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The “compelling” case that Scotland's poor health record could in part be laid at the door of widespread vitamin D insufficiency, as reported yesterday in The Times, has garnered support from across the medical world,
Oliver Gillie, a scientist and writer, spent five years studying the parallels betweeen climate, vitamin D deficiency and indices of disease in his publication Scotland's Health Deficit: An Explanation and a Plan. He found clear links between serious illness and lack of sunshine.
Colin Begg, from the Sloan-Kettering Cancer Centre, New York, said : “I really think we need to find a way to undo the shortsightedness of the broad public campiagns that try to stop entire populaitons from being out in the sun unprotected'.
“I grew up in Scotland, and I often recall my mother, on rare sunny days, exhorting me to go out and soak up the sun' as it was good for me.”
Dr Begg's view was echoed by Edward Giovannucci, a professor at the Harvard School of Public Health, who said that the report “presented a very compelling case that widespread vitamin D deficiency contributes importantly to the many health problems that plague Scotland”.
Publicity about the research was especially welcome to Helga Rhein, an Edinburgh GP, who through her own work has become convinced that the Scots are widely vitamin D deficient and need to take supplements.
For a long time, Dr Rhein had been puzzled by the number of her patients, particularly South Asian women, who were suffering from vague pains, backache and muscle weakness, known as osteomalacia. Then, four years ago, she read an article in the British Medical Journal which showed that similar symptoms among the immigrant population in Switzerland were down to low vitamin D levels. It was as if someone had switched on a light.
“I thought - I have women just like that,” the GP said. “So I began testing the blood of my patients, and I found the same thing. Immediately the first person I took blood from was a young Asian woman who had been born here and who had very little vitamin D.”
Dr Rhein began to test all the people she suspected might have a deficiency. “It was very easy to find them,” she said.
She took blood from 99 people, aged 15 to 85, who were suffering either from vague muscular symptoms, usually in their legs or back; or who were overweight; or Asian; or housebound in some way resulting in little expose to sunlight.
What she found was astonishing. Only 2 per cent of her patients had a satisfactory vitamin D level. The rest, including all the ethnic minority patients she tested, had levels of vitamin D regarded as insufficient and almost half - 48 per cent - had levels that were deficient.
“The really surprising thing was that more than half the people I took blood from were white skinned,” Dr Rhein said. “I thought they would have adapted to the lack of sunshine. But of all these white skinned patients there were over 20 per cent who were in the very low range for vitamin D - in the range the laboratory said was abnormally low.”
Dr Rhein, whose practice is in Sighthill, an area of middle-ranking housing schemes, said that she was astonished when the results came in from the blood tests.
“If I - and I'm not a researcher - in my tiny practice in the middle of Edinburgh can find so many people, there must be so many others out there who have the same deficiency.
“What seems to be clear is a big proportion of the general public is grossly deficient.”
Dr Rhein, who has been a GP for 22 years, said one of the difficulties was availability of high-dose supplements to prescribe; and another was lack of awareness amongst GPs. Dr Rhein said she believed that babies, pregnant mothers, people with dark skins and those who had been advised to stay out of the sun should all take a daily supplement.
Mary Scanlon MSP, Shadow Cabinet Secretary for Health & Wellbeing, said: “Given that the Chief Medical Officer has endorsed the importance of, and noted the lack of vitamin D in Scots, I hope that the Scottish government will now respond.
“For many years, Scots have been told to keep out of the sun due to the high incidence of melanoma. Surely it is time for the government to issue further advice to people living in Scotland?” she added.
“The Scottish government needs to overcome the mixed messages about exposure to sunlight.”
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