Vitamin D not on Aussies’ radar

One in five Australians have “no idea” about what benefit vitamin D has

Australians lack awareness about vitamin D – despite nearly 25% being deficient in the vitamin, new research from Ostelin has found.

The research, released this week ahead of National Vitamin D Awareness Day on Friday, June 30, shows that one in five Australians do not know what the benefits of vitamin D are.

Close to a third (31%) say they are unsure as to whether they might be vitamin D deficient.

For many, the vitamin is simply not on their radar: 49% of those aged 18-44 say vitamin D levels are of little to no importance to them.

A further 24% say that while bone health is important, they have “more pressing concerns” about their health.

There has been some controversy over vitamin D supplementation of late, with a review published in the BMJ last year suggesting that current evidence does not support the use of supplements to prevent disease, except potentially those at high risk.

And debate took place in the Medical Journal of Australia, with suggestions that some GPs were over-screening for deficiency, and one epidemiologist asking, “if you know your patient is at risk — sits in an office all day, or has other risk factors — why test them? Why not just supplement them?”

“Several years ago there were changes made to the Medicare rebate for vitamin D testing because there was nearly a 4000-fold increase in the number of patients having vitamin D levels assessed,” Professor Robin Daly, Chair in Exercise and Ageing at Deakin University, told the AJP this week.

“This was really needed because routine vitamin D testing is really not needed and is really most appropriate for high risk patients.”

Instead, Prof Daly says a simple questionnaire that asks about sun exposure habits/practises, skin type, age, where a person lives and about use of supplements, could be helpful to determine whether someone might be at risk of vitamin D deficiency.

“If such questions indicated deficiency then a person should speak to their GP about taking vitamin D supplements,” he says.

He says pharmacists are in an ideal role to advise on supplementation and lifestyle changes – if they are up-to-date.

“Pharmacists have the potential to play a central role as they are more likely to see patients/people more regularly than GPs and other health professionals and so could be a great resource,” he says.

“The challenge is whether they have the relevant knowledge and expertise to provide evidence-based advice around exercise and other dietary /lifestyle approaches for different conditions/diseases.”

An AJP poll conducted in December 2016 found that 59% of pharmacists only recommend vitamin D supplements to people they think are at high risk of deficiency.

Only 13% said they would sell a vitamin D supplement no questions asked, if that was what a patient asked for. 46% said they would sell the supplement but also give counselling.

Prof Daly adds that there is “no doubt” that there is confusion amongst the general public about the balance between sun exposure, cancer risk and vitamin D status.

Various peak bodies such as the Cancer Council, Endocrine Society of Australia and Australian and New Zealand Bone and Mineral Society have been working together to develop messages about getting this balance right, he says.

“It is tricky in Australia because of our size or spread in latitude and so the amount of sun exposure you need in winter in the northern states of Australia varies considerably from what you need in the southern states (and this varies by skin type as well),” he told the AJP.

People at risk of vitamin D deficiency include elderly people; dark-skinned people; people who wear veils; recent migrants; babies of vitamin D-deficient mothers; obese individuals; people with secondary medical disorders such as renal or coeliac disease; people living at a latitude of greater than 35 degrees; and those that limit sun exposure.

People who work indoors, including in the retail setting, may also be at risk if they avoid sun exposure, Prof Daly says.

Recent data indicates that 1.2 million Australians have osteoporosis and a further 6.3 million have low bone density. In 2013 there is a fracture every 3.6 minutes in Australia; equating to 395 fractures per day. By 2022 there is expected to be one fracture every 2.9 minutes.

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