Vitamin D levels in the Spanish population are lower than in many Nordic countries. Despite the low levels of this hormone in the population, the necessary tests and supplementation are not carried out. These and related questions are exposed in a recent study.
Vitamin D is an essential hormone in different processes in the body, mainly in the absorption and maintenance of calcium, which is essential to keep bones strong, but also has a role in inflammation processes, the immune system, cell growth and metabolism. Even so, is it given the necessary importance?
The study, led by Diana Díaz Rizzolo, a professor at the Health Sciences Department of the UOC (Open University of Catalonia, or Open University of Catalonia) and a researcher at the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) in Barcelona, concludes that the vitamin D levels of the population are not sufficiently analyzed —a particularly serious situation in the population at risk— and questions the usual practice of not supplementing the population, despite the levels being low.
The researchers analyzed a sample of more than half a million adults with massive data techniques, with the support of the UOC’s eHealth Center, using information from the PADRIS program (Public Data Analysis for Health Research and Innovation Program), which makes available to the scientific community duly anonymized data from the Catalan health system. The individuals studied were over eighteen years of age and had been tested between 2018 and 2021.
Less than 10% of the population, tested for vitamin D
Díaz Rizzolo, a doctor in biomedicine, explains that “the main way to obtain vitamin D is its own production through exposure to the sun. Paradoxically, in Mediterranean countries such as Spain, the levels of vitamin D in the population are lower than in Nordic countries such as Finland, the United Kingdom, Iceland, Sweden or Ireland, which carry out vitamin D supplementation campaigns in their population through the systematic fortification of commonly consumed foods”. “This, and other factors such as the use of sunscreens or the low consumption of foods rich in vitamin D in Mediterranean countries, leads to very low levels of vitamin D in the population,” she adds.
Egg yolks are rich in vitamin D. (Photo: Amazings/NCYT)
To calculate the levels of vitamin D, the researchers relied on the parameters established in the guidelines of the Society of Clinical Endocrinology, which establish a level higher than 30 ng/ml as optimal, and a level between 20 and 30 ng as insufficient. /ml, and as deficient a level less than 20 ng/ml. The study shows that less than 10% of the population had had their vitamin D levels tested and that the majority of these people were women aged 45 and over. In fact, the analysis of vitamin D levels in the population without symptoms is currently not recommended, if they do not belong to a risk group (over 70 years of age, pregnant or institutionalized people, with fractures or bone problems).
Of the analyzed population, 80% of the youngsters had lower than desirable levels, but the majority did not receive supplementation; instead, vitamin D was prescribed to the group of women over 45 years of age. This meant that, paradoxically, the older group had vitamin D levels higher than those of the young.
For Dr. Díaz Rizzolo, “it would be necessary to systematically measure the vitamin D levels of the entire population in a given period to have a real picture of what is happening. From here, studies would have to be carried out on how these affect levels to the state of health of the people with the aim of being able to make a clear decision: either supplement when there is a deficiency (establishing the protocols according to the groups or applying nutritional policies as the Nordic countries do) or, if not, it is necessary to stop measuring unnecessarily in populations that don’t need it and worrying people for no reason”.
Another conclusion of the study is that the regulations and recommendations for the measurement of vitamin D levels in risk groups are not met. And not only this, but when low levels are detected, supplements are not prescribed. “The lines of screening and action in these groups must be reviewed, since the usefulness of vitamin D in the prevention of fractures and falls in the elderly population has been widely demonstrated, as well as in some problems during pregnancy and in children’s development,” says the expert.
The researcher affirms that a lot of research on vitamin D is needed to be able to establish public health policies. In addition, despite the fact that there is no clear recommendation to supplement people with low levels who are not in a risk group, “many specialists, when in doubt, prefer to supplement their patients: when they weigh the risk and the benefit of prescribing a supplement, they are clear about it and they choose to do it.
The study is titled “Paradoxical suboptimal vitamin D levels in a Mediterranean area: a population-based study”. And it has been published in the academic journal Scientific Reports, from the Nature group. (Source: UOC)