Vitamin D

[sarahw]

I know in the past we've discussed bones. The Dept of Health and Public Health England released new guidelines in July stating that all people should take vitamin D 10 mcg (400iU) daily in winter. And those at risk should take all year round. Our dancing kids on the whole don't get much sun so I am considering year round for dd.

 

Own brand like Boots are fine. Currently they are 3 for 2 (£2.19 for 90 I think.) I don't work for them!

 

If you're also concerned about calcium intake you can get a combined product also.

[Katymac]

I can't digest tablets/capsules easily so I take a D-Lux spray

 

Apparently half the Scottish Olympic team were deficient in 2012 & it's becoming a real issue

[sarahw]

Should've added the Dept of Health website has a nice summary news item with list of those at additional risk. I can't post the link for some reason but it's under news.

[Jan McNulty]

https://www.gov.uk/government/publications/vitamin-d-advice-on-supplements-for-at-risk-groups

[drdance]

Just a note to say if you are intending on taking supplements, ensure it's the Vitamin D3 version (colecalciferol).I take a prescription version which comes in a little gel capsule but you can buy them over the counter. Check the amount with your GP or pharmacist though.

[Moomin]

If they eat cereals aimed at children you might find they have vitamin d in already

[MumToTu]

Nesquik, I know it's probably quite sweet, but my children have it at breakfast to drink and it has vitamin D added, my children love it and I have always given it to them for this reason.

Edited September 18, 2016 by Snowflake

[Yaffa]

I recall that RBS students were involved in research for Vit D levels in young dancers.. Did any specific recommendations emerge beyond those for the general population?

[Stirrups36]

"In particular, the company now offers a Vitamin D testing and supplementation programme to its dancers - in response to a growing body of research suggesting that indoor athletes may be more at risk of health problems and injuries than sports professionals who train and perform outside. Dancers like Avis, who see little daylight, routinely spending 12 hours a day in the theatre, now undergo a twice annual blood test to check vitamin D levels, with high dose monthly supplements prescribed for those who are found to be deficient. During the summer months, all company members are strongly advised to spend 15-20 minutes daily exposing their skin to the sun, on the outside terraces at Covent Garden’s magnificent Opera House, the company’s London home.

 

Greg Retter, Clinical Director of the Royal Ballet’s healthcare programme, says that international research involving several dance companies including the Royal Ballet, is looking at whether increased Vitamin D levels can deliver better jump-height, fewer coughs and colds, shorter recovery time after injury and improved bone health."

 

and

https://www.theguardian.com/science/2013/nov/29/vitamin-d-ballet-dancers-injury

Edited September 18, 2016 by Stirrups36

[Waitingmum]

My DD is at RBS lower school and although not actually tested, they are certainly recommended to take a Vit D supplement and to eat outside whenever the weather allows!!

[LinMM]

There is some vitamin D in cereals it's true but look for the amount it may not be very much.

 

The problem when taking all single vitamins is knowing how they metabolise in the body and D needs C!

 

I'm not so sure about children under 12 but any older it may be better to take a good multivitamin ( eg Solgar or Viridian just two examples) which will definitely have the right amount of vitamin D in.

[Katymac]

DD & I were both tested - the GP said I was dangerously low & that DD was lower again - so we are both on very high doses to catch up- we could have a prescription but the GP says it's really hard to metabolise so prefers us to buy ours in a better form

 

There is masses of research going on atm & it is anticipated that in the future the RDA will rise dramatically for Vit D; apparently sun on the arm/legs doesn't make nearly enough & it's sun on the torso that matters - to get enough from a normal diet you'd need to eat about 3lbs of oily fish a day!! & run around with a near naked torso for about 300 days a year......bit chilly imo!

 

It's potentially implicated in asthma, arthritis, MS, IBS, Cancer & dementia - or rather the lack of it is

 

BTW the link for the at risk groups is from 2012 so I would expect that to be updated quite soon

[Moomin]

Good advice to check the amounts. Just checked there's 3mcg in our cereal but will depend on your serving size! There are also various other foods which are fortified, if you can get the fortified milk that has a lot in and you get the calcium aswell. vitamin d is needed to absorb calcium which is what is actually needed to keep your bones strong so also very important. So unless you have a high calcium intake maybe best to get a calcium and multivitamin supplement. Although it's also worth bearing in mind that vitamin d is not water soluble so accumulates in the body and can cause problems if you have too much aswell!

[sarahw]

I have reservations as to whether a more expensive brand would be better than a supermarket or chemist own product. The Doh guidelines simply state 10 mcg vit D supplement per day, no more than that.

 

Pregnancy is a classic example where people are tempted to buy expensive brands over plain folic acid (now with vit D as well.)

 

Multi-vitamins may give the reassurance that you are covering all bases but this could be undesirable if you continue to eat a poor diet - there is so much more to a healthy diet than vitamins. And as someone correctly says it isn't always clear whether taking a supplement has the same effect as getting from diet.

 

I've not looked at the new evidence on vitamin D - the debate in medical literative has been going on for decades.

Edited September 18, 2016 by sarahw

[Moomin]

There is masses of research going on atm & it is anticipated that in the future the RDA will rise dramatically for Vit D; apparently sun on the arm/legs doesn't make nearly enough & it's sun on the torso that matters - to get enough from a normal diet you'd need to eat about 3lbs of oily fish a day!! & run around with a near naked torso for about 300 days a year......bit chilly imo

 

I don't think this reflects current nhs guidance? The majority of people are not low in vit d and as it is toxic at higher doses would urge some caution. a lot of GPs will ask you to buy vitamin d as it is freely available and cheap.

[sarahw]

Cross posted with Moomin

Edited September 18, 2016 by sarahw

[sarahw]

In general NHS/Government advice is very conservative in terms of recommendations - as in the evidence of benefit has to be clear and usually cost effective at a 'good rate' to the NHS/state.

[LinMM]

Taking a multivitamin is of course no substitute for a good healthy diet....... it's both and!!

 

Both Solgar and Viridian multis have the current recommended daily dose of D ....10 mcg

 

I'm due for a check on my bones and certain other things like vitamin D this autumn

Last time my D was fine so between diet and multi vits seemed to be doing right or am just plain lucky!

[Katymac]

I think there must be a genetic component too

 

DD is mixed race so high risk, her dad is Jamaican so potentially higher risk but his D is at a much higher than ours (although he supplements the same as us because the GP asked him too) & tbh their (DD & DH) diets were pretty similar until she went to college - almost identical in size & content

 

It massively complicated - all I can do is take what the GP says to

[Katymac]

This might be useful if anyone has a blood test showing a low Vit D https://www.nos.org.uk/document.doc?id=1352

[Moomin]

Does he use sunscreen? As you rightly pointed out the amount gained from diet is low (unless fortified/ supplemented) it's usually lack of sunlight that's the problem whether that be because of limited exposure, use of sunscreen (which is also in a lot of makeup & moisturisers now) or covering of the skin. A word of warning about multi supplements- minerals such as iron tend to bind to lots of things including some vitamins, so they won't be absorbed. Also some food stuffs, never have a cup of tea after eating or a supplement, the tanin binds to some vitamins meaning that you won't absorb them!

[LinMM]

I agree there is probably not COMPLETE absorption of any supplement!

 

I notice my limit for C is around 100 mg because I can see I am "peeing" the rest out mostly!!

 

I think for me taking the multi vit supplements .....and this includes for me regular glucosamine etc for joints (which not sure younger people need that much) is just some sort of back up policy!! A sort of just in case I'm not getting everything from diet.....and I do have some bad days each week in this respect sometimes.....

 

I have no idea exactly how much I'm really absorbing but it makes me feel better anyway.

I could be throwing money down the drain but certainly in the last 8 years have not had at least a poor vit D result but whether this is due in part to supplements or just some natural genetic ability to absorb it I don't know.

I will see what happens this Autumn as was slightly osteopaenic 8 years ago but there was an improvement three years ago without any prescription from a doctor.

 

The original poster was just enquiring about extra D for a child doing lots of dancing and have no idea whether much younger people need this or not but for people who have already been diagnosed with some severe shortage then they should follow GP's advice with whatever the current knowledge is at the time.

[Katymac]

Moomin, despite DH being 'black' he uses a massive amount of suncream as he is on Doxycycline & that can cause sensitivity to sun; DD uses it when the sun is strong & I never use it as I am allergic; which bears out my thinking that there is some sort of genetic component

 

I really think everyone should be tested - everyone I have spoken to who asked for a test was borderline deficient - I think under 100/75 is low & under 25 is deficient - apart from DH I haven't known anyone tested who was over 50

 

Edited to add "Maybe I only know ill people"

Edited September 19, 2016 by Katymac

[Yaffa]

My DD is at RBS lower school and although not actually tested, they are certainly recommended to take a Vit D supplement and to eat outside whenever the weather allows!!

 

I recently met a lady whose daughter was considering vocational training, and showed her a brief video on the RBS site. Her first comment was about how great it was to see children eating outside... 

 

Is Vit D. the only supplement that vocational students are advised to take?

[Moomin]

GPs wouldn't usually do any test unless you have symptoms or risk factors though so those tested are not necessarily representative. It also de mDS on what time of year you had the test. 30- 75 is borderline. It's not cheap to get tested, if just follow the doh guidance should be fine unless you are already eating a high amount of fortified foods or are pale and have a high sun exposure.

I would imagine that the food at a vocational school is quite good quality and balanced so other supplements shouldn't be necessary. If the student has a restricted diet/ low intake of things like dairy they may need supplements but I think it would be on a case by case basis

[dramascientist]

Hang on a minute this seems to be a lot of scare mongering. Surely if people were so deficient in Vitamin D we would be seeing rickets everywhere? This was eliminated in the UK during the Second World War when the government started putting vit D in margarine - a practice that I believe still happens today. Sunlight only on your torso??? I find this highly suspiscous, the skin is all one organ, completely joined as people who suffer from eczema, psoriasis etc will I am sure contest to. I agree it is important to spend time out doors every day, it lightens your mood, prevents lethargy and provides the body with UV light to help it produce vitamin D and yes dancers do need a specialist diet to provide their bodies with the correct nutrients as any athlete does but as for the rest of us, I find it very hard to believe anybody who eats a healthy diet requires any supplements other than the very old or pregnant.

 

Sorry to be controversial but with discussions like this the only people who benefit are the companies who manufacture the supplements, most people would simply excrete most if not all they take in.

[Interested Parent]

My DD had issues with pain in her legs, muscle fatigue and stomach aches. We went to see a consultant for her 'injuries' and he had scans done but also blood tests for vitd deficiency. He advised that many young people are low in vitd for all sorts of reasons suggested above but it was the high energy training since starting voc school and her low vitd levels that had contributed to her injuries. I don't think anyone should just start taking vitd but I do think it's worth getting a blood test done for kids who are involved in high energy training. This way your gp can prescribe the right dose if needed to bring those levels back up and then advise on the right maintenance dose going forward. Made a big difference to my DD.

[Colman]

@dramascientist, a quick look at Wikipedia suggests that rickets cases are rising in the UK as kids are more and more protected from the sun - and darker skinned people are more at risk. Vitamin D production is important enough to have driven the evolution of white skin over a very short time, and very possibly helped drive the adaptions that allow us digest milk.

 

The amount of time required to get enough sun through arms and face rather than whole torso is much higher: production is, I assume, proportional to the amount of skin exposed and there is much more skin on the torso than anywhere else - and in most of the UK winter sunlight is insufficiently energetic to produce much Vitamin D anyway. 

[Moomin]

There is definitely an increase in children with rickets, and yes I agree that it had virtually died out but the main reasons are a. majority of people use sunscreen and limit sun exposure demographic changes mean that there are more darker skinned people c) there is a higher proportion of people who cover their skin for cultural reasons. So I agree with you that the human race has evolved to obtain enough vitamin d but various factors have changed in a very short space of time leaving a number of people exposed to deficiencies. As vitamin d is fat soluble it accumulates and the idea is that you make enough over the summer to build up a store for winter. For a fair skinned person 20 mins direct sunlight on face & arms every day in summer months is meant to be enough, not much really

Edited September 19, 2016 by Moomin

[chloe123]

As a children's nurse I understand that sadly there is an increase in the number of children with rickets. 

It is difficult in UK climate for some people (eg darker skinned, living in the North, covering up their skin) to get enough vitamin D from sunlight. 

Vitamin D supplementation is recommended by the NHS for all very young children - I'm not sure of the guidance for adults and older children. 

Edited September 19, 2016 by chloe123

[aileen]

And adding to Moomin's points, children and teenagers do not spend as much time outside because of parental fears about safety (traffic plus stranger danger) and all the indoor attractions of computers, DVDs available these days. On top of that, more children travel around by car and there has been a move towards organised (and often indoor) activities for children and away from unstructured time spent outside in the street or local park.

[LinMM]

The time of day is important also if trying to get vitD from the sun.

 

If you only want a 20-30 min exposure then it has to be between midday and three pm when the sun is at its strongest.If you want to go out when the sun is gentler than you would have to spend longer.

 

I have read that exposure of the ribs and/or thigh bone part of leg is best for absorbing vit D.

 

I am an older person and take these supplements to help strengthen bones after being diagnosed osteopaenic 8 years ago and because I do a lot of dancing....well for my age!!

 

However I really don't know about pre teens and what their needs may be these days.......although they definitely don't seem to spend as much time outside playing as we did when kids in the 50's and 60's

 

I do remember also in that era especially in the 50's we were given additional foods such as cod liver oil and malt extract( the latter which I loved) So I do wonder how much of a "modern" thing this vitD deficiency is.

The only child I've come across with rickets was on a macrobiotic diet so the diet was causing her problems rather than lack of sun etc.

[Michelle_Richer]

Follow this link it may be of interest:

 

http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCIQFjAA&url=http%3A%2F%2Fwww.researchgate.net%2Fprofile%2FMatthew_Wyon%2Fpublication%2F236338298_The_influence_of_winter_vitamin_D_supplementation_on_muscle_function_and_injury_occurrence_in_elite_ballet_dancers_A_controlled_study%2Flinks%2F00463517e2f86974ef000000.pdf&ei=zbX1VPyhJNKXauavgfAI&usg=AFQjCNG5qR8sTIzkBfNrvFKsA2DXnRRKlg