expert opinion

Vitamin D deficiency – Call for action

March 30, 2011

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Judy Stenmark, Chief Operating Officer, International Osteoporosis Foundation, Nyon, Switzerland.

Osteoporosis is a disease characterized by loss of bone mass and quality, leading to an increased risk of fractures. Worldwide, osteoporosis and resulting fractures constitute a major public health burden with often devastating consequences, leading to increased levels of morbidity and mortality. Globally an osteoporotic fracture occurs every three seconds and at
50 years of age, one in three women and one in five men will suffer an osteoporotic fracture in their remaining lifetime. In the EU someone has a fracture as a result of osteoporosis every eight seconds and with an increasingly larger ageing population, the yearly number of hip fractures alone in the EU is expected to more than double over the next 50 years. In Europe there were an estimated 4 million new fractures in 2000, with almost 1 million of these being hip fractures. Hip fractures have devastating consequences; more than 20% of those who suffer a fracture, die within 12 months, 50% need long-term help with activities of daily living (e.g., cannot walk unaided) and 15–25% require full-time nursing-home care.

Vitamin D is important for bone and muscle development, function and preservation. Therefore, Vitamin D deficiency is an important modifiable risk factor for the development of osteoporosis and fractures, and as such it is now a major public health problem in the EU. Groups of people most at risk of vitamin D deficiency are the elderly, people who are housebound or in residential care, naturally dark skinned people, and those who cover their skin for various reasons. Vitamin D affects fracture risk through its effects on bone metabolism and on risk of falling. The benefits of supplemental vitamin D on reducing fracture risk has been shown mainly in men and women age 65 and older with doses in the range of more than 400 through
800 IU /day, whereas lower doses had no evident effect. The ways of increasing Vitamin D Intake include increasing exposure to incidental sunlight on a daily basis, supplementation (considered for people who are vitamin D deficient or at high risk of deficiency) and increasing consumption of foods that are high in
vitamin D (e.g., fortified milks and margarines, fatty fish and eggs).

We call on all policy makers to support actions to prevent vitamin D deficiency by supporting awareness, education and policy initiatives throughout the EU in the next 5 years, specifically regarding the following:

  • evidence-based cost-effective recommendations that support improved nutrition for the general EU population (and older people in particular),
  • education and awareness campaigns that specifically highlight the importance of incidental daily exposure to sunlight as a means of preventing vitamin D deficiency,
  • vitamin D supplementation as a public health initiative for older people and those at high risk of osteoporosis and fractures.”

Brussels, Belgium, March 2011

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