Prescribe sunshine, not a leaflet

Last week the Scottish Government announced that it was producing a leaflet “aimed at increasing awareness of the recommended vitamin D levels”.  It is being sent to all GPs and health professionals, because no doubt this is information that will be very new to them…   

Clearly, some people are more at risk of Vitamin D deficiency than others.  Apparently – depressingly – there is an increase in reported cases of rickets in Scotland.  But it is safe to say that Scotland is not exactly a sunshine state and therefore, the general population is also at risk of this deficiency.  It is increasingly being linked to a host of diseases and conditions, like multiple sclerosis.

“Shine on Scotland” is a great campaign and deserves to succeed.   But its rather obvious objectives are symptomatic of our nation’s continuing belief that only the state can fix things.  So providing Vitamin D supplements to all children and pregnant women is the number one aim, and of course it would work.  But it would cost money.  And such an intervention would not address the need for the whole population to improve its vitamin D levels.

Applying a state sticking plaster to every problem was very much the way of the Labour led Scottish Executive of old.  So it is disappointing to see the SNP continue this obsession with statism, though the fact that the leaflet initiative emanates from that bastion of top down public sector-ism, the NHS, makes it perhaps less surprising.  Of course, a leaflet is not going to do a single thing to actually improve vitamin D levels in the populace nor address the rising numbers of children and others with rickets.  

The solution to all of us getting more vitamin D in our systems is more sunshine on our skin in the key months of April to September.  And in the winter to eat more foods such as oily fish, eggs and meat that contain naturally high doses of vitamin D.

So here is the burdz alternative plan to combating vitamin D deficiency:

  • schools should not be allowed to close classroom curtains and blinds on natural daylight between April and September
  • during these months, playtimes and lunchtimes should be extended by 10 minutes a day
  • school dinners should serve salmon, sardines, cod, shrimps, liver, eggs and cold milk to drink once a week, every week in the winter months
  • the NHS should serve salmon, sardines, cod, shrimps, liver, eggs and cold milk to drink on their menus all year round
  • there should be a national care standard upon which care providers are inspected, relating to time spent outside between April and September and on the nutritional content of meals provided
  • contracts for meals and wheels should stipulate the provision of vitamin D rich foods (and other essential vitamins and minerals)
  • other public procurement contracts relating to food provision should contain similar stipulations
  • fish shops and butchers should be offered special business rate reductions and other incentives to start up and to stay in business
  • supermarkets should be provided with an incentive rates/tax package relating to their loss leader policies, that rewards those who loss lead on vitamin D rich foods (and others that are good for us) and punishes those who don’t
  • supermarkets that refuse to pay at least market value for home produced milk and meat should pay business rate penalties
  • pregnant women and parents of children who qualify for milk vouchers should also be provided with vitamin D vouchers which allow them to buy these foods for themselves – incidentally, milk vouchers or tokens should switch into being fruit and veg tokens until the child is eight
  • employers should be encouraged to operate flexible lunch hours so that on sunny days between April and September, employees are allowed and encouraged to take an extra 30 minutes to spend outside walking, or sitting in a park etc, that can then be returned on a really wet, horrible winter’s day
  • public sector employers should lead by example

Call it a national action plan.  One admittedly that needs a bit of work.

But essentially it is a plan that doesn’t prescribe a quick fix solution but sets in motion a range of low level, preventative interventions;  that addreses the cause of the problem and not just the symptoms; that has some front end costs but which will result in medium term and long term savings; that requires some practical adjustments but mostly involves thinking creatively about the deployment of current resources.

I won’t be precious if the Scottish Government decides to adopt it.

3 thoughts on “Prescribe sunshine, not a leaflet

  1. Interesting points ryan, you may some good arguements, I happen to think that vitamin D is one of the best supplements to take but must agree its best if you get it from sunshine as that’s how its best absorbed, I have been taking vitamin D for a while and can only see positive effects, however to much of anything can be bad!

  2. Pingback: Scotland the grave – Scottish Roundup

  3. many thanks for the kind words of support may I please add some comments to the idea’s you have raised ? I have also considered all or most of these!

    On Points 1 and 2 – the country is deficient FACT and it is not summer months that are the main problem in Scotland its the winters months Sept thru to April.

    Point 3 – since kids in school often don’t get a full meal with the current program many kids only getting ‘ whats left ‘ for school lunch – I think it hardly likely that we could add the type of nutritious meal to the school meals program you discuss

    Do you know some kids get a bowl of potatoes or a slice of bread and butter at the 2nd sitting in a primary school for a cost to our parents of £1.15 a day because food runs out ? This is because the budgets provided do not stretch to enough for all ! where would the money come from for this ?

    On the same point kids from poor area’s like myself in Drumchapel don’t eat salmon, sardines, cod, shrimps, liver and milk doesn’t contain vitamin D in the UK. Are you unaware of the eating habits of a the poor family are you telling me that a kid who’s parents struggle to provide any breakfast at all can provide them with such a balanced breakfast as you think would solve the problem?

    can those parents provide these items even ever as a part of the family meal ? I don’t and i don’t think the kids will eat it – how many kids eat the 5 a day ?

    point 4 : its been known for a considerable time from studies that older people and those in care in NHS homes are highly deficient in vitamin D yet its not being tackled – you will also find the latest studies highlight that research points to vitamin d having an effect in Alzheimer’s without immediate action this diseases will continue to increase without immediate supplementation.

    Point 5 – A good idea except over 65’s still need a supplement between Sept to April

    Point 6 – I agree with however I think on balance it would be hard to find the increased funding for such a plan – by my own costing it would add perhaps a 50p – £1 to the cost of each meal compared to £3 – £5 per year per person for supplements and would cost less in red tape and cosultants or management – i don’t want any solution to cost this country money but this problem will not go away i still believe my plan offers the best solution.

    As for the rest of the points raised I am fear i may be getting embroiled in the problems of the country while I’m trying to prevent a disease not fix the country’s problems.

    If you read the news you will find that on the back of the summit Australia has announced that the scientific evidence was good enough for Australia to announce today that they will start trials next year !

    http://www.msra.org.au/summit-scotland-shines-australian-trial

    [audio src="http://mpegmedia.abc.net.au/rn/podcast/2010/09/bst_20100923_0820.mp3" /]

    Perhaps the Government should look at the problems is being made worse or not been considered properly by the advice taken by theiir own advisors ( SACN ) giving them bad advice.. it cant be solved by nutrition alone its requires bigger thinking and like it or not its the only solution if you can find a genuine solution ill listen to it with open ears and take it forward – this is not a national action plan its full of holes.

    I’ve studied some 20 + alternative plans across 7 countries but not one is 100% perfect but on balance – fortified school milk or a fortified fruit drink offers best solution for protection for all children with an added opt out clause for those not wishing to participate due to wish or other reasons!

    for national protection against a disease that costs 1.4 million per patient and a lifetime of suffering a national supplementation program/ trial would seem best practise at a cost of £5 per person per annum small potatoes to the 40 million pounds it will save the UK economy and within 5 years you will see a effect on other diseases like diabetes – there is no looser only winners !

    As I said before are we children not worth a penny a day !

    Many thanks for the support and allowing me to add some comments to it.

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