I was delighted to read Lisa Jamieson’s opinion piece ‘It’s not just medicines that improve health — pharmacists need a better understanding of nutrition’.
Jamieson is quite right to call on pharmacy educators to emphasise the importance of nutrition in health. Her article mentions the importance of sensible nutrition for reducing the impact of asthma and diabetes on the population. She mentions vitamin D in the context of asthma control, and it is needed for the secretion of insulin, but it also has effects on many other important aspects of health.
At this time of year, it is worth being reminded that the body does not produce vitamin D by sun exposure between October and March, since the sun does not provide sufficient UVB rays. If your shadow is longer than you are, you will get no vitamin D from sunlight. Even in the summer, going for a run at dawn or dusk, while spending the rest of the day indoors, will not be useful for getting vitamin D.
Public Health England says that everyone needs at least 400 international units (or 10 micrograms) of vitamin D every day. Vitamin D is a fat-soluble substance and, if taken in tablet form when there is no lipid in our digestive tract, the oral dose will not be absorbed. If taken in capsule form, the vitamin D is already dissolved in oil and will be absorbed even if taken without food.
Many vitamin D supplement preparations are provided in tablet form and, although some packets say “take with food”, none of the supplements I have seen address the need for lipid in the meal. Pharmacists have an excellent opportunity to advise patients about this.
Brian Curwain, Hampshire
