Denmark promotes vitamin D supplements

People living in the Nordic region, where daylight hours drop dramatically in the winter, are at particular risk of vitamin D deficiency as the vitamin is mainly manufactured through exposure to sunlight.

Recently Nordic nutrition guidelines have raised the recommended vitamin D intake from 5mcg daily to 7.5mcg for those aged two-60 years old, and 10mcg per day for those over the age of 60.

However Denmark is the first country in the region to promote supplements in a targeted campaign.

The Danish Veterinary and Food Administration, supported by the health ministry, has printed leaflets advising that the elderly consume 10mcg of vitamin D per day in supplement form. If they are resident in a nursing home, they should take 20mcg along with 800-1000mg of calcium.

A second leaflet, also to be distributed to food and drug stores as well as doctors around the country, is translated into different languages to reach dark-skinned immigrants who are at a similar heightened risk of deficiency in the vitamin.

The recommendations are based on a report published by an expert group last year, which found that vitamin D insufficiency is widespread in the Danish population, especially in the elderly.

In the oldest age-groups close to 80 per cent have vitamin D insufficiency and 25 per cent are vitamin D deficient, it said. This is largely because of the skin's reduced capacity to synthesise the provitamin calcidiol.

Housebound elderly people are at greater risk as they do not get adequate exposure to sunlight and probably get less exercise than other elderly people, which can reduce the incidence of falls.

Vitamin D is important in bone health and muscle strength, and deficiency of the vitamin raises the risk for osteoporosis-related fractures. Previous research has found that vitamin D supplementation reduces the risk of potentially life-threatening falls among institutionalised elderly people by more than 20 per cent.

Immigrants living in northern Europe are also prone to vitamin D deficiency as they may not expose their skin to the sunlight for cultural reasons. Darker skins also require more sunlight to manufacture the vitamin than lighter skins.

Denmark's campaign highlights the growing awareness of the role of vitamin D in bone health, and follows a number of calls in recent months by scientists on both sides of the Atlantic for increased recognition of the latest research by health officials.

However Denmark continues to have a strict policy on food fortification, preferring to recommend supplements rather than permit the introduction of more vitamin D-fortified foods.

Heddie Mejborn from the country's food research agency, responsible for the report last year, noted that supplement maker Ferrosan has recently launched the first single vitamin D supplement available on the market, which should support the campaign.

"Until now, you could only get vitamin D with calcium in supplements. But if you need to consume 20mcg of vitamin D, that's a lot of calcium too, which is not so good for the elderly,"​ she told NutraIngredients.com.

A European research project, Optiford, has nevertheless found bread to be a good vehicle for increasing vitamin D intake in the elderly.

This research is supported by a study presented at the Experimental Biology meeting in San Diego last week, which found that elderly patients who consumed 5000 IU of vitamin D and 320 mg calcium carbonate a day through a specially formulated bread had a 28 per cent increase in lumbar bone mineral density after one year.

This compares to the 8 per cent increase in bone mass density typically achieved with bone-building drugs.

The levels of vitamin D are however well above recommended safe intake levels by European and US authorities. But there is growing support among the scientific community for higher doses of the vitamin, which may also reduce risk of certain cancers and autoimmune diseases, according to epidemiological trials.

Every 30 seconds someone in the EU suffers a fracture as a result of osteoporosis. The number of hip fractures caused by this disease is estimated to increase 135 per cent from 414,000 to 972,000 by the year 2050.