Vitamin D and Calcium during COVID 19.

The current pandemic has seen the importance of Vitamin D in our overall health. Not only is Vitamin D essential for bone health, but it helps to regulate cell growth and the immune system. Vitamin D is vital for the absorption of Calcium; it increases the body’s ability to absorb Calcium by 30-80%. It is the only vitamin that you do not have to consume in food or supplements as it can be manufactured through the skin when exposed to the sun.

Research has not been carried out yet around Vitamin D and COVID 19. However, common sense suggests that if our immune systems are negatively affected by low levels of Vitamin D, we might find it harder to fight off COVID 19.

Vitamin D

The sun is the most potent source of Vitamin D which is a fat-soluble vitamin that when consumed or made in the skin can be stored in the blood and body fat, for several months.

About 15 minutes of sunlight a day, without sunblock on any part of the body during the summer months will enable the body to store Vitamin D. Sunblock should be applied to the skin after 15 minutes.

The amount of Vitamin D formed depends on the age of the person and the amount of sunblock as well as the amount of makeup used by the person. It is essential to avoid overexposure resulting in sunburn, as we are all aware of the damaging effects of the sun.

In Ireland, we have a lack of sunshine, and only a few foods naturally contain Vitamin D.  Due to Ireland’s northern latitude, little UV light is available between October and March. This can result in low levels of Vitamin D. The Vitamin D that we store in the summer months must last through the winter season.

If you are not getting Vitamin D via the sun, there may be inadequate amounts of Vitamin D in your diet. In this case, supplementation is necessary when dietary intake of Vitamin D is insufficient.

It is recommended that everyone from birth throughout life should be taking daily amounts of Calcium and Vitamin D in food or medically approved supplements. Remember also to take plenty of fresh fruit and vegetables that contain other vitamins and minerals.

There are a small number of people who take too much Calcium and Vitamin D, so check your daily amounts.

Vitamin D is essential for Calcium absorption.

Low levels of Vitamin D have been linked to: multiple forms of cancer, TB, MS, osteoarthritis and Type 1 Diabetes. Low levels of Vitamin D mimics the symptoms of Fibromyalgia (therefore Vitamin D levels should be checked on those diagnosed or thought to have possible Fibromyalgia).

NOTE Calcium and Vitamin D supplementation have been shown to reduce the risk of fracture and falls and improve muscle function in the elderly.

NOTE We thankfully have had some sun during this pandemic but ensure to put sunblock on after 15 minutes and increase your water intake, so you do not become dehydrated.  In Ireland, 74% of adults and 88% of primary school children, have less than half of the recommended daily amount of Vitamin D. Many people do not get the recommended amounts of Vitamin D through food so supplements are usually recommended.  The ability of people to produce Vitamin D in their skin from the sun reduces with age.

NOTE Senior citizens tend to spend very little time outside in the sun, especially those who have limited mobility or are living in nursing homes. Those with darker skin (e.g. Africans) do not absorb Vitamin D from the sun, as quickly as people with lighter skin. Those who are obese are at a higher risk of low Vitamin D levels.

Vitamin D can be found in some foods.  These include :

• Fortified dairy products like yoghurts, margarine, and eggs.
• Fish oils and species of fish such as salmon, tuna, sardines, mackerel, halibut and herring.
• Breakfast cereals, soya milk and rice milk may also be fortified with Vitamin D.

Please check individual labels for Vitamin D amounts as they can vary.

How much Vitamin D do you need?

Babies 0-12 months breast fed or formula fed = 5μ/200 IU *

Children 1-18 years= 10μ/400 IU per day***

Adult women 19-49 years = 10-20μ/400-800 IU per day**

Adult women 50+ years = 20-30μ/800-1000 IU per day**

19+ years pregnant and/or breastfeeding = 20-30μ/800-1000 IU per day**

Adult men 19-49 years =10-20μ/400-800 IU per day**

Adult men 50+ years =20-30μ/800-1000 IU per day**

Sources:

* HSE 2011

** National Osteoporosis Foundation USA

*** American Academy of Paediatrics.

Low Levels of Vitamin D can be due to many reasons.

Please contact the Irish Osteoporosis Charity if you have any further queries.

Calcium

Calcium is the most abundant mineral found in our bones and helps to give bones strength and rigidity. Every cell in our body, including those in the heart, nerves and muscles rely on Calcium.

It has been said that Osteoporosis is a childhood disease that manifests itself in adult years. As children, it is necessary to grow a strong, healthy skeleton that will last a lifetime. Typically, we reach our peak bone mass by age 25-30, and the density of our bones will depend in part upon the Calcium and Vitamin D intake in childhood and teen years.

Calcium is also particularly important at menopause because Calcium absorption slows down due to lower levels of oestrogen.

Calcium is best absorbed from dairy products.

The best sources are

• Yoghurt, milk and cheese.
• Bread, almonds and tinned fish.
• Dark green vegetables.
• Some brands of orange juice
• Most breakfast cereals have added Calcium.

NOTE: Calcium alone is not enough to treat bone loss.
Calcium should not be taken without Vitamin D and is not a substitute for drug therapies that treat bone loss.

How much Calcium do you need?

0-12 months = 525 (non breast fed infants only)*

1-3 years = 500 mg per day***

4-8 years = 800 mg per day**

9-18 years = 1300 mg per day**

Pregnant/or breastfeeding women 18 years & under = 1300 mg per day**

Women 19-49 years = 1000 mg per day**

Pregnant and breastfeeding women 19 years + = 1000 mg per day**

Women 50+ years = 1200 mg per day**

Men 19-49 years = 1000 mg per day**

Men 50+ years = 1200 mg per day**

Sources:

* National Osteoporosis Society UK

** National Osteoporosis Foundation USA

*** IOF-FAO/WHO: Human Vitamin and Mineral Requirements, 2002

Teenagers & pregnant/breastfeeding mothers may need to increase to 1500 mg

Calcium per day if they have Osteopenia or Osteoporosis.

Yoghurt, milk and cheese and are some of the best sources of Calcium. Low-fat options are available for those with high cholesterol. Pregnant women and teenagers require 1200mg per day of Calcium and will need at least 5 of these servings to get the recommended daily intake.

Calcium and Vitamin D Supplements

Calcium and Vitamin D supplements are recommended for anyone unable to get the daily recommended amounts of Calcium and Vitamin D through food. Supplements help provide building blocks for healthy bone production. Several of these are available on prescription. Some over-the-counter supplements do not contain adequate amounts of Calcium and Vitamin D.

It is essential that people try to drink 6-8 glasses of water a day for overall health and also to prevent constipation when taking Calcium and Vitamin D Supplements and other medications unless otherwise instructed by your Doctor.