Professor James Bernard Walsh:

I thank Deputy Shortall for her support. She has been tremendous. With regard to food fortification, I want to add to what I said earlier and to what Professor Kenny said. I mentioned the only two foods that show some degree of fortification. These are fortified milk and cereals. With regard to ordinary milk, cows are no different from humans and do not get much sunshine either in winter. It takes 40 L of ordinary milk to equal 1 L of super milk so there is a significant degree of fortification in it. Half a litre of super milk has 400 units and there are also cereals that will bring up people's levels. If children take fortified milk in the morning, they will get some supplementation but it takes a long time to build up. It is not an insignificant amount, as people can imagine, but other than this there is not really much fortification. Most farmed fish will not get much vitamin D either. This is very important.

We have all been in communication individually with individual members of NPHET, almost all of whom we know quite well. They know of our concerns. What they say is we must wait for the randomised controlled studies of the intervention of vitamin D but the trouble with this is we would have to give a large population enough vitamin D for a year and have another controlled population not being given vitamin D. It would be like giving one group parachutes and not giving parachutes to the other group. This is what we are speaking about. We are not speaking about something that will do harm. It is something that has been proven to be effective. The only reason we do not have sufficient levels is because of the fact we live here. With regard to fortified food, the US and other places have reduced incidence of severe rickets. I still get people coming in with severe bone disease and osteomalacia in the Irish culture. This is the reality. There is a huge instance of deficiency and insufficiency in the Irish community.