Vitamin Information Center

A national campaign to persuade every Scot to take daily supplements of vitamin D is needed if the country’s appalling health record is to be reversed, leading scientists believe.

A report, published this week, links poor weather to the lack of the “sunshine vitamin” in Scotland, and urges the Scottish government to launch a nationwide vitamin D programme to lower the incidence of devastating illnesses, such as heart disease, cancer and multiple sclerosis.

The research points to the country’s damp, cloudy climate as a significant contributor to its bleak record of ill health and disease.

Vitamin D deficiency – caused by lack of exposure to sunshine – is twice as common among the Scots as it is among the English. The average Scot has a vitamin D level four times lower than their neighbour south of the Border.
A five-year research project by Oliver Gillie, a scientist and writer, demonstrates extensive and remarkable parallels between Scotland’s dull weather and indices of disease.

It suggests that the “Scottish effect”, the country’s hitherto unexplained high mortality rate compared with other industrial countries, is in large part down to lack of sun. Crucially, a shortage of the “sunshine vitamin” is established as a factor in higher rates of multiple sclerosis (MS), diabetes, hypertension, arthritis, several types of cancer, cardiovascular disease and other ailments that together give Scotland one of the worst health records and highest premature mortality rates in Western Europe.

Dr Gillie’s study – Scotland’s Health Deficit: An Explanation and a Plan – echoes world-wide research on vitamin D deficiency but goes further, showing how the higher rates of disease in Scotland mirror closely the lower amount of available sunlight.

A lack of sunshine in Glasgow and the West of Scotland reflects levels of chronic illness that which cannot be explained by deprivation alone. A lack of sunshine on Orkney and Shetland – only 24 per cent of the maximum number of hours possible – corresponds to the highest prevalence of MS in the world.

By contrast, the South Coast of England, where such diseases are much less common, receives 400 more hours of sunshine a year than Scotland.

Dr Gillie says that successive reports on the state of Scotland’s health have failed to recognise that insufficient sunlight and vitamin D are important risk factors, and calls for firm action from the Scottish government on supplementation and the fortification of food.

Last week The Times convened a panel of experts who studied the report and endorsed unanimously the importance of vitamin D as an important ingredient in creating a healthy Scottish population.

Dr Harry Burns, the Chief Medical Officer for Scotland, said: “It is important that attempts to improve health in Scotland remain focused on action on the social, economic, behavioural and psychological determinants of health. If vitamin D supplements can be shown to contribute to that agenda then we will make the appropriate recommendations.”

Dr Adrian Martineau from Queen Mary’s School of Medicine, London, who is working on evidence that vitamin D can reduce cold and flu symptoms, said: “This is a very important initiative. What [Dr Gillie] has highlighted is that 85 per cent of us have lower Vitamin D levels than we should have and 85 per cent of our cells need vitamin D to function properly. It’s highly plausible that supplementation would be of great benefit.”

A new study by the National Cancer Institute has found that people with one or more chronic illness are the primary factor behind the use of dietary supplements. Cancer survivors also contribute to the use of supplements, although not specifically as cancer treatments.

Dr. Melissa Farmer Miller, the study’s lead author, told Reuters that its important for cancer patients to inform their physicians about any non-prescription medications or natural products they may be taking, as a lack of information exists on the risks and benefits of many supplements. In addition, there may be potential for drug interactions with medications, such as tamoxifen, that many cancer survivors may be taking.

“We really are just beginning to build an evidence base on the benefits of dietary supplements,” said Miller, of the National Cancer Institute in Bethesda, Maryland.

“Even if there’s not a benefit, there is a potential for them to cause harm,” she said, noting that the use of supplements is growing among all Americans.

To determine whether cancer survivors are using supplements at greater rates than the general population, Miller and her team analyzed information from 1,844 cancer survivors and compared it with a random sampling of 7,343 people with no history of cancer.

The team found that vitamins were the only type of supplement use independently associated with having a cancer diagnosis. However, those participants with a  chronic illness were 82 percent more likely than those without a chronic disease to be using two or more supplements, regardless of whether or not they also had cancer.

Other factors associated with the use of dietary supplements were greater physical activity, consumption of fruits and vegetables, being female, being of older age and the use of other alternative and complementary medicines.

Miller said it was not possible at this time to conclude whether or not people living with cancer should either take supplements, or avoid them.

“The primary message should always be to promote a healthy diet,” she said.

She said that doctors and other cancer patient caregivers should be up to date on the literature about various supplements, and should be aware of any supplements their patients may be taking. Cancer patients should also be informed as much as possible about any supplement before they take it, Miller added, noting that it can often be tough due to the lack of regulatory oversight of dietary supplements in the U.S. and the  limited information available on their risks and benefits.

“Consumers are really kind of out there on their own, and should confer with their health care providers about supplement use.”

Dr. Miller‘s report was published in the March 2008 issue of the Journal of the American Dietetic Association.

A summary of the report can be viewed at http://www.adajournal.org/article/S0002-8223(07)02206-7/abstract.

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