Healthspan February 01, 2018

If there’s any breakfast we want you to make a regular part of your diet, it’s porridge. Not only does it gift you the health benefits of oats, it’s easy and can be personalised for the whole family.

Maintaining healthy joints and bones is an important part of staying healthy. Many people, however, are at risk of developing a variety of joint issues as a result of nutrient deficiencies. One particular nutrient that’s essential for health, but that we often lack, is vitamin D. In fact, around 1 in 5 people in the UK have low vitamin D levels — a concerning number considering these low levels have been linked to bone and joint conditions like osteoporosis, osteomalacia (or ‘soft bones’), and an increased risk of bone fractures.1, 2 The symptoms of vitamin D deficiency vary and are often quite vague — and even hidden.3 Here, we’ll take a look at why vitamin D is so important, and how to increase your intake to keep your joints healthy.

Who is at risk of vitamin D deficiency?

Until recently, it was believed that people living in the UK should be able to get sufficient vitamin D by eating a balanced diet and through sun exposure during the summer.4 However, the Latest National Diet and Nutrition Survey shows that 17% of UK adults have low vitamin D levels all year round – not just from October to March when sunlight isn’t strong enough to trigger vitamin D synthesis in the skin. If, as advised, you cover up in the sun and use high sun protection factor skin products, it’s wise to take a vitamin D supplement all year round to bridge the gap.5

Some people are at high risk of vitamin D deficiency, and should definitely select vitamin D fortified foods and supplements all year round. These include children between 1-4 years old, people who get very little or no sunshine exposure, and people with darker skin.6

Some medical conditions also affect your vitamin D levels. Those with coeliac and Crohn’s disease, for example, are at risk of vitamin D deficiency because of reduced absorption from the diet.7

The older you get the more difficult it becomes to synthesise vitamin D in your skin too.8 Therefore, as you age, it’s important to consider taking a vitamin D supplement to prevent deficiency.

How does vitamin D affect bones and joints?

Vitamin D plays many roles in the maintenance of strong, healthy bones and joints. One key role is the absorption and regulation of calcium levels. Calcium is not only essential for bones and joints, but also for muscle contraction, nerve impulses and secretion of hormones.9

Vitamin D controls how much calcium is absorbed from food into the body, as well as affecting how much calcium is excreted through the kidneys. Your body prioritises your serum calcium levels over your bones, so if there isn’t enough calcium in the blood, vitamin D will remove calcium from the bones to correct it.10 This means that if you aren’t getting enough vitamin D, your calcium levels may drop, which can increase your risk of osteoporosis and fractures associated with low bone mineral density.11

When you do have enough calcium though, vitamin D acts directly on osteoblasts — the cells that lay down calcium in the bones. Sufficient vitamin D is therefore particularly important for building bone density, as well as maintaining it.12

However, vitamin D isn’t just important for maintaining strong bones and joints. It also plays an important role in your overall health by inhibiting many of the inflammatory processes that can occur in the body. Inflammation is both a contributing factor and an aggravating factor in many joint conditions, so avoiding deficiency is incredibly important.13

Another area that vitamin D affects is muscle health. As muscles that support your joints can have an impact on your overall joint health, it’s important that vitamin D levels are sufficient. Vitamin D plays a role in muscle strength, with one review finding that correcting vitamin D deficiency can increase the strength of proximal muscles — those muscles found in or near the body’s core.14 This is important because weak proximal muscles can negatively affect balance and increase the risk of falling and injuring your joints.

Can vitamin D relieve or prevent joint conditions?

Vitamin D deficiency is a known risk factor for issues such as osteoporosis. Recent research also suggests that vitamin D could help to prevent the onset of inflammatory conditions such as rheumatoid arthritis. The findings also showed that once rheumatoid arthritis was present, patients were less responsive to vitamin D and therefore needed higher dosages.15

There is also growing evidence that vitamin D supplementation could benefit conditions such as osteoarthritis in people who are vitamin D deficient. One study showed that supplementing with vitamin D for 12 months reduced knee pain and improved knee function in those with osteoarthritis of the knee.16

How to boost your vitamin D levels naturally

There are plenty of ways to boost your vitamin D levels naturally. One way is through increasing sunlight exposure. When the skin is exposed to sufficient UVB light, the body will go through the process of producing vitamin D. So, the easiest way to support vitamin D production is to get yourself out into the sun. The British Association of Dermatologists that going outside for a matter of minutes around the middle of the day without sunscreen.17 However, during the winter the sunlight may not be enough to get adequate levels of the vitamin.18

While sunlight triggers the synthesis of natural vitamin D in the skin, it’s also important to consume vitamin D through your diet. Foods that contain vitamin D include eggs, oily fish and foods that are fortified with vitamin D. 19 Mushrooms that are exposed to UVB rays can also contain a good amount of vitamin D.20

Taking a vitamin D supplement is a convenient way to ensure you are getting enough, particularly if you are at risk of deficiency.21 In addition to adults taking a supplement daily, it’s also recommended that children between the ages of 1 and 4 are given a daily vitamin D supplement to ensure they have sufficient levels as they grow.

Ultimately, keeping your vitamin D levels sufficient can help not only your joint health, but also your overall health. From food to supplementation, it’s important to make sure you’re getting enough vitamin D from a variety of sources. If you’re interested in learning more about joint health, head over to our advice hub for more information and advice.


References
1NHS. (2016). The new guidelines on vitamin D — what you need to know. NHS.
2Wang, H., Chen, W., Li, D., et al. (2017). Vitamin D and chronic diseases. Aging and disease, 08(03).
3Harding, M. (2017). Vitamin D Deficiency. Patient.info.
4British Nutrition Foundation. (n.d.). New advice on vitamin D.
5British Nutrition Foundation. (n.d.). New advice on vitamin D.
6British Nutrition Foundation. (n.d.). New advice on vitamin D.
7Harding, M. (2017). Vitamin D Deficiency. Patient.info.
8Harding, M. (2017). Vitamin D Deficiency. Patient.info.
9Veldurthy, V., Wei, R., Oz, L., et al. (2016). Vitamin D, calcium homeostasis and aging. Bone research, 05.
10Veldurthy, V., Wei, R., Oz, L., et al. (2016). Vitamin D, calcium homeostasis and aging. Bone research, 05.
11Veldurthy, V., Wei, R., Oz, L., et al. (2016). Vitamin D, calcium homeostasis and aging. Bone research, 05.
12Van Driel, M., and Van Leeuwen, J. P. (2014). Vitamin D endocrine system and osteoblasts. BoneKEy Reports, 03.
13Yin, K., and Agrawal, D. K. (2014). Vitamin D and inflammatory diseases. Journal of Inflammation Research, 07.
14Stockton, K., Mengersen, K., Paratz, J. D., et al. (2011). Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporosis International, 22(03).
15Jeffery, L. E., Henley, P., Marium, N., et al. (2018). Decreased sensitivity to 1, 25-dihydroxyvitamin D3 in T cells from the rheumatoid joint. Journal of Autoimmunity, 88.
16Sanghi, D., Mishra, A., Sharma, A. C., et al. (2013). Does vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial. Clinical Orthopaedics and Related Research®, 471(11).
17British Association of Dermatologists. Vitamin D and the Sun.
18British Nutrition Foundation. (n.d.). New advice on vitamin D.
19Harding, M. (2017). Vitamin D Deficiency. Patient.info.
20Keegan, R. J. H., Lu, Z., Bogusz, J. M., et al. (2013). Photobiology of vitamin D in mushrooms and its bioavailability in humans. Dermato-endocrinology, 05(01).
21British Nutrition Foundation. (n.d.). New advice on vitamin D.
22British Nutrition Foundation. (n.d.). New advice on vitamin D.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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