Increasing the vitamin D level of all Canadians to 40 ng would save 6 to 18 billion dollars a year – Grant Nov 2016

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Estimated economic benefit of increasing 25-hydroxyvitamin D concentrations of Canadians to or above 100 nmol/L

Dermato-Endocrinology , Volume 8, 2016 - Issue 1, http://dx.doi.org/10.1080/19381980.2016.1248324
William B. Grant, Susan J. Whiting, Gerry K. Schwalfenberg, Stephen J. Genuis & Samantha M. Kimball

Mounting evidence from observational and clinical trials indicates that optimal vitamin D reduces the risk of many diseases. We used observational studies and recent data on 25-hydroxyvitamin D [25(OH)D] concentrations of Canadians from Cycle 3 of the Canadian Health Measures Survey to estimate the reduction in disease incidence, mortality rates, and the total economic burden (direct plus indirect) of disease if 25(OH)D concentrations of all Canadians were raised to or above 100 nmol/L. Recently, the mean 25(OH)D concentration of Canadians varied depending on age and season (51–69 nmol/L), with an overall mean of 61 nmol/L.
The diseases affected by 25(OH)D concentration included

• cancer,
• cardiovascular disease,
• dementia,
• diabetes mellitus,
• multiple sclerosis,
• respiratory infections, and
• musculoskeletal disorders

We used 25(OH)D concentration–health outcome relations for breast cancer and cardiovascular disease and results of clinical trials with vitamin D for respiratory infections and musculoskeletal disorders to estimate the reductions in disease burden for increased 25(OH)D concentrations. If all Canadians attained 25(OH)D concentrations>100 nmol/L, the calculated reduction in annual economic burden of disease was $12.5 ± 6 billion on the basis of economic burdens for 2016 and a reduction in annual premature deaths by 23,000 (11,000–34,000) on the basis of rates for 2011. However, the effects on disease incidence, economic burden, and mortality rate would be phased in gradually over several years primarily because once a chronic disease is established, vitamin D affects its progression only modestly. Nevertheless, national policy changes are justified to improve vitamin D status of Canadians through the promotion of safe sun exposure messages, vitamin D supplement use, and/or facilitation of food fortification.
 Download the PDF from VitaminDWiki

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News Release on the study by Vitamin D Society of Canada Nov 2016

Study finds boosting vitamin D could save 23,000 Canadians lives, $12.5 billion in healthcare spending

Researchers urge national health policy changes to battle Canadian vitamin D deficiency

TORONTO, Ont. (November 21, 2016) – Increasing vitamin D intake could spare 23,000 Canadians premature deaths annually and save Canada $12.5 billion in healthcare spending and associated costs, says a new study on vitamin D deficiency.

The study, published by Dermato-Endocrinology examines the devastating medical and financial toll Canadians suffer because they don’t get enough vitamin D.

“This research really should act as a wake-up call for policy-makers in Canada,” said study co-author Dr. William Grant, a researcher with the Sunlight, Nutrition and Health Research Center in San Francisco, CA. “Thousands of lives and billions of dollars could be saved by bringing in policy changes that promote messaging around safe sun exposure, vitamin D supplement use and eating foods fortified with vitamin D.”

Researchers determined Canadian vitamin D levels have actually been dropping since the last time a similar study was carried out in 2010, putting more people at risk of life-threatening illnesses.

Vitamin D levels in the blood are measured in nanomoles per litre (nmol/L) using what’s called the 25-hydroxy vitamin D blood test (25 (OH)D). In Canada, doctor lab tests consider the normal range to be between 75 to 150 nmol/L or higher in some provinces. The study determined Canadians have a mean level of vitamin D which measures 61 nmol/L. That represents a drop from a level of 67 nmol/L in 2010. Health Canada’s guidelines recommend maintaining vitamin D levels of at least 50 nmol/L.

However, researchers estimated that if Canadians could raise their mean level of vitamin D to at least 100 nmol/L, it would prevent approximately 23,000 premature deaths and save $12.5 billion annually in direct health care and related costs.

Only approximately 10% of Canadians currently have vitamin D levels that exceed 100 nmol/L, while one-third of Canadians don’t even meet Health Canada’s minimum recommended target of 50 nmol/L. The diseases which were estimated to be reduced through higher vitamin D levels in the study included: cancer, cardiovascular disease, dementia, diabetes, multiple sclerosis, osteoporosis (hip fractures), and respiratory infections.

“Safe sun exposure is the main source for our bodies to absorb UVB rays and generate vitamin D,” said study co-author Dr. Gerry Schwalfenberg, a scientific advisor to the Vitamin D Society and an Assistant Clinical Professor at the University of Alberta. “Unfortunately, many Canadians are staying out of the sun altogether to avoid health risks associated with burning exposure. The reality is that they could be doing themselves more harm than good by not getting moderate amounts of sun to boost vitamin D.”

Even if they’re not deliberately dodging the sun, it can be difficult for Canadians to tap into the positive impact of UVB rays. Due to Canada’s northern latitude, the sun’s rays are not strong enough from November to May for Canadians to generate vitamin D naturally.

For vitamin D intake during winter months, the Vitamin D Society recommends Canadians use artificial UVB sources or supplements.

The study noted the average Canadian adult would need up to 4,000 international units per day (IU/d) of vitamin D3 to increase their levels to at least 100 nmol/L. The U.S. Institute of Medicine determined that 4,000 IU/d was a safe adult dose and does not require doctor supervision.

“We’re confident our research shows national health policy changes are justified to improve the vitamin D status of Canadians through the promotion of safe sun messages, vitamin D supplement use, and food fortification,” said Dr. Schwalfenberg.

“November is Vitamin D Awareness Month. A time when we begin the vitamin D winter where the sun is not strong enough to produce vitamin D through our skin. All Canadians should assess and improve their vitamin D intake to ensure they achieve optimal blood levels of between 100-150 nmol/L,” said Perry Holman, Executive Director of the Vitamin D Society.

About the Vitamin D Society:
The Vitamin D Society is a Canadian non-profit group organized to increase awareness of the many health conditions strongly linked to vitamin D deficiency; encourage people to be proactive in protecting their health and have their vitamin D levels tested annually; and help fund valuable vitamin D research. The Vitamin D Society recommends people achieve and maintain optimal 25(OH)D blood levels between 100 – 150 nmol/L (Can) or 40-60 ng/ml (USA).
To learn more about vitamin D, please visit www.vitamindsociety.org

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136 citations as of Aug 2023

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Summary by VitaminDwiki

The study did not include the costs for increasing the vitamin D levels
The following is my pessimistic estimate of the cost to increase Vitamin D levels for ALL Canadians
This assumes that all costs are born by the government, not by the individual.
Guess costs = $100 per person/year (if give vitamin D for free, education, marketing, free testing, etc)
There are 32,000,000 Canadians
Cost = $3.2 Billion ==> Net savings would be $3 billion to $15 billion
$8 billion savings @ 40 ng ==> $250 per Canadian

Reduction in 7 health problems (table 9)

Outcome	Reduction due to improving vitamin D status
Cancer	15 %
Cardiovascular Disease	14 %
Dementia	7 %
Diabetes Mellitus	18 %
Multiple Sclerosis	40 %
Osteoporosis (hip fractures)	22 %
Respiratory infections	25 %
Average Reduction	16 %    (20% ?)

Note: The calculation does not appear to incorporate savings due to

• Other health problems: Asthma, Pregnancy, Gut problems, Autism, Fibromyalgia, Osteoarthritis, Sepsis, TB, Dental, Back Pain, Drug usage. Rickets, Long-term disability, Allergy, Depression, Alzheimer's. Parkinson's, . . .
• Reduced sick time and improved productivity
  Able to stay employed (not on disability)

Suspect that:

1. Incorporating an addtional 20 health problems
2. Increasing Vitamin D to 50 ng
3. Including costs of sick leave, disability, loss of income due to disability or death
   might increase the cost savings by 10X

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See also VitaminDWiki

• Cost savings with Vitamin D category listing has 99 items along with related searches
• Vitamin D could save More than 10,000 Canadian lives annually 2009 - Dr. Grant was a co-author
• 52 studies with GRANT in the VitaminDWiki title as of Aug 2023
• Increase life expectancy by 2 years if double Vitamin D levels – Grant July 2011
• Increasing German levels of vitamin D to 30 ng could save 18,300 lives annually - Dec 2009
• Dr. Grant on vitamin D and mortality in VitaminDWiki
• Dr. who got patients to vitamin D level of 80 ng Doctor visits dropped from 4 per year to 1 per year
• Is 50 ng of vitamin D too high, just right, or not enough

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Many vitamin D articles and videos by Schwalfenberg in Canada

• A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation - Oct 2019 10.3390/nu11102452  PDF
• Econometric methods for secondary data in health research - Dissertation Fall 2019 https://doi.org/10.7939/r3-e75f-sc19  PDF

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Canadian Cancer costs (reference #44)

CANADIAN CANCER RISK MANAGEMENT MODEL: EVALUATION OF CANCER CONTROL - March 2013

 Download the PDF from sci-hub via VitaminDWiki

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Short URL - is.gd/grant2016