Calcium and Vitamin D: Implications for Social Distancing 

Although current restrictions make it more difficult to access the outdoors for our daily dose of Vitamin D, our Medical Director & Consultant Rheumatologist gives some advice on ways we can still achieve this.

As we all endeavour to socially distance ourselves and reduce the risk of Covid 19 transmission — many of us are confined to home and not spending as much time outdoors as we normally do. It is vitally important to remain fit and active so we can stay as healthy as possible to ward off infection and to our normal lives when the pandemic is over. 

For many, exercise opportunities are limited and exposure to sunlight restricted, which raises the question of whether people in these situations can obtain enough Vitamin D to remain healthy. 

Fortunately, at this time of the year there are still opportunities to obtain enough Vitamin D through exposure to the sun. The following is a brief guide on what Calcium and Vitamin do and how that influences your health. 

Vitamin D

There is increased awareness of the importance of vitamin D, not only in the maintenance of bone health but also its potential role in the prevention of autoimmune disease, cancer, mental health problems and cardiovascular disease. 

There are three ways you can get vitamin D: 

  • From safe sunlight exposure (80 – 90%) 
  • From diet (10 – 20%)
  • From vitamin D supplements (if needed)

Vitamin D Deficiency who is at risk?

Certain people are at higher risk of vitamin D deficiency, including: 

  • People who spend little time in the sun or those who regularly cover up when outdoors; 
  • People living in nursing homes or other institutions or who are homebound; 
  • People with certain medical conditions such as Coeliac disease and inflammatory bowel disease; 
  • People taking medicines that affect vitamin D levels such as certain anti-seizure medicines; 
  • People with very dark skin; 

Getting vitamin D from Sunlight

When the sun’s Ultra-Violet (UV) rays fall on the body, they react with a chemical in the skin (7 Dehydrocholesterol) to make vitamin D. This is then processed in the liver and then kidney to make a stable, more potent version 1,25-dihydroxy vitamin D (Calcitriol) which helps absorb and manage Calcium levels in the body and improves bone health and muscle function. 

Vitamin D and Calcium are closely interlinked. 

Sun Exposure

In the UK, your skin can only get vitamin D from sunlight between April and September so we are thankfully coming into the period in the UK when we can start to benefit from the UV rays of the sun. As a general guide you are unlikely to get benefit from the sun if your shadow is longer than you are tall – as the sun is too low in the sky. 

The good news is that you do not need much exposure. it’s recommended you expose your skin to direct sunlight for around 10 minutes, once or twice per day. The effect seems to reach a limit after that so longer exposure is not necessarily going to generate more Vit D. 

Other factors

  • In cloudy weather, it may take longer to produce the same levels of vitamin D as on a sunny day 
  • You have to be outside — glass blocks the sun’s UV rays 
  • If you have darker skin, it produces vitamin D at a slower rate, so you need to spend longer in the sun to get the amount your body needs 
  • Using sunblock or high factor sunscreen stops the sun’s rays reaching your skin, which reduces the amount of vitamin D that your body makes 

Avoiding sunburn and skin damage

It’s important to give your skin short periods in the sun, when you haven’t applied sunscreen. But don’t avoid wearing sunscreen to increase your vitamin D levels. To protect your skin, aim to get your vitamin D from the sun while you’re doing short outdoor tasks, like walking to the shops or gardening. 

For longer periods of exposure always apply a sunscreen and avoid exposing your skin to direct sunlight when the sun it at its strongest, in the middle of the day. Take care with babies and children who have much more sensitive skin. 

How much vitamin D do you need?

It is advised that everyone over the age of one should get 10 micrograms (400IU) of vitamin D a day, from their diet or a supplement, all year round. 

This is in addition to any vitamin D you get from sunlight. 

Getting vitamin D from your diet

From April to September, most people get all the vitamin D they need from the sun. At other times of the year it is important to make sure you’re also getting it in your diet. 

Foods naturally rich in vitamin D include: 

  • oily fish, like herring, salmon and mackerel 
  • eggs
  • some pork products 
  • lamb’s liver

Some foods have vitamin D added to them, such as some bread, some yoghurts and specially processed mushrooms. 

You can calculate how much Vitamin D is available in particular foods 

Vitamin D Rich Foods

Do you need a supplement?

The Royal Osteoporosis Society recommends a vitamin D supplement all year-round if: 

  • Your child is under one year old, unless they get at least 500ml of formula milk a day 
  • Your child is between one and four years old 
  • You don’t get much exposure to sunlight, such as:
  • You cover up your skin
  • You are confined to the indoors
  • You use sunblock for medical reasons

In all other cases, they recommend you consider taking a 10 microgram (400IU) supplement to ensure you’re getting enough vitamin D, especially in the winter months 

There are two types of vitamin D supplements. They are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Both types are good for bone health. 

Vitamin D supplements can be taken with or without food and the full amount can be taken at one time. You do not need to take vitamin D at the same time as a calcium supplement. 


Calcium is very important as the building block for strong bones and teeth. Food is the best source of calcium. Dairy products, such as milk, yogurt, and cheese are high in calcium. Certain green vegetables and other foods contain calcium in smaller amounts. Some juices, breakfast foods, soymilk, cereals, snacks, breads and bottled water have added calcium. To determine if you are taking enough Calcium here is a link to a simple on-line calculator. 

Calcium Intake Calculator


And of course – stay physically active. 

Take a regular daily walk or run outside if you can – getting some exposure to the sunlight. Weight-bearing activity, particularly with a degree of higher impact through the legs is good for your bones and improves muscular strength 

Keep Active, Keep Healthy!