Vitamin D deficiency is particularly common in Finland due to a relative lack of sunlight.
Sun is one of the main sources of the vitamin so in Scandinavian countries that are deprived of a lot of sunshine, the case for fortification and supplementation is at its strongest, and it also may explain why Denmark became the first European country to run a campaign promoting vitamin D supplements.
Raija Kara, secretary general of the Finnish National Nutrition Council, told Nutraingredients.com that the implication of its proposals would mean that all persons in the 60+ age group would be required to take a vitamin D dietary supplement daily, throughout the whole year, in order to reach the recommended intake levels.
Medical sector advised
“We are targeting those most at risk of osteoporosis, and are advising medical staff that they should ensure vitamin D intake of patients in this age group meets the new recommended level to help reduce this major public health threat,” she said.
She said that the proposals are a precursor to the recommendations on vitamin D expected from the Nordic Nutrition Council in 2012, of which Finland is a member.
In Finland, the current recommended daily intakes (RDIs) of vitamin D for most adults is 7.5mcg but 10mcg for children under the age of two as well as those over 60.
Fortification
Only a few foods provide a natural source of vitamin D such as fatty fish, egg yolks, fish liver oils but Kara said often it is the people who are most in need of high intakes of vitamin D such as the elderly do not consume enough of these recommended foods.
And while fortification of fluid milks and margarine products - commonly consumed products - has been compulsory since 2003, she said that the Nutrition Council is now recommending that vitamin D levels in these products be increased to ensure higher intake of the vitamin in those sections of the population most at risk from its deficiency.
“The recommendations are for 1mcg of vitamin D per decilitre in regard to fluid milk levels and 20mcg for spreadable fats levels,” said Kara.
She added that industry is on board with these fortification proposals.
Deficiency impact
Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The former, produced in the skin on exposure to UVB radiation (290 to 320 nm), is said to be more bioactive.
In adults, it is said vitamin D deficiency may precipitate or exacerbate osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious diseases and cardiovascular diseases. There is also some evidence that the vitamin may reduce the incidence of several types of cancer and type-1 diabetes.
A recent Europe-wide study put the direct and indirect costs of inadequate vitamin D levels at €187 billion for the bloc’s 363 million people.
Supporting evidence
The science supporting the muscle function of vitamin D, as well as the vitamin’s role in immune health, is sufficiently robust to have merited a positive opinion from the European Food Safety Authority’s (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA).
The Panel concluded that “a cause and effect relationship has been established between the dietary intake of vitamin D and contribution to the normal function of the immune system and healthy inflammatory response, and maintenance of normal muscle function”.
The vitamin’s role in calcium absorption has also led to a wide range of studies supporting a bone health and anti-osteoporosis role for vitamin D, but this is not covered by the EFSA opinion.