Ireland, vitamin D report

well a warm welcome to today's talk now there's been a report from the aristos the the irish parliament uh and the president on vitamin d and it's a very thorough report and i'm really pleased to see i really welcome it because it's in agreement with a lot of the research that we have been discussing for over a year now on this channel so let's look at it and i particularly like it because it's completely accessible it's not written in jargonese anyone can read it and it's fine so this is the report directly from the aristas as we've said joint committee on health so open transparent accessible clear report there from the chair and all the members are there completely transparent clear open process i wish all processes were as clear and open as this in international health now let's get straight down to the detail um that that's uh that's a pre say there that that's that site have just been on there with the with the information on it um so let's have a look at what it's saying now i'll just read you out briefly the introduction because it's um it really summarizes things quite nicely the committee heard evidence that vitamin d deficiency is prevalent across the population this is of ireland and report recommendations that public health measures are established to address that deficiency these public health measures are preventative in nature and are recommended to reduce the risk of respiratory and other illnesses such as osteoporosis so um they're talking about ireland of course but we know that this applies to a lot of other places as well now uh let's go straight on to the for now i'm going to go into a bit of detail on this um as i say nothing taxing it's all it's all common sense research based stuff but uh let if you've short of time i'm just going to give you the uh the main recommendations so here's the main recommendations that daily vitamin d supplementation of 20 to 25 micrograms and of course 25 micrograms 25 micrograms is a thousand international units so that equals 1 000 international units it really is inconvenient that there's two different forms used so 25 micrograms a thousand international units same same thing anyway um supplements of 25 20 25 micrograms a day should be recommended to the entire adult population as a public health measure a direct quote from the paper the first the first point but they go on higher dose is recommended for vulnerable groups under medical supervision so they point out for example the elderly people with a high body mass index will probably need additional uh higher dose so really here what they're doing is recommending the irish doctors consider this and that for everyone considering prescribing a much higher dose in some circumstances for people at at increased risk point two second main recommendation uh that a public health policy which promotes better knowledge of the benefits of vitamin d and encourages vitamin d supplementation should be developed in time for consideration of the budget for 2022. now fortunately vitamin d is pretty cheap so i don't anticipate that being a problem but thinking about that the the irish is saying uh that reducing the cost of vitamin d supplementation in order to promote its uptake should be considered now i mean i must say it's um it is it is pretty cheap anyway i mean what's this one i mean this one's 25 micrograms 60 tablets and i think it was about two or three english pounds i mean i mean vitamin d is inexpensive but they're going to make it cheaper which of course is brilliant that specific measures need to be put in place for vulnerable groups and frontline healthcare workers who of course as a frontline healthcare worker you're exposed to uh to every organism virus bacteria going because you're working with poorly people so excellent if uh frontline healthcare workers have additional protection or they optimize the immune system so that vitamin d supplementation is administered on an opt-out basis so what they're saying here is vulnerable groups and frontline healthcare workers should be taking vitamin d supplement by default and vitamin d supplementation is administered on an opt-out basis if they need to opt out and for the duration of this pandemic people should be offered vitamin d supplements when presenting at covered 19 testing centers so clear indication there that they are thinking that vitamin d is going to be protective in covid19 now we know it takes about a week to convert the vitamin d into the active form but i still i still like this um that's that's what they're doing so that is the position in that's the report in ireland now so they're the main recommendations of your shorter time but but do stick around this is really it's so encouraging to see a national government take this sort of proactive action um at doses which are reasonable with recommendations for for higher doses for at-risk groups now let but let's go on um why vitamin d is important well again this is directly from the report so and the report is also well referenced now i'm limited to how much information i can put in the uh in the comment section on youtube you can only put in so many words but i will be putting in as many references as i can but all the references are on the report if you go into the report you'll see the references you can click on the references from the report so assisting in muscle strength good inadequate levels of vitamin d associated with now when we know about bone disorders and um uh flexible bones in young people so um that that that's that's fairly well known but the the these are in addition to that so metabolic disorders autoimmune conditions psychiatric disorders respiratory disorders cardiovascular disorders and cancers so inadequate vitamin d levels are associated associated with all of these according to this report and we have looked at research for all of these ourselves so this is really reassuring confirmation uh the quote data from the irish longitudinal study on aging now if you i mean i'm not going to put all the references in here but this largely comes from this report here vitamin d deficiency is associated with increased likelihood of incidence of depression uh in old adults so so that's on that one so as i say i'm not going to give all the references they are on the uh on the report so but over the age of 50 75 more likely to experience depression if their vitamin d levels are low so i mean this is just huge so people over the age of 50 are 75 percent more likely to experience depression if their vitamin d levels are low 75 percent more likely i mean this is huge depression is is a horrible wretched condition and um i know i know it's anecdotal evidence that well it's not evidence it's only anecdotes but so many people have written in and put on the comments that they feel better now they're taking vitamin d supplements but that that's what the data from the irish work is showing 75 more likely to experience depression it really is a big big factor and of course we've known about the seasonal affective disorders for a long time as well increase increases the likelihood of developing depression in later life so deficiency of vitamin d increases the likelihood of depression in later life and this is really quite common and it's a horrible horrible condition high prevalence of vitamin d deficiency amongst our older population so there's a lot of deficiency therefore they are going to be prone to this increased likelihood of depression and depression affects functional status and longevity so here they're saying depression can actually uh mean that someone dies at a younger age and functional status if you're depressed you're just not functional you know i mean i've had periods of depression many of you have had peers depression and you just can't do things if you're in a depressed state is what they're saying supplementation has a low risk of toxicity according to the irish study right in the context of covet 19 vitamin d is known to assist the immune system in fighting harmful bacteria and viruses now notice the language here vitamin d is known to assist known to assist known to assist this report says they know this reduces the risk of acute respiratory infections ari evidence that it reduces the risk of acute respiratory infections so vitamin d adequacy reduces the risk of respiratory infections evidence from major international studies the the the these papers here the jolly papers again all referenced these say 25 reduction in the risk of respiratory infections in those taking daily vitamin d supplements so in the context of the irish population which is a fairly they well this is international actually but the irish marriage population is representative 25 reduction in reducing the risk of respiratory infections of those taking vitamin d supplements i am happy to accept a 25 reduction in my risk of respiratory infections to be quite honest um right now this is interesting as well and we have mentioned this several times um you might have um listened to the uh discussion with professor spector uh i was talking about the bradford hill criteria i only got time to do one of them which was strength but uh the bradford hill criteria allow you to not prove but infer causation from associations so um the evidence from existing studies meets the bradford hill criteria for causality now this is from this paper by uh austin bradford hill uh published way back in 1965 when they didn't have the internet of course but it is now on the internet you can actually read the full um original paper so richard doll and austin bradford hill uh famous epidemiologists and they discovered a little link between smoking and um mortality in relation to smoking 10 years observational studies of british doctors the british doctor studies so what richard dolan austin bradford hill actually did was they use these methodologies to work out firstly that smoking cigarettes caused lung cancer that was the first thing that worked out then they worked out that cigarette smoking was a major factor in ischemic heart disease and caused atherosclerosis furring up of the coronary arteries great epidemiologists and of course they put forth this idea that smoking was harmful but there was vested interest in smoking people were making a lot of money out of it so uh it wasn't admitted for a long period of time and had a long prolonged battle because financial interests were taking precedent over health interests and um interestingly um my brother was working on a paper or a letter from richard dahl where i can't remember quite when it was now but it was back in the 60s i think when he i think it was early 60s when he identified the risk of uh asbestos unfortunately my brother didn't survive to complete his research but um richard doll was warning about the risk of asbestos and mesothelioma back in the early 60s and again that wasn't acted on it was almost as if people were put in commercial interests more importantly than people's lives let's hope no one today is putting commercial interests above people's lives let's hope that is the case i'm not sure but um we can hope it is right so um i'm just putting these down as the credibility of the people that are talking here it strongly supports the causal relationship between low vitamin d status and increased risk of severity of covid19 disease so they are satisfied that the bradford hill criteria are met and this strongly supports a causal relationship in other words their support that they're postulating here strongly that it's the low vitamin d levels that causes the increased severity of covid19 this is what this irish study is suggesting so more than suggesting it's strongly supported right irrespective of recovered 19 they say vitamin d supplementation is an essential public health measure required to address the widespread deficiency noted across the irish population significant adverse health effects significantly adverse health effects of this deficiency so the significant adverse health effects because of the deficiency now the next one they talk about is probably fairly obvious ireland is an intensely green and beautiful country because of its oceanic climate um lack of sun in ireland and this is what the report says especially from late autumn to mid-spring longer working hours indoors those in nursing homes spend considerable periods indoors who died most from this pandemic highest death rates for rent care facilities lockdown reduced outdoor exposure still further professor john fall direct quote in the report for this reason alone we should be increasing the supplementation purely because of lockdown so there was shortages already and of course lockdown people not getting out as much made it worse so advocating supplementation for that reason professor rose and kenny we do not get it we do not get it in ireland from sunshine vitamin d um we do not get it in ireland from sunshine at this time of the year or indeed during most of the spring and some of the autumn in other words it's only summertime you get you get enough vitamin d in ireland basically it's the same in where i am in england the the sun needs to be 45 degrees in the sky so that the ultraviolet b radiation gets through so your skin can synthesize the vitamin d um and of course it doesn't happen this message needs to get out there says the professor right now why is the professor saying this direct quote i say this because i have heard scientists speaking on radio saying there is no need to supplement because people get sufficient from food and sunshine in ireland this is very incorrect and it needs to be said this is very incorrect in other words they're not getting enough from the sun and they're not getting enough from their diet in the island situation so where does the vitamin d come from uh in the irish diet well fortified milk super milk and cereal so there is some fortification in ireland i don't think there's much fortification in the uk certainly not in milk that i'm aware of and they talk about oily fish which is good um oily fish is a good source of vitamin d but farm salmon not so good and of course the salmon you get now is all is all farmed the poor things live the whole lives in these pens in the sea and they're often fed on not not not a sort of seafood diet i think they're fed largely on soya and of course that affects the nutrients that actually end up in the fish tissues so farm salmon is less than a third of the vitamin d con compared to wild salmon so basically it's very very hard to get vitamin d from the diet in in a modern environment unless you can afford to eat lots of oily fish and things like that therefore the only way for the irish population to get sufficient level of vitamin d is through the regulation of vitamin d supplements again direct quote if it's in italics it's a direct quote the only way their eyes can get enough is through vitamin d supplements now i mean obviously if you're uh a builder and you're working outside you can take your shirt off or if you're the allotment for for summertime you can you can make a lot of summertime but then autumn and winter winter you're going to make virtually none and it's going to run low that's what they're saying my safety vitamin d supplementation is addressed by the committee there's a consensus they reference the european food safety authority scientific institute of medicine from the u.s um so that that's the uk group so so basically the the support the putting references from international countries that there's consensus about the safety of vitamin d supplementation all the vitamin d intakes below 100 micrograms per day so that remember that's 100 micrograms is as they say 4 000 international units are safe for adults and do not pose a risk to humans so basically they're saying you can take up to 4 000 international units a day and according to this report there is consensus that that is safe that is what this report is saying food safety authorities of ireland endorse the uh the upper intake threshold of 100 micrograms right so the food safety authority of ireland is an agreement that 100 micrograms a day should be the upper limit but is uh safe is what they're saying there's consensus about this so they're saying up to 100 micrograms a day which is four thousand international units a day for adults and they say that that can be suitable for children over the age of 11. and of course younger children also need vitamin d or beard at a proportionately lower level right irish population deficiency levels um do you know geo mapping vitamin d status in a large sydney event so so that that that's i've just put another reference in there that's that one there but this is where the report and this is but this is uh agreed to by the report now this is interesting deficiency according to them is less than 50 nanomoles of the the active form of the vitamin d in the blood let less than 50 nanomoles a liter now that is exactly the same as 20 nanograms per mil so we tend to use that unit in the uk and europe we tend to use those units in the united states but it's exactly the same so all you do to convert that nanograms per ml into nanomoles per liter as you multiply it by 2.5 that's the that's the conversion so that and that are exactly the same and there's a deficiency is less than 50 nanomoles or less than 20 nanograms per mil so again very clearly defined in this in this very transparent report clear definition you might not agree 100 with that but that's what they're saying it's clear it's easy to understand so um and i i am more than happy with those with those definitions now using those definitions who is deficient in ireland 47 of 18 to 39 year olds nearly half of them to 18-39 young adults 47 deficient of vitamin d 50 to 59 year olds 35 deficient over 80 is 64 deficient and in nursing home residents greater than 67 percent are deficient of vitamin d and wait for this 93 of dark skinned i can't remember what it stands for actually black and minority ethnic groups i think who's died most in the united states for example in this pandemic those with darker skins that make vitamin d much more slowly deficiency 93 in ireland the death rate in being communities in the uk has been terribly high terribly high but in ireland we know that 93 percent in the bain community are deficient in vitamin d i don't think anyone's bothered to find out in england not as far i haven't seen any large-scale studies on it don't we bothered but the irish have impressive excellent work obesity is another risk factor so agent increasing risk factor uh dark color skin of risk factor obesity six percent of the population of ireland are overweight dear me but don't think we're any better in the uk or the united states that results in vitamin d deficiency requiring higher oral doses of vitamin d so again they would require higher doses of vitamin d now i've gone on for quite some time so i'm going to leave that there we will come back and talk about this report again because there's quite a bit more to look at so um it's all there well worth a read it's completely accessible you can read through it in about a couple hours but and i skim through in an hour um it's all there um this is what we've we've talked about uh that's the proportion there vitamin d in ireland that we've just looked at give some nice graphics yeah around vitamin d status in irish adults um do look at it for yourself well worth looking at increasing the older population increased in obesity increased in the bain community and uh next time we'll look at um i know that's international approaches to vitamin d deficiency oh no we haven't done that yet so that they talk about finland and they talk about spain and all sorts of interesting things but um that's enough for that one we'll put that one up to be going on with um hope that helps um if this is what the evidence is showing this is what we need to to follow and um it looks like the irish government are um going to implement all of this and i just love this transparent report you know everyone is there it's all it's all clear it's there's accountability there's governance you know we need accountability and governance in our national and international organizations and uh the eye of government seems to be leading the way let's hope others follow but anyway that's that's very reassuring about about uh vitamin d and um for an alternative perspective do listen to the discussion i hope with tim spector but um i believe i've presented quite a lot of evidence then we'll put a lot more references in the uh in the comments section follow the evidence wherever it leads thank you thank you of course uh very much for for watching and i hope this was helpful

Channel: Dr. John Campbell

Views: 216,785

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Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: hG72xGd0W0M

Length: 26min 5sec (1565 seconds)

Published: Thu Apr 08 2021