Your Danish Post

“Are you taking your vitamin D”?

In Denmark, winter time can be a real challenge – not only because of the dark months that are hard to get through, but also because the lack of sun may impact directly on people’s health, as our expat writer found out.

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By Evmorfia Tsakiri Picture: Hisham Ammar

“Are you taking your vitamin D”? This is one of the most frequent questions I have heard during the Danish winter.

The truth is, I thought I would never ever face a problem with vitamin D deficiency; I come from a Mediterranean country and spend a lot of time there, especially during the summer months.

Moreover, I always prefer following a healthy diet, rich in fruit, fish and vegetables, where I get my vitamin supply through my diet. However, as I found out, living in the long and dark Danish winter means that all the above are not enough to supply the body with the necessary amount of vitamin D.

I realized it when I started noticing some weird changes to my body. I started feeling intense fatigue and a lot of pain in my bones and muscles.

When I visited my doctor, she immediately asked me; “Are you taking your vitamin D?” My answer was “No”.

So, she urged me to have the necessary blood tests in order to check my vitamin D level. After getting the results, I found out that I had a vitamin D deficiency, so my doctor recommended the appropriate supplement of vitamin D.

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Vitamin D: a precious treasure
All research shows that vitamin D is one of the most important vitamins for our body. It is a fat-soluble vitamin, which is synthesized in our body mainly through the effect of the ultraviolet sunlight on our skin and includes D-1, D-2 and D-3 vitamins.

It is considered a precious ally in the proper development of our bones and the health of our skeleton.

Recent scientific studies have highlighted the vital role of vitamin D, and especially; its contribution to the much-needed functioning of our immune system, the control of glucose, and its importance in acting against some forms of cancers, and not least, in reducing the risk of depression.

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The “sunlight” vitamin
It has justifiably acquired the title as the sunlight vitamin, since the main source of vitamin D intake is from the sun.

In order for our body to synthesize vitamin D, it must be exposed to the sun for about 15-20 minutes on a daily basis (for some this may not be enough, and it can depend on other factors such as a person’s age and skin colour).

This is certainly a challenge when you live in Denmark and go through the dark and short winter days. From October to April (and sometimes longer), the sun in Denmark is non-existent or too weak for our body to produce vitamin D.

This means that the level of vitamin D that can normally be acquired through sunlight is too low, making the need for extra vitamin D greater during the wintertime, compared to the rest of the year.

The lack of sun during the winter period, combined with an increase in the number of people who have very low levels of vitamin D, has made researchers point out that we need to consume more vitamin D.

In the Nordic region, the nutritional recommendations, adapted by the Nordic Council, have only recently been amended (2012), and was raised from 7.5 micrograms of vitamin D per day, to 10 micrograms.

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However, Lars Rejnmark, Associate Professor (Århus University Institute of Clinical Medicine), says that he believes it is reasonable to raise even these recommendations for a daily intake, because vitamin D deficiency is widespread in Denmark, especially in the winter. However, he also notes that the authorities’ recommendations do not have an effect on how much vitamin D those living in Denmark consume.

“Danes already cut into less than half the 7.5 micrograms that the authorities have recommended so far, as a survey of Danes’ dietary habits showed,” he says. “If we want to take the 2012 Nordic nutrition recommendations seriously, I think we should consider enriching some foods with D vitamins, maybe we should begin to enrich foods with vitamin D, as wells as mixing iodine in salt to ensure that the population meets its needs,” he says to Danish science site videnskab.dk.

In Denmark, vitamin D is not added to any foods, whereas in Sweden for instance, vitamin D is added to some products and in the US and Canada milk is fortified with vitamin D.

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Prevention is better than cure
It is better to take care in advance in order to avoid vitamin D dropping to very low levels, since if the levels become low, it can take some time to get these levels back up again.

If you notice any symptoms or have any suspicions of having lack of vitamin D, you should contact your GP and make an appointment. The GP will advise you on the tests you have to do and, if you really have a vitamin D deficiency, will recommend the appropriate supplement to take and ensure a follow up to ensure these levels are increasing .

Unfortunately, most surveys show that it is really difficult to acquire the daily requirement for vitamin D through diet only.

In a recent study (Danskernes Kostvaner 2011-2015), many Danes’ vitamin D intake through their diet was much lower than the recommended 10 micrograms a day, with about one third of the population’s intake through their diet at about 3.3 micrograms and a general average of the total population at about 4.8 micrograms.

In this research, accessing the effect of intake through sunlight was not measured; however, it does show how difficult it is to obtain the needed levels of vitamin D through the diet.

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Even if you are not D-vitamin deficient, it can be important to take a daily D-vitamin supplement.

In Denmark, the health authorities have so far been reluctant to issue recommendations concerning taking a D vitamin supplement for the population in general.

Instead, the Health Board, Sundhedsstyrelsen, recommend that, for instance children and adults, who do not spend much time outdoors daily, should take a supplement of up to 10 micrograms a day. Or for anyone who thinks they are not getting enough vitamin D, a daily supplement of 5 to 10 micrograms is recommended as sufficient for most individuals.

The lack of a general recommendation is contested by some medical experts, who believe that a general vitamin D supplement, and certainly during the winter, is necessary. D

Dietician, Lotte Bruun, has written the book, Super5:2, together with Dr Jerk W. Langer in which she recommends that Danes in general should take up to 25 micrograms of vitamin D as a supplement during the winter months. Other medical experts are of the same opinion.

There are many different vitamin D supplements available, and you can find them everywhere, even in super markets. Undoubtedly, winter in Denmark is a big challenge especially for the body but being properly prepared will let you enjoy it!

Symptoms of vitamin D deficiency: Muscle pains, difficulty in getting up from a chair or up the stairs, pain in your bones or other parts of the body. A blood test can ascertain if you have a vitamin D insufficiency.

Daily recommend intake of vitamin D: 10 micrograms – as set by the Danish Health Board

The main source of vitamin D comes from the sun – and a daily dose of sunlight for 15 to 20 minutes is estimated as enough to reach the daily-recommended dose. During the winter in Denmark, this can be difficult to obtain.
Take note, in Denmark, no food products are fortified with vitamin D contrary to for instance Sweden, Canada and the US (milk is fortified).

Sources: videnskab.dk,sciencenordic.com,health.com, Danskernes Kostvaner 2011-2015,Sundhedsstyrelsens kostråd