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    Random thoughts, some science, and the latest research.

    Kent, Inner Mongolia and Calgary of course! It also happens to be the point at which, heading northwards in the winter months, no Vitamin D is produced from sunlight when it hits our skin.

    In my profession there is ‘debate’, even disagreement, about the use of food supplements yet we have been advocating them for decades — without much thought about the ‘evidence’. So up North (even further than 51 degrees) in Scotland the decision to provide free vitamin supplements for all mothers-to-be is a curiosity. It includes Folic Acid (reduce risk of neural tube defects like spina bifida), Vitamin C (no evidence of benefit says NICE) and Vitamin D (no clear evidence of benefit). Nor for iron by the way. If we were following best ‘evidence’ well-nourished ladies have no need for supplementation. Promoting a healthy diet (but supplementing with folic acid) seems sensible. BUT it is official policy — also to give vitamins to infants and children. Actually, Vitamins A, B1, B2, B3, B6 and D2. I have come round to the idea of targeted food supplements not only because the principle is consistent with public policy but because maybe there is indeed nutrient deficiency in our modern diet. Maybe there should be less ‘debate’ and more effort in producing regulated food supplements so we know what we are swallowing.

    Personal view: Dr Rob Lawson

    • Natalie Salvesen

      Just a comment Rob….along the same theme. I did my MSc thesis on iodine supplementation during the antenatal period. Evidence suggests that in severe cases iodine insufficiency during pregnancy can lead to ‘cretinism’ of the infant. But there is also good associative data suggesting that even mild iodine deficiency during pregnancy is significantly associated with reduced IQ of the infant. There are also studies to show that supplementing UK pregnant women with iodine would be cost effective given the implications on increased IQ. The UK is one of a minority of countries in the world who haven’t taken this on board. Most countries recommend and increase of iodine intake during pregnancy – whether in the form of food or supplement. There is multi-centre evidence suggesting that women of child bearing age in the UK are iodine deficient, but still no action has been taken by NICE etc. Antenatal nutrition is critical to the health of the infant – both in early life and later on (Barker hypothesis). As you pointed out, the nutritional intake of the UK may be deficient – this is monitored so that Public Health regulations can be changed. The Scientific Advisory Committee on Nutrition (SACN) take the monitoring data and produce reports/recommendations – in case you are interested you can find them online….