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UK Food Standards Agency Workshop Report: an investigation of the relative contributions of diet and sunlight to vitamin D status

  • Margaret Ashwell (a1) (a2), Elaine M. Stone (a3), Heiko Stolte (a3), Kevin D. Cashman (a4), Helen Macdonald (a5), Susan Lanham-New (a6), Sara Hiom (a7), Ann Webb (a8) and David Fraser (a9)...

Abstract

The UK Food Standards Agency (FSA) convened an international group of scientific experts to review three Agency-funded projects commissioned to provide evidence for the relative contributions of two sources, dietary vitamin D intake and skin exposure to UVB rays from sunlight, to vitamin D status. This review and other emerging evidence are intended to inform any future risk assessment undertaken by the Scientific Advisory Committee on Nutrition. Evidence was presented from randomised controlled trials to quantify the amount of vitamin D required to maintain a serum 25-hydroxy vitamin D (25OHD) concentration >25 nmol/l, a threshold that is regarded internationally as defining the risk of rickets and osteomalacia. Longitudinal evidence was also provided on summer sunlight exposure required to maintain 25OHD levels above this threshold in people living in the British Isles (latitude 51°–57°N). Data obtained from multi-level modelling of these longitudinal datasets showed that UVB exposure (i.e. season) was the major contributor to changes in 25OHD levels; this was a consistent finding in two Caucasian groups in the north and south of the UK, but was less apparent in the one group of British women of South Asian origin living in the south of the UK. The FSA-funded research suggested that the typical daily intake of vitamin D from food contributed less than UVB exposure to average year-round 25OHD levels in both Caucasian and Asian women. The low vitamin D status of Asian women has been acknowledged for some time, but the limited seasonal variation in Asian women is a novel finding. The Workshop also considered the dilemma of balancing the risks of vitamin D deficiency (from lack of skin exposure to sunlight in summer) and skin cancer (from excessive exposure to sunlight with concomitant sunburn and erythema). Cancer Research UK advises that individuals should stay below their personal sunburn threshold to minimise their skin cancer risk. The evidence suggests that vitamin D can be produced in summer at the latitude of the UK, with minimal risk of erythema and cell damage, by exposing the skin to sunlight for a short period at midday, when the intensity of UVB is at its daily peak. The implications of the new data were discussed in the context of dietary reference values for vitamin D for the general population aged 4–64 years. Future research suggestions included further analysis of the three FSA-funded studies as well as new research.

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Corresponding author

*Corresponding author: Dr M. Ashwell, email margaret@ashwell.uk.com

References

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1Scientific Advisory Committee on Nutrition (2007) Update on Vitamin D. London: TSO.
2Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Committee on Medical Aspects of Food Policy. London: HMSO.
3Department of Health (1998) Nutrition and Bone Health: With Particular Reference to Calcium and Vitamin D. Committee on the Medical Aspects of Food and Nutrition Policy. Working Group on the Nutritional Status of the Population Subgroup on Bone Health. London: The Stationery Office.
4Francis, RM (2008) What do we currently know about nutrition and bone health in relation to United Kingdom public health policy with particular reference to calcium and vitamin D? Br J Nutr 99, 155159.
5Gregory, J & Lowe, S (2000) National Diet and Nutrition Survey (NDNS): Young People Aged 4–18 Years. London: The Stationery Office.
6Ruston, D, Hoare, J, Henderson, L, et al. (2004) The National Diet and Nutrition Survey: Adults Aged 19–64 Years. vol. 4: Nutritional Status (Anthropometry and Blood Analytes), Blood Pressure and Physical Activity. London: The Stationery Office.
7Finch, S, Doyle, W, Lowe, C, et al. (1998) National Diet and Nutrition Survey: People aged 65 years and over. vol. 1: Report of the Diet and Nutrition Survey. London: The Stationery Office.
8Hypponen, E & Power, C (2007) Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 85, 860868.
9Bischoff-Ferrari, HA, Giovannucci, E, Willett, WC, et al. (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84, 1828.
10Institute of Medicine Food and Nutrition Board (1997) Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press.
11Doets, EL, de Wit, LS, Dhonukshe-Rutten, RA, et al. (2008) Current micronutrient recommendations in Europe: towards understanding their differences and similarities. Eur J Nutr 47, Suppl. 1, 1740.
12Ashwell, M, Stone, E, Mathers, J, et al. (2008) Nutrition and bone health projects funded by the UK Food Standards Agency: have they helped to inform public health policy? Br J Nutr 99, 198205.
13Cashman, KD, Hill, TR, Lucey, AJ, et al. (2008) Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr 88, 15351542.
14Cashman, KD, Wallace, JM, Horigan, G, et al. (2009) Estimation of the dietary requirement for vitamin D in free-living adults > = 64 y of age. Am J Clin Nutr 89, 13661374.
15Henderson, L, Irving, K, Gregory, J, et al. (2003) The National Diet and Nutrition Survey: Adults Aged 19–64 Years. vol. 3: Vitamin and Mineral Intakes and Urinary Analytes. London: The Stationery Office.
16Vieth, R (2009) Experimentally observed vitamin D requirements are higher than extrapolated ones. Am J Clin Nutr 90, 11141115, author reply 1115–6.
17Cashman, K & Kiley, M (2009) Reply to R Vieth. Am J Clin Nutr 90, 11151116.
18Mavroeidi, A, O' Neill, F, Lee, P, et al. (2010) Seasonal 25-hydroxy vitamin D changes in British postmenopausal women at 57°N and 51°N: a longitudinal study. J Steroid Biochem Mol Biol (epublication ahead of print version 17 March 2010).
19Clewes, C & Mander, A (2007) N05076: report of the analysis of 25-hydroxy vitamin D to compare four different methods.
20Wallace, A, Gibson, S, de la Hunty, A, et al. (2010) Measurement of 25-hydroxyvitamin D in the clinical laboratory: current procedures, performance characteristics and limitations. Steroids 75, 477488.
21Lanham-New, S, Darling, A & Berry, J (2010) Vitamin D, food intake, nutrition and exposure to sunlight in southern England (D-FINES). Final Study Report. London: Food Standards Agency.
22Clements, MR, Davies, M, Fraser, DR, et al. (1987) Metabolic inactivation of vitamin D is enhanced in primary hyperparathyroidism. Clin Sci (Lond) 73, 659664.
23International Agency for Research on Cancer (IARC) (1992) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Solar and Ultraviolet Radiation. Lyon: IARC, WHO.
24Armstrong, BK & Kricker, A (2001) The epidemiology of UV induced skin cancer. J Photochem Photobiol B 63, 818.
25Cancer Research UK (2006) CancerStats: Malignant Melanoma-UK.
26Gandini, S, Sera, F, Cattaruzza, MS, et al. (2005) Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer 41, 20402059.
27Chang, YM, Newton-Bishop, JA, Bishop, DT, et al. (2009) A pooled analysis of melanocytic nevus phenotype and the risk of cutaneous melanoma at different latitudes. Int J Cancer 124, 420428.
28Armstrong, BK & Kricker, A (1993) How much melanoma is caused by sun exposure? Melanoma Res 3, 395401.
29Elwood, JM & Jopson, J (1997) Melanoma and sun exposure: an overview of published studies. Int J Cancer 73, 198203.
30Rivers, JK (2004) Is there more than one road to melanoma? Lancet 363, 728730.
31International Agency for Research on Cancer (IARC) (2008) Vitamin D and Cancer. Lyon: IARC, WHO.
32Waltz, P & Chodick, G (2008) Assessment of ecological regression in the study of colon, breast, ovary, non-Hodgkin's lymphoma, or prostate cancer and residential UV. Eur J Cancer Prev 17, 279286.
33Webb, AR, DeCosta, B & Holick, MF (1989) Sunlight ultimately regulates the production of vitamin D in the skin by causing its destruction. J Clin Endocrinol Metabol 68, 882887.
34Webb, AR, Kline, LW & Holick, MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D synthesis in human skin. J Clin Endocrinol Metabol 67, 373378.
35Webb, AR & Engelsen, O (2006) Calculated ultraviolet exposure levels for a healthy vitamin D status. Photochem. Photobiol 82, 16971703.
36Webb, AR & Engelsen, O (2008) Ultraviolet exposure scenarios: risks of erythema from recommendations on cutaneous vitamin D synthesis. Adv Exp Med Biol 624, 7285.
37Webb, AR (2006) Who, what, where and when? Influences on cutaneous vitamin D synthesis. Prog Biophys Mol Biol 92, 1725.
38de la Hunty, A, Wallace, M, Gibson, S, et al. (2010) A consensus report on the Workshop held in November 2009: to discuss the choice of method for measuring 25OHD to estimate vitamin D status for the UK National Diet and Nutrition Survey (NDNS). Br J Nutr (epublication ahead of print version).

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