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Vitamin D the importance of a healthy balance Fizz Thompson

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3The National Osteoporosis Society is the only UK-wide charity dedicated to ending the pain and suffering caused by osteoporosis.

We are committed to helping people with osteoporosis live the lives they want to lead

We want every person over 50, who breaks a bone, to be assessed and treated for osteoporosisWe support researchers and healthcare professionals to improve the prevention, diagnosis and treatment of osteoporosis and fragility fracturesWe are campaigning for better provision of Fracture Liaison Services across the UK because it is a proven way of preventing future fractures.Key messages

4Vitamin D

5Vitamin D role in health Everyone needs Vitamin D for good bone health Promotes calcium absorptionEnables mineralisation of osteoid tissue in bonesPlays an important role in muscle functionSome studies have suggested that high levels of vitamin D are associated with a reduced risk of bowel cancer

6Problems associated with low vitamin DNational surveys suggest that around a fifth of adults have low vitamin D status

Deficiency:leads to rickets in children and osteomalacia in adultsIs associated with osteoporosis, hip fractures and falls in older people

Perhaps linked to cancers, multiple sclerosis, heart disease and diabetes but more research is needed

7SourcesSunlight is the best source vitamin D is made in your skin through exposure to sunlightDietary sources - egg yolks, cod liver oil and oily fish such as herrings and sardines.Fortified foods e.g. margarine, some cereals and yogurt, breadSupplements 400IU/day

8National Osteoporosis Society Work

Consensus Vitamin D position Statement 2010Vitamin D and Bone health : A practical Guideline for patient management (adult and paediatric )Stop at one - national campaign Nutrition and Lifestyle Forum national expert group to provide advice links through experts to National groups (SACN)

9Vitamin D and public health

10NICE recommendations: sunlightWhen to go out in the sun:11am and 3pmApril October Short periods exposing small areas Hands, arms, lower legsAlways take care not to burn seek shade, cover up, use sunscreenVitamin D can be produced on cloudy days, but it takes longer

X You cant make vitamin D through glass

11NICE recommendations: sunlightBabies under 6 months should be kept out of direct sunlight, especially 11am 3pmUnder 5s should be encouraged to spend time in the shade 11am 3pm. Supplements should be consideredOlder people should be advised about supplements and increased risks of skin cancer as they get older

12NICE recommendations: supplementsAims to increase supplement use to prevent vitamin D deficiency among at risk groups:Infants and children aged under 5Pregnant and breastfeeding womenPeople over 65People who have low or no exposure to sun, e.g. those who cover up for cultural reasons, are housebound, or confined indoors for long periodsPeople with darker skin, e.g. people of African-Caribbean or South Asian family origin

13Groups who might need supplementsThehousebound, especially frail, older people.Those with a poor diet.Asian women and children. Those who wear sun block all the time when outdoors.Pregnant women.Breast feeding women.Infants and children under three.Those using long term anti-epileptic drugsPeople with severe liver, kidney disease or malabsorption problems.

14Scientific Advisory Committee on NutritionA Reference Nutrient Intake (RNI) of 10 micrograms/day (400IU) is proposed for everyone over the age of 4 years in the UKA Safe Intake level is recommended for babies and children:0 to