Health, Medical, Research, Science

Vitamin D: Who should take it?

HEALTH

Intro: Vitamin D’s main role is in helping your body to absorb calcium from food. If you don’t get enough, the body draws calcium out of your bones

As the winter nights draw closer, many of us will be reaching for the vitamin D tablets. One of the UK’s most popular supplements, the “sunshine vitamin” is known to be essential for healthy bones, teeth, and muscles – and the NHS advises all adults to take a daily 10mcg supplement from October/November to April, when the sun’s rays are too weak for our skin to make it.

Many older people also take it year-round (as the skin’s production of it declines with age and they spend less time outdoors). More recently, research has suggested it also plays an important role in immunity and may even help to prevent dementia and cancer.

But a new study appears to raise questions about who really needs it.

Published in the British Medical Journal (BMJ), the research showed that vitamin D supplements made no meaningful difference to whether older people suffered bone fractures.

The accepted wisdom is that supplements are vital during winter months because of the low position of the sun in the sky. Susan Lanham-New, a professor of nutrition at the University of Surrey and a leading expert on vitamin D, explains: “When UV rays hit our skin, it triggers sterol 7-DHC [a precursor of vitamin D] that sits just under the skin, to commence production of an active form of the vitamin.”

In the UK, ten to 15 minutes of midday sun on bare skin in spring and summer is generally considered sufficient to manufacture our body’s recommended daily need for 10mcg. But the weaker rays in the winter months do not contain the UVB rays that our bodies need to make it, says Professor Lanham-New.

Vitamin D’s main role is in helping your body to absorb calcium from food. If you don’t get enough, the body draws calcium out of your bones. Over time, this makes them more fragile, raising the risk of fractures and osteoporosis (which affects more than three million Britons).

Although certain foods, including oily fish, eggs and fortified breakfast cereals contain modest amounts, you’re only likely to get about a third of your daily requirement from food at best.

About one in six adults in the UK is deficient in vitamin D – and the figure rises to one in three during winter months.

The NHS recommendation to take a supplement is based on the evidence for the nutrient’s crucial role in bone health and follows a 2016 recommendation by an independent committee of experts, the Scientific Advisory Committee on Nutrition (SACN).

Earlier this year, however, the recommendation was challenged as being too low by a group of UK doctors. They argued in the journal Frontiers in Endocrinology that the definition of vitamin D deficiency – a blood level of anything under 25nmol/l – should be increased to 50nmol/l, the threshold used by the World Health Organisation, the US National Academy of Medicine and the European Food Safety Authority.

The doctors cited the fact that, although uncommon, rickets – weak bones due to a lack of vitamin D – has not been wiped out, with about 480 hospital cases in year in England alone. Another argument is that people with obesity, those with darker skin (which absorbs less from the sun) and people in deprived areas who may not have sufficient quantities in their diet, were more likely to be deficient.

Vitamin D intake from food has also fallen, partly because people are eating less meat and fish.

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Vitamin D also plays a critical role in immunity and in preventing cardiovascular disease, cancer, and dementia. People who are severely deficient in it are 33 per cent more likely to be hospitalised with respiratory infections, according to a recent study by the University of Surrey. The researchers analysed data from 36,000 adults and found that those with a severe vitamin D deficiency – classed as a blood concentration below 15nmol/l – were a third more likely to be admitted to hospital with infections such as flu, pneumonia and bronchitis, compared to those with levels over 75nmol/l. They concluded that taking adequate vitamin D could protect against respiratory infections.

The vitamin is also thought to play a role in heart and brain health, by regulating inflammation, blood pressure-related hormones and the function of blood vessels, which could in theory reduce artery damage and high blood pressure. Laboratory research suggests it might also slow cancer cell growth and limit damaging inflammation (by enhancing immune cell function). According to Eamon Laird, a lecturer of nutrition and health at Atlantic Technological University, Sligo, Ireland, as we get older, our immune systems become less efficient and produce inflammatory molecules that circulate more freely in the body, potentially causing damage and disease. It is thought vitamin D might help to regulate this.

A US study also found that older adults who took high doses (125mcg) of the vitamin daily scored higher on memory and cognitive tests than those who didn’t take it. These findings were reported in the journal Sleep Medicine in August.

In addition, it protects cells from “rusting” caused by unstable molecules in the body and environment, and may help immune cells to remove the sticky amyloid plaques which build up in those with dementia.

Nonetheless, these results on cognition should be treated with caution, says Paresh Malhotra, a professor of clinical neurology at Imperial College London. “This was an exploratory study: The number of people studied was low and there was no before and after comparison,” he said.

He adds that the study merely used a questionnaire “to determine who took vitamin D supplements” and did not measure the vitamin D levels in participants.

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More concerning is whether the latest research that shows no meaningful improvement in bone health among older people raises questions about the key reason to take vitamin D supplements in the first place.

The BMJ study pooled results from 69 trials, involving 154,000 adults aged over 65, and found that taking vitamin D made no difference to fracture rates over the following 2.5 years.

The authors concluded that the evidence “does not support routine supplementation” to prevent fractures, and they speculated that older people may be better spending their time and money on resistance exercise and balance training, which have a proven track record in this regard.

This echoes earlier large trials, including a study published in the New England Journal of Medicine in 2019, which found that taking 50mcg of vitamin D a day did not prevent fractures in generally healthy middle-aged and older people. It also did not prevent cancer or heart disease.

A study in 2022 involving 21,000 older Australians who took a monthly vitamin D pill (1,500mcg) for up to five years found that it didn’t reduce overall deaths or cancer or cardiovascular deaths.

However, Professor Lanham-New says that these trials largely involved people who already had healthy levels of the vitamin and “there’s little evidence that giving extra vitamin D to those with adequate amounts will give extra protective benefits”.

So who should take it?

Professor Lanham-New says the recommended daily supplement of 10mcg is enough to keep most people’s blood level above 25nmol/l in the winter months.

In addition, those who spend little time outdoors, including many care home residents, and people with darker skin tones whose skin makes less vitamin D from sunlight, should all take a year-round supplement, she says.

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Arts, Drama

Whodunnit: Harvey’s Mistake

LATERAL THINKING DRAMA

– Use your crime-solving skills to solve who murdered Leonard Harvey in this whodunnit conunundrum

THERE was a good reason, Inspector Denton thought, why most wills remained confidential. Leonard Harvey had called his family together to inform them of changes he was considering to his last will of testament. Specifically, he informed each of them of how much they were due to receive under the current will, and then gave them until the following morning to justify that amount. If he didn’t like their answer, he would leave their portion to a local charity which looked after homeless cats.

He was dead within ninety minutes, from a potent cocktail of poisons.

The bereaved were still in varying degrees of shock the following morning. Denton’s first interviewee was Harvey’s business partner, Peter Fulton. A few years younger than Harvey, he had come along to the family meeting at Harvey’s express request.

“I tried to talk Len out of it,” Fulton told Denton sadly. “But he was determined to put them on the spot. I can’t help thinking that if I’d done more . . . But Len wanted to see their faces, you see. They didn’t know that there was no way to pass the test. He’d already decided to give it all to the cats no matter what. He just wanted to watch them squirm and try to justify themselves, and then rip up the old will in their faces. An unworthy urge perhaps, but he’s paid a very high price for it now. He was a good friend to me, and I’ll miss him. I stayed at the house until the end of the meeting, but I left immediately afterwards, and went straight to my club. I was there until midnight. Just all a bit too much for me.”

Sheila Harvey was Len’s third wife. Some thirty years his junior, she had taken the events of the previous evening particularly hard. “I just don’t understand,” she said. “I loved Len. Why would he do something like this to me? Was it all some sort of peculiar ruse? What will happen to me now?”

Inspector Denton gradually managed to help her understand that he himself had no answers to any such questions and brought her back to the details of the evening.

“I had no idea what the meeting was about,” she said. “Then he dropped his bombshell, and left us to it. I don’t think I moved from my seat for so much as a moment until David came shouting that Len was dead. That was a little after nine. Gail, the maid, was there in case we needed anything, and she stayed with me. The others were in and out, apart from Mr Fulton, who was gone almost before Len finished. David kept me company for a while. He’s very kind.”

David Harvey was Len’s son by his first wife. Just a few years younger than Sheila, he lived in lavish apartments in the city. “Do? I suppose you could say that I’m an art appreciator, Inspector. I have a passion for beauty. Yes, I was taken aback by father’s declaration. He was an odd bird, though, always given to whimsy and calculated cruelty. A bit like those damned cats, I suppose. I significantly doubt that any answer I could produce would have been sufficient for the old coot – except that one, perhaps. Hm? Maybe a little worried, I suppose, yes. I’ll probably have to talk to a pal and get set up in business of some sort. A bother. After father’s speech, Clare and I went into the billiards room. We had a bit of a catch-up. The butler was there, I think. Anyway, she wanted to get a snack from the kitchen, so I came back to the library to see how poor Sheila was doing. She’s rather lovely, don’t you think? Like a porcelain angel. I sat with her for a while, but she was quite out of it. When I went looking for father, I found him quite dead.”

Clare Davidson was David’s full sister. Two years younger than her brother, she was married to the son of a local papermill baron. “He was a nasty old fool,” she said. “I never liked him, and I most certainly won’t miss him. I’m glad he’s dead, in fact. The only time he paid attention to me was when he had just inflicted some emotional hurt or other. It’s a shame, though – I was looking forward to telling him that I neither needed nor wanted his money, his time, nor anything else to do with him. Once he’d finished his juvenile stunt and doddered off, I had a bit of a chinwag with David, in the billiards room. Then I popped down to the kitchen and shared a couple of glasses of sherry with Mrs Beechwood, the cook. She’s always been the sanest person in this dashed madhouse.”

Afterwards, Inspector Denton went to stroll around the ornamental rose garden, so that he could smoke a pipe and ponder the specifics of the case.

He had been there about ten minutes when an officer bustled up with a report. Analysis suggested that Harvey had ingested the poison some three hours before his death.

Denton immediately brightened: “That clears it all up nicely,” he said.

Who does Denton suspect of being the murderer?

Tip: Timing

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Economic, Middle East, Politics, Society, United States

Trump’s capriciousness is undermining international stability

GEOPOLITICS

Intro: Trump boasted he would make America great again. What bitter irony that he’s now presiding over its slow demise as a superpower

President Donald Trump has never been shy of hubris in his self-declared role as a negotiator of world peace.

When sworn into office for the second time in January last year, the 47th US President claimed he would be ushering in a new era: “My proudest legacy will be that of a peacemaker and unifier,” he proclaimed.

Just days ago, following the award of the Nobel Peace Prize to UN human rights commissioner Navanethem Pillay and his evident belief it should have gone to him, he went further: “I have saved more lives than anyone in history.”

And yet since his inauguration it has become abundantly clear this president’s most enduring legacy may well be the greatest threat to the world order for decades.

From the battlefields of Ukraine to the oil-rich Persian Gulf and volatile waters of the Red Sea, the consequences of Trump’s erratic foreign policy are being felt across the globe.

At precisely the moment when the world desperately needs calm and experienced leadership – with 130-armed conflicts raging globally – it finds itself dependent on a US president whose capricious behaviour is directly undermining international stability.

The missile attacks on Riyadh airport by Yemen’s Houthi rebels, which killed 14 people and injured hundreds more, represented a chilling and unprecedented escalation in a Middle Eastern conflict that threatens to plunge the global markets into further imminent chaos.

For those in Saudi Arabia and beyond, it remains a terrifying reality that the Houthis, an Iranian-backed militia whose fighters have often been dismissed as little more than barefoot tribesmen, now not only have the capacity to throw the Arab world’s largest economy into further turmoil but also to inflict such economic damage on the West that it could dwarf the ongoing war between America and Iran.

To date, much attention has been focused on Iran’s blockade of the Strait of Hormuz, the narrow waterway through which enormous quantities of the world’s oil and gas ordinarily pass. The disruption sent shockwaves through energy markets, caused prices to soar, and worryingly threatened supplies of fuel and fertiliser, the lifeblood of industrial and agricultural production.

Several hundred miles to the south-west, however, lies another maritime bottleneck that might yet prove even more damaging, particularly for Britain and Europe.

The Bab al-Mandab Strait, separating Yemen from the Horn of Africa, is the gateway to the Red Sea and, ultimately, the Suez Canal.

It is one of the great arteries of international commerce, carrying not only oil and liquified natural gas but container ships transporting everything from Chinese cars to Japanese electronics and white goods. If the Houthis succeed in closing this passage, the consequences could be catastrophic.

The Red Sea corridor handles roughly 30 per cent of global container traffic and, while it is one thing to pay more to fill your car, it is quite another when the supply of vehicles, fridges, washing machines, and pretty much everything else is suddenly imperilled.

This is not a theoretical threat. The Houthis have demonstrated through their attacks on Riyadh airport that they possess missiles and drones capable of penetrating defences in Saudi, a country that has spent billions on sophisticated military equipment.

And at a moment when the future of world trade has seldom looked more vulnerable, the current US president is so unpredictable we can no longer assume Washington would intervene in the Bab al-Mandab Strait to protect global commercial shipping.

While the US Navy may have done so under Joe Biden – in 2024 American carrier strike groups were deployed to counter Houthi attacks on shipping in the Red Sea, albeit ineffectively – the current US President has demonstrated an alarming unwillingness to protect anything other than American interests.

Only last month, for example, he called off a missile strike against the Houthis in return for a guarantee that attacks on US vessels in the area would not take place. And he will be fully aware that if he launches strikes, the Houthis may well attack US bases in the Middle East.

Despite his bellicose rhetoric, the truth is that President Trump looks desperately weak when confronted with the realities of international power. Supporters of Trump believed they were electing an “American First” president that would extricate them from expensive foreign entanglements, rebuild the economy, and end the military adventures of past administrations.

Instead, their erstwhile hero has achieved almost precisely the opposite. And with midterm elections fast approaching, the president is staring in the face the political consequences of his overseas adventures. With just over two weeks to go before the vote, polls show he is failing to arrest his declining popularity.

This is the primary reason why Trump decided to ease sanctions on Russian diesel, pursuing short-term political expediency at the expense of long-term international stability.

For years, Western policy towards Vladimir Putin has rested on the principle that Russia must pay an economic price for invading Ukraine.

Yet now the American President is prepared to loosen those restrictions to ease the energy crisis and attempt to bring down prices in the US.

The message this sends out is beyond appalling. While Western sanctions have never been watertight, and European countries have permitted exceptions when vital economic interests were at stake, there is a big difference between limited exemptions and the world’s most powerful democracy handing Russia a lifeline. It raises the possibility that the West’s entire strategy towards Ukraine could unravel.

At the same time, Trump continues to espouse extravagant and fantastical claims about his diplomatic achievements. Consider his announcement that there had been an energy ceasefire in the war between Russia and Ukraine, and that both parties had agreed. This was greeted with surprise in Kyiv. Relentless Russian attacks have continued.

The louder the threats and more extravagant the pronouncements, the greater the impression of a man desperately posturing while events slip beyond his control.

Together, these crises cannot be considered separately. Russia’s invasion of Ukraine has disrupted our access to energy supplies from eastern Europe while the confrontation with Iran has threatened supplies from the Persian Gulf. Now the Houthi escalation threatens a crucial commercial route linking Europe to Asia. In effect we are facing a disastrous triple whammy.

While Trump blusters, Britain and France may promise further assistance to Saudi Arabia, but neither possesses the resources required to replace American power, for so long the guarantor of international security and free trade.

And herein lies perhaps the most unsettling prospect of all. It may fall to China, possibly alongside India, to broker an agreement between the Houthis, Iran and Saudi Arabia that removes the threat to international commerce.

Beijing has every reason to want this outcome, with its export economy depending on functioning trade routes. Yet their intervention would be one of the most troubling kind: what might this authoritarian state ask in return?

The erosion of America’s world leadership did not begin with Trump. But under this president it is accelerating at a terrifying pace.

The bitter irony is that the man who promised to make America great again may instead be presiding over its great dismantling as an international superpower.

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Arts, Books, Psychology, Science

Book Review: Agency

LITERARY REVIEW

Intro: The father of positive psychology, Martin Seligman, offers a three-step plan that means you can take control of your own destiny

Shakespeare got it right: “All things be ready, if our minds be so,” says King Harry in Henry V. The scene depicts the English being vastly outnumbered by French forces, but he has no doubt what will bring about an English victory on St Crispin’s Day.

Sheer will, he tells the assembled Lords. Will is at the root of agency; willpower drives performance and success. Even in these depressed and uncertain times, that seems self-evident.

Over a half-a-century ago, however, the world-renowned psychologist, Martin Seligman, witnessed the collapse of will in his best student at Cornell University.

Faced with a project well within her capabilities she simply gave up, because she had convinced herself she couldn’t do it.

Her professor realised that, “in 1968, psychology had no vocabulary for what I wanted to say”.

For even the rival “camps” in his subject agreed on one thing: “Free will was an illusion. People were products – of conditioning, of unconscious drives, or forces beyond their control.”

It became Seligman’s mission to identify, “the most important force in human experience: agency – the belief that you can influence your own future”. He thought of his brilliant student giving up and wondered if she might have been able to learn how to persist, how to strive for what seemed impossible, and how to resist her own sense of inadequacy.

“Agency”, he writes, is “the audacious human belief that tomorrow can be better than today, and that we have the power to make it so.”

Seligman is widely respected as the founder of positive psychology – the scientific study of what makes life worth living and what can make people thrive.

He is known for his inspiring works on happiness, optimism, change, and wellbeing – yet he is most emphatically not to be mistaken for a self-help guru or therapist.

His bracing view that individuals can take control of their own lives is central. This hard-won optimism counters his own natural depressive tendencies by focusing on human strength, not weakness – as he insists, the most effective way to become more optimistic is through “mental toughness”.

Strict scientific data underpins whatever motivational advice readers may take from his many books.

This latest volume is perhaps the most ambitious, embracing a vast sweep of human history in order to assess how “agency” affects human progress and survival.

There are lessons for the individual in his analysis of why some societies thrive, why some flounder, and how whole civilisations can be swept away.

Seligman admits to being a pessimist himself, which perhaps explains his life’s work as a personal pep talk.

He identifies three elements that combine to form the energy behind “the belief that I can achieve my goals” – which is the agency driving the human spirit.

1. Efficacy is “my estimate of achieving a specific goal in the here and now”. 2. Optimism is about “achievement in the future”. 3. Imagination is “my mental representation of the range of goals I can achieve beyond the here and now”.

That three-step works on a personal level. But the whole drive of the book is societal too: “Efficacy causes trying hard, optimism causes persistence, and imagination causes innovation. This is exactly how agency causes progress.”

This is the core belief of the book. Without agency there is no action.

When a society is confident and forward-looking, progress occurs. When it is absent the result is stagnation – a malaise which, incidentally, some readers may recognise in Britain today.

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To illustrate his theory, Seligman conducts us on an exhilarating whistlestop tour through human history, seeking answers to the question, “Why some [people] crumble under life’s blows while others bounce back.”

Why are some individuals resilient while others exhibit “Learned Helplessness”? How does that play out across a whole culture? Is it inevitably true that “poverty . . . causes present-mindedness and wealth causes future-mindedness”? What does rigorous belief in an ideology or religion do to human agency? Just some of the fascinating and vital questions Seligman poses in this hugely important book.

His answers are to be found in history. He examines the later books of the Hebrew Bible and makes a comparison between their growth of human agency, and the writings of the Zhou Dynasty in China and the Golden Age of Greece: “Three unrelated civilisations across the globe and within a broadly comparable period, recognise the power of human agency and their gods retreat.”  

He compares the development of those three different cultures and observes that their Golden periods of success arrived once people had lessened their slavish belief in gods as the source of power, who therefore had to be obeyed. “When we mortals are thought to control our destiny, we actually do. When supernatural forces . . . are thought to control our destiny, we languish,” he notes. Readers should be reminded this is a book written by a psychologist.

Technology allows Seligman to dissect language, listing “agentic” words of action and determination and hope used through key texts and documents, which indicate the states of mind of individuals and societies.

After a cheerful and useful chapter called More Agency In Your Life (tips on how to learn optimism), Seligman does an extraordinary thing.

This brilliant book about human agency ends with what some critics’ regard as a kowtow to Artificial Intelligence (AI). He even shows how it can take his place in solving problems.

I did wonder if it had infected the brilliant brain of a man who has sought nothing but good, yet fails to grasp the obvious peril that the will of AI will banish human agency altogether.

– Agency by Martin Seligman is published by John Murray One, 400pp

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