Vitamins and supplements – why choice and context are key

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  Posted by: The Probe      16th July 2021

At the end of 2020, the vitamin and supplement market was set to reach nearly £500 million in the UK, a record rise in value of around 9% on the previous year.[i] The biggest rise was for vitamin D, which will come as no surprise, after it was repeatedly linked with the prevention and management of covid-19. Although some benefits from taking vitamin D are “to optimise musculoskeletal health”, the evidence in relation to the coronavirus remains “indirect and inconclusive” and last December, NICE, Public Health England and the Scientific Advisory Committee on Nutrition issued joint guidelines for healthcare practitioners on this matter.[ii],[iii] Current government advice suggests taking a vitamin D supplement between October and March, with different recommendations for groups that could be deficient all year round, also for babies and young children.[iv]

The issue of choice

The vitamin D question aside, people are choosing to spend more money on protecting their health. But, if eating a healthy balanced diet, aside from certain exceptions, do most people need them? The answer is usually no from a clinical point of view and, if taken incorrectly and not according to the manufacturer’s instructions, some vitamins and supplements might even be harmful. [v] Also, as the body can’t store water-soluble vitamins such as B and C, any excess, as well as any money spent on these products, will end up down the toilet, literally.[vi]

The link between vitamin C and gingival health has long been known, patients deficient in vitamin C are more likely to develop gingivitis and present with gingival bleeding. But research now suggests a significant link between vitamin D and oral health. A recent study showed a link between vitamin D deficiency and a variety of oral health disorders particularly in children, these include increased risk of and onset of the progression of dental caries, higher prevalence of periodontitis and, in some cases, oral cancers.[vii] A connection can also be found between vitamin A and the regulation of salivary secretions, meaning patients lacking in vitamin A could be at higher risk of caries and gum disease due to xerostomia.

Research suggests that, for the most part, it is more beneficial to acquire these essential vitamins and minerals through dietary means. During your oral health consultations, diet and nutrition must be discussed. If the conversation turns to vitamins and supplements, and your patient is not in one of the groups for whom they are strongly advised, ensure you have plenty of resources on hand.

Because we have to consider the issue of choice. For example, if an individual is interested in their health and wellbeing, they adhere to good preventive behaviours and have done their research, choosing to take a high-quality daily multivitamin is no cause for concern. The bigger picture here is that they want to protect themselves against future illness. We’re in the second year of the pandemic and people feeling motivated to take control of their health is one, perhaps the only, positive to come out of this time.

The context of poor nutrition

We must also look at the context of long-term concerns about poor diets in the UK. Despite ongoing public health campaigns, the data for childhood and adult obesity, including hospital admissions where obesity was a factor, has continued to show an increase, year-on-year, particularly in deprived areas.[viii]

Better nutrition means better health. It stabilises mood and improves immunity.[ix] Plenty of everyday foods are nutrient rich and, when part of a balanced diet, will give your patients what they need without having to take a supplement (unless there is a recommendation that they do).

A healthy diet is not boring. The typical Mediterranean diet – which includes fruit, vegetables and wholegrain cereals, also moderate amounts of animal/fish protein and unsaturated fats, doesn’t exclude the odd, sweet treat or glass of something alcoholic and yet it is widely endorsed as the best way of eating to prevent disease, and even enjoy better mental wellbeing.[x],[xi]

A common sense approach

If people are choosing to take vitamins and supplements, this should be part of a common-sense approach to preventive health, alongside other proven practises. These include eating a balanced diet, daily exercise, drinking in moderation, avoiding tobacco and having an effective oral hygiene routine – TANDEX has daily toothbrushes, interdental brushes and other adjuncts that make this job simple.

The vitamins and supplement market is worth millions, and we must hope that this means more people than ever want to stay well. By helping our patients learn as much as they can about the role of nutrition in preventing disease, and the other simple lifestyle changes that they can make, we will achieve better engagement, which will ultimately lead to improved outcomes for oral and general health.

 

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Author: Kimberley Lloyd- Rees on behalf of Tandex

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.

 

[i] The Vitamin D Factor: Brits spend almost £500 million on vitamins and supplements. Mintel Press Office,
23 October 2020. Link: https://www.mintel.com/press-centre/beauty-and-personal-care/the-vitamin-d-factor-brits-spend-almost-500-million-on-vitamins-and-supplements (accessed March 2021).

[ii] Vitamin D and covid-19. BMJ 2021; 372: n544.

[iii] NICE. Covid-19 rapid guideline: vitamin D. https://www.nice.org.uk/guidance/ng187 (accessed March 2021).

[iv] Vitamin D. NHS website. Link: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ (accessed March 2021).

[v] Do I need vitamin supplements? NHS website. Link: https://www.nhs.uk/common-health-questions/food-and-diet/do-i-need-vitamin-supplements/ (accessed March 2021).

[vi] Supplements: Food Fact Sheet. Association of UK dieticians. Link: https://www.bda.uk.com/resource/supplements.html (accessed March 2021).

[vii] Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020 May 19; 12(5):1471. doi: 10.3390/nu12051471. PMID: 32438644; PMCID: PMC7285165.

[viii] Statistics on Obesity, Physical Activity and Diet, England, 2020. NHS Digital, published 5 May 2020. Link: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/england-2020  (accessed March 2021).

[ix] Chandra RK. Nutrition and the immune system from birth to old age. European Journal of Clinical Nutrition. 2002 Aug; 56 (3): S73-6.

[x] Ultra-processed food linked to early death. BBC, 30 May 2019. Link: https://www.bbc.co.uk/news/health-48446924 (accessed March 2021).

[xi] Food and mood: how do diet and nutrition affect mental wellbeing? BMJ 2020; 369:m2382.


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