Dr Robert Verkerk, executive and scientific director at the Alliance for Natural Health-International (ANH-I), told us his group was preparing a response to the European Food Safety Authority (EFSA) consultation before the May 16 deadline.
“We will be disclosing science that has been omitted in our consultation response,” Dr Verkerk said. Its response would include a recommendation of about 100 µg a day to better combat muscular and skeletal issues like rickets.
“EFSA has been very selective in the data they have used. The opinion ignores clinical perspectives as well as the huge potential for nutrients to be used as a low-cost mechanism for disease prevention.”
He added the agency would benefit from dialogue with clinicians: “You need to look beyond research on a single vitamin studied in isolation if you are developing public health policy and disease prevention strategies that are amenable to the general public.”
EFSA’s Panel on Dietetic Products, Nutrition and Allergies (NDA) used bodily vitamin D levels known as (serum 25(OH)D) as its fundamental measure to determine appropriate vitamin D levels.
After consideration of factors like exposure to sun (which provokes bodily vitamin D production) the Panel set an adequate intake (AI) level of 15 micrograms (µg) per day from food sources for adults and children to achieve a serum 25(OH)D) level of 50 nanomoles per litre (nmol / L). For infants aged 7–11 months, 10 µg / day was established.
Vitamin D can also be generated in the body by exposure to UV sources like the sun and is important in the maintenance of bone and muscular health, along with a role in other bodily functions.
The NDA noted the difficulty in establishing vitamin D dietary reference values (DRVs) due to the complex interplay between how much of the ‘sunshine vitamin’ is generated in the body and how much is synthesised from sources like foods and food supplements.
An explanation of different intake measures can be found here.
But others noted the EFSA levels were broadly in line with the likes of the Institute of Medicine (IOM) in the US (15 µg) and recently issued recommendations from the UK Department of Health Scientific Advisory Committee on Nutrition (SACN) of 10 µg.
“There is a general recognition that obtaining even the current recommended levels of vitamin D through diet alone is impossible and that, for more northerly European areas, it is not possible to obtain sufficient vitamin D through sunlight to sustain blood levels throughout the year,” said John Smith, chief executive of the supplements trade group, Proprietary Association of Great Britain (PAGB) and general manager of Wyeth Consumer Healthcare in the UK.
“If the EFSA recommendations are ultimately adopted in the EU, the UK government will need to actively recommend the consumption of food supplements in order for people to achieve the levels advised.
“There are already many products on the market which carry these levels of vitamin D; if the recommended levels are adopted there will almost certainly be a growth in this market.”
Which level to roost?
Dr Carrie Ruxton, from the PAGB-backed Health Supplements Information Service (HSIS), said however that differences between the levels recommended by different agencies could be problematic.
“With two vitamin D opinions within a year – from SACN and EFSA – there is the risk of major confusion amongst health professionals who will responsible for communicating the refreshed advice to the public,” said Dr Ruxton.
“It is unclear which opinion will take precedence in terms of labelling recommendations, cut-offs for health claims or general consumer advice.”
Dr Ruxton advised the agencies to consult over their level setting.
“As both reports are still in draft form, SACN and EFSA must surely get together to determine a consensus approach. At the end of the day, we must bear in mind that substantial groups of Europeans are vitamin D deficient."
She added: “I would go with EFSA’s opinion to be on the safe side. It seems rather risky having the cut-off at the point where bone disorders are likely to occur – surely it is better to introduce a margin of error and ensure that people are consuming an optimal intake.”
In its data review EFSA tasked an ‘external contractor’ to perform a meta-regression analysis of “the relationship between serum 25(OH)D concentration and total vitamin D intake (habitual diet, and using vitamin D3).”
This featured 83 trials with children and adults (excluding pregnant or lactating women).
Current UK government advice, replicated in many European nations, states no additional dietary intake of vitamin D is necessary for individuals living a ‘normal lifestyle’.
Rickets, rates of which have been rising in recent years in many countries, causes bones to become soft and weak in children, which can lead to bone deformities.
Vitamin D is a fat-soluble vitamin family encompassing ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Both forms are found in foods and supplements, while vitamin D3 is synthesised in the body when skin is exposed to UV light (like the sun).
Vitamin D has won several claims under the strict EU nutrition and health claims regulation (NHCR) including its role in bone, muscle, teeth, immune system and cellular health.