them one each every 10 days as vitamin D builds up in your body so a dose every 10 days is just as good as 1,000 IU every day. The twins have had one very mild cold in 3 years.
DH and I take one a day each. Neither of us are ever ill with colds, flu etc.

This is the one we take <a class="break-all" href="//www.amazon.co.uk/Healthy-Origins-Vitamin-000-Softgels/dp/B0031BQN10/?tag=mumsnet&ascsubtag=mnforum-21" rel="nofollow noindex" target="_blank">//www.amazon.co.uk/Healthy-Origins-Vitamin-000-Softgels/dp/B0031BQN10/?tag=mumsnet&ascsubtag=mnforum-21

For those giving your children Abidec. You may want to check because I think that it's D2 in that which is nowhere near as effective as D3.

[fanjobiscuits]

Two reasons why you may be vitamin d deficient even if you eat lots of fish etc and spend time outside:

1. You can't get enough from diet alone. You need sunshine or a supplement.
   
2. In the Uk you will only get vit d from our sun half the year and a small part of the day. It's not strong enough at other times. So walking to and from school for example, even with enough skin exposure, you are possibly not making vit d at all due to the sun exposure.

[Thenapoleonofcrime]

Some people do take the sun safety message a bit far though, I saw someone a while back who came into the playpark about 10am, children dressed in long-sleeved cossies, hats with flaps at the back, then covered any remaining bits of skin with cream in great quantities, then got out a tent and made the children sit in that! They were allowed out for extremely small amounts of time before being put back the tent, ate their lunch in the tent and so on.

Now of course they may have had some extra skin sensitivity I was unaware of, but mainly I was thinking it didn't look like a fun day out as they mainly stayed in the tent on a warm sunny day! In terms of Vit D exposure, there would have been nil.

[Rainydayblues]

Still there are people who really struggle to raise their Vit D levels despite taking supplements and getting 20mins of sunshine every day. These are people with auto immune conditions like crohns, MS etc who have their levels regularly checked but it may apply to other people too - how many people get their levels checked? And my point was that the concentration of Vit D supplements is variable, some supplements have a very low dose - obviously read the packet where the dose will be highlighted and also take a supplement that is suspended in oil which will give your body a better chance of absorbing it.

The Vit d you get from sunshine is better though and will stay in your system for longer - my dermatologist said it didn't break down as quickly....which is pretty important for getting through the winter.

[Timeisawastin]

This is also interesting, it raises the issues of washing off the oils on our skin that contain the essential stuff for the absorption of Vit D. www.vitamindcouncil.org/blog/washing-away-vitamin-d/

[WhyBeHappyWhenYouCouldBeNormal]

Thanks for all the info guys

[Kewcumber]

I am as white as white can be - pale celtic skin get at least 20 mins of sun exposure on bare arms a day through the summer wihtout suncreams.

My vit D was so low that it required weeks of injections to bring it up to normal and I had to have bone density tests to ensure it hadn't already affected my bones.

I take a lifelong high dose suppliment now.

Does it matter if 0.4 in 1000 (or whatever you quoted) of caucasian population have vit D deficiency if you are one of them. I don;t get why you're so aerated about it

[StillWishihadabs]

Yes of course read the packet. In my practice we give those with very low levels (less than 5) an intra muscular injection as it will take toolong to build up stores with oral and they are at immediate risk. However for a mild deficiency (I think anything under 40 is deficient although I know it's controversial ) oral supplements available in supermarkets ( hariborange is one) have 1,000u in and over 6 weeks will will correct the deficiency

Of course in chrons it may not be absorbed.

[antimatter]

there are many days in UK with 0 minutes of sunshine

then you need to be outdoors for nearly 2 hours to get enough exposure to rely on that exclusively as a source of wit D

also - there must be great genetic variation between how much vit d each of us produce

anyway - unless each of us is tested we don't know if we are defficient, all we do is speculate

if anyone has a bit of understanding how NHS works you would know they would not be prescribing free meds if there was not enough evidence to prove that it's worth the money

[WhyBeHappyWhenYouCouldBeNormal]

The NHS website still says "Most people should be able to get all the vitamin D they need by eating a healthy balanced diet and by getting some summer sun." Is that wrong then?

[WhyBeHappyWhenYouCouldBeNormal]

NHS also says

"Taking too many vitamin D supplements over a long period of time can cause more calcium to be absorbed than can be excreted. The excess calcium can be deposited in and damage the kidneys. Excessive intake of vitamin D can also encourage calcium to be removed from bones, which can soften and weaken them."

So from what information they give it would seem that it can be damaging to have this one size fits all idea of supplements...

[ItsAllGoingToBeFine]

They tested Scottish athletes in the run up to the Commonwealth games. Now I think it is reasonable to assume that athletes are a bit fitter/health aware/nutritionally aware than most.

60% were deficient.

[antimatter]

but they also say:

If you are exclusively breastfeeding your baby you should give your baby a daily vitamin D supplement from six months of age.
If your baby is fed with infant formula, you should give them a daily vitamin D supplement if they are drinking less than 500ml (one pint) of formula a day.
If you are breastfeeding your baby and giving them infant formula as well, they will need a daily vitamin D supplement from six months of age, or if they are drinking less than 500ml (one pint) of formula a day.
You should continue to give your child a vitamin D supplement until they are four years old.

AND

However, the Department of Health recommends a daily vitamin D supplement for the following people:
all children aged six months to four years (see below)
all pregnant and breastfeeding women
all people aged 65 and over
people who aren’t exposed to much sun, for example people who cover up their skin for cultural reasons, or people who are housebound (stay indoors) for long periods of time

----

sun - not daylight!