“For those of you living in the US you may find the following non-MS-related publication of interest. It shows a surge in vitamin D deficiency diagnoses and mirrors that what is happening in the UK. We are in the process of auditing our own MS neurology practice to see how large the increase is in our outpatient setting. Why is this occurring?
Outdoor activities: Other behavioural changes has been the shift from outdoor activities to indoor activities. Children and teenagers now spend much less time in the sun. Why? This is the era of facebook and gaming. Young girls spend large amounts of time on social networks and boys playing computer games. There are several studies from the past that have demonstrated that outdoor activities in childhood protect against MS; reversing this trend is very worrying.
Fish consumption: It is well known that fish consumption worldwide is going down. This is based on economic factors, as we deplete fish stocks prices have risen and consumption has dropped. We are also increasingly eating farmed fish which has about a third of the vD levels of wild fish; wild fish have higher vD levels because of their diet is higher in phytoplankton which provides the vD.
Pollution and weather: Atmospheric pollution and cloud cover is another issue; this is a particular problem in certain areas of the world. In heavily polluted areas of the world air pollution exacerbates vD deficiency as it acts a ultraviolet B light filter.
Cultural changes: I have mentioned before that covering up for cultural reasons is a problem for woman. Whether or not covering up is for religious or other cultural reasons it contributes to very low vD levels in some parts of the world.
OBJECTIVES: In light of the growing medical interest in the potential consequences of vitamin D deficiency, it is important that clinicians are informed about the varying factors that may complicate the assessment of vitamin D status and the diagnosis of deficiency. To better understand the frequency of vitamin D deficiency diagnoses in the ambulatory setting over time, the objective of this investigation was to examine unspecific, general, and bone-related vitamin D deficiency diagnoses between 2007 and 2010 and to determine whether the rate ofdiagnoses differed by patient age and sex.
METHODS: We used data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to assess the rate of vitamin D deficiency diagnoses provided between 2007 and 2010 during outpatient visits with non-federally employed physicians in offices and hospitals. Two hundred ninety-two unweighted patient visit records were included. Trends in vitamin D deficiency diagnosis over time, diagnosis of bone disease associated with a vitamin D deficiency diagnosis, and patient age and sex were reported.
RESULTS: The number of diagnoses for vitamin D deficiency rapidly increased from 2007 to 2010. More than 97% of diagnoses were for unspecific vitamin D deficiency; 9.6% of vitamin D deficiency visits also resulted in a diagnosis of osteoporosis or bone fracture.
CONCLUSIONS: Although the rate of diagnoses for vitamin D deficiency increased between 2007 and 2010, many diagnoses rendered were for nonspecific disease; therefore, vitamin D deficiency screening may have been ordered for preventive care purposes rather than as a diagnostic aid.