Vitamin D: some perspective please

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e4695 (Published 19 July 2012) Cite this as: BMJ 2012;345:e4695
  1. Nicholas C Harvey, senior lecturer and honorary consultant rheumatologist,
  2. Cyrus Cooper, director and professor of rheumatology
  1. 1MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
  1. nch{at}mrc.soton.ac.uk

Health claims are ahead of the evidence

Vitamin D deficiency has been associated with an ever expanding list of diseases, and with this has come almost tonic-like claims for vitamin D supplementation. In observational studies, low vitamin D status has been associated with increased risk of multiple sclerosis, type 1 and type 2 diabetes, cardiovascular disease, colon cancer, breast cancer, autoimmunity, and allergy.1 The UK government has advised that all pregnant women, and children under 5 years, should take 400 IU vitamin D daily; a recent news story, however, reported a survey conducted by a charity which suggested that only 26% of pregnant women and 46% of healthcare professionals are aware of these guidelines.2 The most recent musculoskeletal trend seems to be the attribution of childhood problems such as Blount’s disease and slipped femoral epiphyses to vitamin D deficiency and the incorrect conflation of rickets with low serum calcidiol (25-hydroxyvitamin D3) concentrations.3 So are health professionals causing ill health through their lack of awareness and advocacy of vitamin D supplementation?

The high profile news coverage and the enthusiastic promotion of the results of observational studies as though they proved …

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