Vitamin D deficiency in Australia and New Zealand: What are the dietary options?

Abstract

Measurement of serum vitamin D levels in population samples has revealed unexpectedly high prevalence of vitamin D deficiency among children, adults, the elderly and other vulnerable groups in Australia and New Zealand. The new Nutrient Reference Values report has established dietary recommendations for vitamin D of between 5 and 15 µg/day, depending on age. Dietary intakes of vitamin D in Australia typically fall in the range of 2–3 µg/day, below intakes in comparable countries. Dietary intake of vitamin D is currently dependent on consumption of a few key foods, notably margarine and oily fish. Current models of healthy eating do not deliver the recommended amounts of vitamin D and need review. Consideration should be given to the range of foods fortified with vitamin D, which is currently limited. Higher dietary intakes of vitamin D in overseas countries have been achieved through the fortification of margarine, milk and breakfast cereals. Increased voluntary fortification of dairy products with vitamin D would be a safe and simple means of increasing vitamin D intakes in Australasia in the short term. The relatively high dietary recommendation for vitamin D for elderly people cannot be met through the existing food supply and supplementation appears to be a desirable option for many.

Vitamin D in health and disease: an insight into traditional functions and new roles for the ‘sunshine vitamin’

“…This study was unique as a result of the multiple interventions used and showed that oral vitamin D 3 and Ca given daily were more beneficial at increasing BMD than injected megadoses of vitamin D 2 with or without oral Ca (75) . A second study by the Randomised Evaluation of Calcium oR vitamin D (RECORD) trial group (66) , however, showed no significant differences in incidence in low trauma secondary fractures for elderly participants on vitamin D 3 , Ca and vitamin D 3 or a placebo followed over 24-62 months (see Table 4).…”

“…Results showed that first fracture risk was reduced by 22 % in the intervention group, while fracture risk for common osteoporotic sites (hip, wrist and vertebrae) was reduced by 33 % (71) . Two trials using BMD as the endpoint, rather than fracture incidence, have also shown that vitamin D 3 and Ca supplementation or the use of vitamin D 3 -and Ca-fortified food products were associated with an increase in BMD (72,73) (see Table 4). Both of these studies had a number of weaknesses including the use of relatively low levels of supplemental and dietary vitamin D (7·5 -12·5 mg/d) and small subject numbers.…”

“…Both of these studies had a number of weaknesses including the use of relatively low levels of supplemental and dietary vitamin D (7·5 -12·5 mg/d) and small subject numbers. However, they do provide support for the use of vitamin D 3 and Ca for bone loss prevention and the use of fortified dairy products by Moschonis & Manios (72) was particularly unique considering the role of other bone nutrients in dairy products in osteoporosis prevention.…”

“…Dietary intake contributes only small amounts of vitamin D overall, with vitamin D found in reasonable amounts in North Sea oily fish such as salmon, herring, sardines and tuna (4 -25 mg/100 g), egg (1·8 mg/100 g), butter (1·4 mg/ 100 g) and red meat and liver (0·7 -1·1 mg/100 g) (3) . The vitamin D within the same food products may also vary, with recent research showing that the vitamin D content of fish may vary enormously depending on whether fish is farmed or wild.…”

“…This creates a dilemma whereby our main source of this essential vitamin is via a known carcinogen that has been shown to increase the risk of skin cancers and is associated with other detrimental effects such as eye damage (2) . Foods contribute only relatively small amounts of vitamin D; however, useful amounts of vitamin D are found in foods such as fortified margarine (these are mandatorily fortified in Australia), fortified milks, eggs, and fish species such as North Sea salmon, herring and mackerel (3) .…”