Worldwide health authorities urged to rethink vitamin D guidelines following revolutionary study

Vitamin D

Worldwide health authorities are being urged to rethink official guidance around vitamin D following the publication of a ground breaking study from the University of Surrey, which dispels the myth that vitamin D2 and D3 have the same nutritional value.

In the first ever study of its kind, using low doses of vitamin D in fortified food, researchers from the University of Surrey investigated which of the two types of vitamin D, D2 or D3, was more effective in raising levels of this vital nutrient in the body. Vitamin D3 is derived from animal products, while D2 is plant-based.

Researchers examined the vitamin D levels of 335 South Asian and white European women over two consecutive winter periods, a time when the nutrient is known to be lacking in the body. The women were split into five groups, with each group receiving either a placebo, a juice containing vitamin D2 or D3 and a biscuit with D2 or D3.

They found that vitamin D3 was twice as effective in raising levels of the vitamin in the body than its counterpart D2. Vitamin D levels in women who received vitamin D3 via juice or a biscuit increased by 75 per cent and 74 per cent respectively compared to those who were given D2 through the same methods. Those given D2 saw an increase of 33 per cent and 34 per cent over the course of the 12-week intervention.

The research also found that nutrient levels of both vitamin D2 and D3 rose as a result of both food and acidic beverages such as juice, which were found to be equally as effective.

Those who received the placebo experienced a 25 per cent reduction in the vitamin over the same period.

Current guidance given by a number of Government bodies around the world including the US National Institute of Health, state that the two forms of vitamin D are equivalent and can be used to equal effect.

Latest figures from Public Health England has found that more than 1 in 5 people in the UK have low levels of vitamin D and has increased the recommended intake of the vitamin to 10 micrograms per day, throughout the year, for everyone in the general population aged four years and older. Daily consumption of products containing vitamin D3 but not vitamin D2 will enable the population to meet this target helping to avoid the health implications such as osteoporosis, rickets and increased risk of cardio vascular disease which are associated with insufficient levels of vitamin D in the body.

This finding not only has implications for the health sector but also for the retail market. In recent years many retailers have added vitamin D2 to their products in the belief that it will help a person fulfil their daily intake. This study has proven that D3 is the most effective form of increasing vitamin D levels in the body.

Lead author Dr Laura Tripkovic from the University of Surrey, said: “The importance of vitamin D in our bodies is not to be underestimated, but living in the UK it is very difficult to get sufficient levels of it from its natural source, the sun, so we know it has to be supplemented through our diet.

“However, our findings show that vitamin D3 is twice as effective as D2 in raising vitamin D levels in the body, which turns current thinking about the two types of vitamin D on its head. Those who consume D3 through fish, eggs or vitamin D3 containing supplements are twice as more likely to raise their vitamin D status than when consuming vitamin D2 rich foods such as mushrooms, vitamin D2 fortified bread or vitamin D2 containing supplements, helping to improve their long term health.”

Professor Susan Lanham-New, Head of the Department of Nutritional Sciences at the University of Surrey, and who was Principal Investigator of the BBSRC Diet and Health Research Club funded trial said: “This is a very exciting discovery which will revolutionise how the health and retail sector views vitamin D.

“Vitamin D deficiency is a serious matter, but this will help people make a more informed choice about what they can eat or drink to raise their levels through their diet.”

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Met Office research suggests parents are worryingly relaxed about sun safety

More than a third of parents incorrectly believe that suntans are a sign of good health, according to a recent study by the Met Office, despite sun damage in childhood being strongly linked to skin cancer in later years.

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The study, which involved 1,000 parents with children aged 11 and under, looked at perceptions of good sun care and produced some alarming results, with 7% of respondents stating that they have never put sunscreen on their children.

A quarter of those surveyed actively encouraged their children to ‘get a tan’, with 10% encouraging them to sunbathe and 7% allowing their children to use a UV sunbed.

The Met Office believes that these figures could be explained by a ‘lack of knowledge amongst parents of the damage the sun can inflict.’ Findings also backed up this claim, with 7% unaware of links between UV rays and cancer, 15% unaware of any risk from UV rays on cool or cloudy days and 21% unaware of the increased risk from UV rays between May and September.

Furthermore, just 19% checked the UV forecast each day and 40% had never done so.

The NHS calls for parents to take extra care with protecting the skin of children and babies, who have far more sensitive skin than adults.

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New infographic looks at the bigger picture of health

The Health Foundation has released the first in a series of infographics looking at the social determinants of health.

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The foundation says these determinants include political, social, economic, environmental and cultural factors which shape the conditions in which we are born, grow, live, work and age.

The first infographic, entitled ‘What makes us healthy’ looks at how health is often shaped by factors outside the direct influence of healthcare, claiming that as little as 10% of a population’s health and wellbeing is linked to access to healthcare.

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Greater muscle strength – better cognitive function for older people

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Greater muscle strength is associated with better cognitive function in ageing men and women, according to a new Finnish study. The association of extensively measured upper and lower body muscle strength with cognitive function was observed, but handgrip strength was not associated with cognitive function. Cognition refers to brain functions relating to receiving, storing, processing and using information. The findings were published in European Geriatric Medicine.

The study population comprised 338 men and women with an average age of 66 years. Their muscle strength was measured utilising handgrip strength, three lower body exercises such as leg extension, leg flexion and leg press and two upper body exercises such as chest press and seated row. Sum scores to depict lower body and upper body muscle strength were calculated separately, and cognitive function was assessed using the CERAD neuropsychological test battery with calculated total score.

Handgrip strength is relatively easy and fast to measure, and it has been widely used as a measure of muscle strength in various studies. However, this new study could not demonstrate an association between muscle strength and cognitive function when using a model based on mere handgrip strength and age. Instead, an association between muscle strength and cognitive function was observed only when sum scores depicting upper or lower body muscle strength were included in the model.

‘The findings suggest that it may be justified to go beyond the handgrip and to include the upper and lower body when measuring muscle strength, as this may better reflect the association between muscle strength and cognition,’ says Early Stage Researcher Heikki Pentikäinen, the first author of the article, who is currently preparing a PhD thesis on the topic for the University of Eastern Finland.

Exercise is known to have various health benefits, and strength training is a way for practically everyone to increase muscle mass and enhance muscle strength. However, the association of muscle strength with various aspects of cognitive function is a relatively under-researched area. The study provided new insight into the methodology of measuring muscle strength and into the role of muscle strength in cognitive function. The study constituted part of the extensive, population-based DR’s EXTRA study, which was a four-year randomised and controlled intervention study analysing the effects of exercise and nutrition on endothelial function, atherosclerosis and cognition. The study was carried out at Kuopio Research Institute of Exercise Medicine in 2005–2011 and it involved more than 1,400 men and women living in the eastern part of Finland.

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Improvement needed in mental health services for children & adolescents across Europe

A study of child and adolescent mental health care has found that provision needs to be improved across the whole of the EU.

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Research led by Professor Swaran Singh of Warwick Medical School at the University of Warwick found substantial improvements were needed across the board from planning to monitoring, and delivery. The study Architecture and functioning of child and adolescent mental health services: a 28-country survey in Europe has been published today recently in The Lancet Psychiatry. Professor Singh’s fellow lead authors are Giulia Signorini MSc and Giovanni de Girolamo MD of the Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia.

Professor Singh said: ‘In all 28 countries we found that resource allocation wasn’t evenly spread to effectively deal with need.

‘Our survey provides important information for the evaluation and planning of child and adolescent mental health services (CAMHS) in Europe.

‘It highlights areas of concern: poor service planning and the paucity of standardised outcome assessments for service provision or performance, scarce or variable involvement of service users and their families, and the scarcity of interdisciplinary CAMHS and adult mental health services.’

The team of academics examined characteristics of national child and adolescent mental services across the EU, including legal aspects of adolescent care. Using an online survey completed by child psychiatrists and national child psychiatry associations in each country they obtained data on issues such as availability of services; inpatient beds; clinicians and organisations; and delivery of specific services and treatments.

The study highlighted that the number of public services varies considerably across the EU, from just two each in Malta and Luxembourg to 939 in the UK. The number of public CAMHS relative to the target population ranged from 12.9 per 100 000 young people in Finland to 0.5 per 100 000 young people in Bulgaria. On average young people constitute a fifth of the general population of Europe.

In several countries, specific subgroups of children and adolescents had poor access to specialised mental health services dedicated to them. For example, of 27 countries, only ten (37%) provided access to refugees, seven (26%) to orphans or victims of natural or man-made disasters, six (22%) to seriously emotionally disturbed children, four (15%) to minority groups, three (11%) to runaway or homeless children, and two (7%) to indigenous people.

Nine (33%) of 27 countries had no special services designed to meet the specific needs of these subgroups, and only seven (26%) of 27 countries indicated having highly specialised services for fostered children, children who have offended and been charged with crimes, disabled children, children with autism, or children who misuse substances.

Professor Singh added: ‘Clearer national policies are needed for service delivery and structure and for standardised tools to assess the delivery, take up, and effectiveness of treatment. Young people’s needs should be central to service provision, which requires improved understanding of their treatment experiences and satisfaction with services. Professional training should be revised to bridge the gap between professional and service-related cultures.’

The study is part of the five year MILESTONE project which aims to improve transitions for young people from CAMHS to adult mental health services across Europe.

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Complementary medicine in Switzerland now a mandatory health insurance service

The Swiss Federal Government announces that specific medical services using complementary medicine are to be covered by mandatory health insurance (basic insurance).

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The Swiss Umbrella Association for Complementary Medicine and the Union of Associations of Swiss Physicians for Complementary Medicine welcome this decision. It implements one of the key demands of the constitutional referendum held on 17 May 2009. With this decision, the Swiss Federal Council is acknowledging that complementary medicine in Switzerland meets statutory regulations when it comes to effectiveness, guaranteeing high quality and safety.

At the 17 May 2009 constitutional referendum, the Swiss people voted in favour of complementary medicine being included in public healthcare by a two-thirds majority. A key requirement of the new constitutional article 118a on complementary medicine is that mandatory health insurance (basic insurance) also has to cover specific services using complementary medicine.

It is now decided that the following disciplines of complementary medicine will be fully covered by mandatory health insurance (basic insurance) as of 1 August 2017: anthroposophical medicine, classical homoeopathy, traditional Chinese medicine and herbal medicine, provided that these are practised by conventional medical practitioners who have an additional qualification in one of the four disciplines as recognised by the Swiss Medical Association (FMH).

The Swiss Federal Health Insurance Act (HIA, 1996) together with constitutional article 118a provide everyone with access to complementary medical services (according to the solidarity principle). Despite these regulations, the implementation was followed by several years of controversy about how to cover the costs of complementary medical services. Scientific programmes commissioned by the government were abused for political ends, meaning that, for a while, such services were no longer covered.

With today’s decision, the Swiss Federal Government is finally acknowledging that complementary medicine meets the regulations of the HIA when it comes to effectiveness, guaranteeing high quality and safety. By law, only those services that are effective, appropriate and cost-effective (art. 32 of the requirements of the Federal Act on Health Insurance) can be covered.

The Swiss government’s decision is important for any person or family that cannot afford private supplementary insurance and for people with indications for which the only available options in conventional medicine carry a higher potential risk.

The Swiss Umbrella Association for Complementary Medicine and the Union of Associations of Swiss Physicians for Complementary Medicine are pleased with the Federal Council’s policy decision to strengthen support for complementary medicine in basic medical care.

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Exposure to sunlight linked to reduction in eczema inflammation

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Exposure to sunlight alleviates symptoms of eczema by helping to release a compound in the skin that moisturises inflammation, according to a recent study the Medical Research Council (MRC).

Researchers found that exposing a small patch of skin on healthy volunteers to UV light triggered the release of nitric oxide into the blood stream.

These findings will pave the way for future research into new therapies that could mimic the effects of sunlight while minimising the damaging side effects of the sun’s rays.

UV light therapy is currently used for people with severe eczema and while this can improve the condition, it can have damaging side effects, including ageing, burning and increasing the risk of skin cancer.

Further lab studies showed that this chemical activated regulatory T cells that were directly linked with disease improvement.

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