VITAMIN D and MS

Introduction

The prevalence of MS around the world varies greatly and this variation seems to correlate with the distance a country is from the equator – the latitude gradient. Countries that are further from the equator have a higher prevalence of MS. In the UK a higher prevalence of MS is found in Scotland than in England, in numbers you go from a rate in England and Wales of between 100 and 120 cases per 100 000 people up to 190 cases per 100 000 in Scotland (Figures from the MS Trust). This north-south gradient correlates inversely to sunlight exposure, particularly exposure to the ultraviolet B (UVB) component of light. The further north we live the less sunlight we see.

The link between sunlight and MS could be mediated by vitamin D. Vitamin D, also known as the sunshine vitamin was discovered in 1922 as the element in skin and cod liver oil that was responsible for treating rickets, a severe bone-deforming disease. In addition to this vital role in the maintenance of bone structure more recent studies have shown that vitamin D is important in regulating the body’s responses to infection and disease. Our major source of vitamin D is though exposure of the skin to the UVB wavelengths in sunlight. In the summer in the UK a couple of 20 minute breaks in the sun each week are sufficient for a fair skinned person to generate all the vitamin D that they need.

However from October to April in the UK the sunlight does not contain sufficient UVB rays to generate vitamin D. This means that our vitamin D levels fluctuate annually and are at their lowest in winter. The prevalence of MS also shows annual fluctuations; it appears that the month that you are born in affects your chances of developing MS. Individuals born in November least likely to develop MS, where as those born in May are most likely to develop the disease. We know already that vitamin D is important for development of the fetus, and this vitamin D must come from the mother. It is very possible that the seasonal fluctuations in vitamin D levels in individuals explain the month of birth effect seen in MS. The NHS recommends that all women take vitamin D supplements during pregnancy and while breastfeeding, regardless of the time of year.

How might vitamin D levels alter our chances of developing MS? The exact link is still under investigation and it is likely that it acts with other environmental and genetic risk factors for MS. Vitamin D is important for the correct development of many organs in the fetus including the central nervous system and the immune system. Once born vitamin D continues to be important in regulating our immune system. Vitamin D helps the body to clear infections by promoting the production of anti-microbials for example, but stopping the immune system from getting carried away by dampening some of the more potent adaptive immune responses to prevent tissue damage. Low levels of vitamin D are associated with the development of certain allergies, cancers in addition to the link to MS which are all diseases involving inappropriate immune responses.

How does this tie into our talk?
Professor George Ebers studies the genetic and environmental factors associated with MS. This includes identifying the month of birth effect seen in MS, identifying genetic risk factors and most recently linking one of these genes to vitamin D.

Dr Mark Taylor, who has MS, takes daily vitamin D supplements, he also makes sure that he sees plenty of sunshine in the summer (he still wears sun cream, just only after he’s been in the sun for 20 minutes). He also gives his children vitamin D supplements.

Cholecalciferol or vitamin D3, made by the skin in response to UVB light.

What are we knitting?

We decided that vitamin D would be a little complicated to knit (see structure) so instead we’ve gone for things that contain/give us vitamin D. So we’ve got the sun, vitamin D supplements, and two food groups that contain vitamin D; eggs and fish. We’re going to assemble them in layers into a giant D shape to really get our point across for this tableau.

Patterns

For each pattern you will need in addition to wool, a small amount of stuffing and a darning needle. Gauge is not important for any of these patterns, but it’s best if it’s tight enough to stop the stuffing poking through. As a guide we used 3.5 mm needles and double knitting wool.

Sunshine
Vitamin D Supplements
Egg
Oily Fish - Salmon or Sardines

A key to the abbreviations used in the patterns can be found here.

You can download a pdf document of these patterns here.

Sunshine pattern

You'll need two shades of yellow/orange for this sunshine one for body and another for rays.

Body

Cast On 12 stitches
R1 (RS): [M1, k3, M1, k1] repeat to row end (16 stitches)
R2 and all following WS rows: Knit.
R3: [M1, k5, M1, k1] repeat to row end (20 stitches)
R5: [M1, k7, M1, k1] repeat to row end (24 stitches)
R7: [M1, k9, M1, k1] repeat to row end (28 stitches)
R9: [M1, k11, M1, k1] repeat to row end (32 stitches)
R11: [M1, k13, M1, k1] repeat to row end (36 stitches)
R13: [M1, k15, M1, k1] repeat to row end (40 stitches)
R15: [M1, k17, M1, k1] repeat to row end (44 stitches)
R17: [M1, k19, M1, k1] repeat to row end (48 stitches)
R18-30: Knit.
R31: [K1, ssk, k18, k2tog, k1] repeat to row end (44 stitches)
R33: [K1, ssk, k16, k2tog, k1] repeat to row end (40 stitches)
R35: [K1, ssk, k14, k2tog, k1] repeat to row end (36 stitches)
R37: [K1, ssk, k12, k2tog, k1] repeat to row end (32 stitches)
R39: [K1, ssk, k10, k2tog, k1] repeat to row end (28 stitches)
R41: [K1, ssk, k8, k2tog, k1] repeat to row end (24 stitches)
R43: [K1, ssk, k6, k2tog, k1] repeat to row end (20 stitches)
R45 [K1, ssk, k4, k2tog, k1] repeat to row end (16 stitches)
R47: [K1, ssk, k2, k2tog, k1] repeat to row end (12 stitches)
R48: Cast off all stitches.

Fold in half and sew up the bottom and side of the sun. Fill with stuffing before sewing up the top.

Sunrays (make 10)

Cast on 10 stitches
R1: knit
R2: purl
R3: k2tog, k6, ssk (8 stitches)
R4: purl
R5: k2tog, k4, ssk (6 stitches)
R6: purl
R7: k2tog, k2, ssk (4 stitches)
R8: purl
R9: k2tog, ssk (2 stitches)
R10: Cast off

For each sunray, take two ray pieces and, placing wrong sides together, stuff lightly and overstitch edges together. Stitch rays to sun around the edges.

Vitamin D supplement pattern

You need two colours of wool for this pattern, or maybe 3 if you want to stitch a D into the pill. We're using pink and yellow.

Cast on 3 stitches in colour 1
R1: 3 x M1 (6 stitches)
R2: purl row
R3: 6 x M1 (12 stitches)
R4: purl row
R5-12: stocking stitch starting with a knit row
R13: change to colour 2, knit row
R14-21: stocking stitch starting with a purl row
R22: 6 x k2tog (6 stitches)
R23: purl row
R24: 3 x k2tog (3 stitches)
Cast off: Cut wool with 15-20cm/6-8” length left. Use darning needle to bring wool through remaining stitches and slide off needle.

Pull stitches tight at the end and sew up the sides of the pill, stuff before sewing up the other end.

Egg pattern

You'll need white and yellow wool for this fried egg.

Egg white

An egg rich in vitamin D by Zoe Jorro

Cast on 7 stitches
R1: knit row
R2: knit row, M1 at the beginning and end of row (2 x M1) (9 stitches)
R3-5: knit row
R6: knit row, 6 x M1 (15 stitches)
R7-10: knit row
R11: knit row, 8 xM1 (23 stitches)
R12-15: knit row
R16: knit row, 7 x M1 (30 stitches)
R17-22: knit row
R23: 10 x [k2tog, k1] (20 stitches)
R24-31: knit row
R32: 6 x [k2tog, k1], k2tog (13 stitches)
R33-36: knit row
R37: k1, 6 x k2tog (7 stitches)
R38-42: knit row
Cast off

Egg Yolk

Cast on 12 stitches, leave long tail
R1-25: knit
Cast off, leave long tail

With the wrong side of your yolk facing upwards, thread your long cast on yarn tail on to your sewing needle, complete a running stitch gather all the way around the edge of your square, pull yarn gently to gather your yolk into a round shape, push some toy stuffing inside your yolk and shape before tying off your yarn.

To put your fried egg together: using your other yellow yarn tail, sew the yolk onto your egg white base.

Fish pattern

One, two or three colours of wool depending on how you want your fish to look, plus a little scrap of black yarn to sew the eye. We're using white, light blue, silvers, greys and golds.

This pattern belongs to www.ButterflyLove1.etsy.com, we thank her for allowing us to use it in our project. Copyright for this pattern remains with ButterflyLove1 so please don't distribute the pattern or use it to make money.

The head

Cast on 36 stitches
R1-16 Stocking stitch starting with a knit row

The lateral fins

R17: k7 stitches, 2 x M1, k1, turn
R18: p5 stitches, turn
R19: M1, k2, M1, K1 (7 stitches)
R20: p7
R21: M1, K4, M1, k1 (9 stitches)
R22: p9
R23: M1, k6, M1, k1 (11 stitches)
R24: p11
R25: k11
R26: p11
R27: k1, k2tog, k6, k2tog (9 stitches)
R28: p9
R29: k1, k2tog, k4, k2tog (7 stitches)
R30: p7
R31: k1, k2tog, k2, k2tog (5 stitches)
R32: p5
R33: k1, 2 x k2tog (3 stitches)
R34: p
R35: k3 by picking up the corresponding stitches in r17 and knitting the relevant stitches in the two rows (row 17 and 35) together to make a loop and hence forming a lateral fin, k16, 2 x M1, k1, turn

Next repeat rows 18-34 to form the next fin.

Turn and K3 by picking up the corresponding stitches in row 17 and knitting the relevant stitches in the two rows together to make a loop and hence forming a lateral fin, knit to end of row.

The body stripe

Change to stripe colour if using multiple colours, leave a long tail incase needed for sewing up.

R36: K1, P1 repeat to end of row
R37: p1, k1 repeat to end of row
R38 k1, p1 repeat to end of row

The tail

Change to tail colour if using multiple colours, leave a long tail incase needed for sewing up.

R39-52: St st beginning with a k row
R53: k1, k2tog, k13, k2tog, turn
R54: p16
R55: k1, k2tog, k11, k2tog, turn
R56: p14
R57: k1, k2tog, k9, k2tog, turn
R58: p12
R59:k1, k2tog, k7, k2tog, turn
R60: p10
R61:k1, k2tog, k5, k2tog, turn
R62: p8
R63: k1, k2tog3, k2tog, turn
R64: p6
R65: M1, k2, M1, k1 (8 stitches)
R66: p
R67: M1, k7 (9 stitches)
R68: p
R69: M1, k6, M1, k1 (11 stitches)
R70:p
R71: M1, k10 (12 stitches)
R72: p
R73: M1, k9, M1, k1 (14 stitches)
R74: p
R75: M1, k13 (15 stitches)
R76: p
R77: M1, k12, M1, K1 (17 stitches)
R78: p
R79: M1, k16 (18 stitches)
R80: p
R81: M1, k15, M1, k1 (20 stitches)
R82: p
R83: k
R84:p
R85: cast off, leaving only a small length of yarn to weave in when finishing off.

Reconnect tail yarn to remaining 18 stitches on your left needle, leaving a long end fro sewing up later, and repeat rows 53-64 until only 6 stitches remain.

With right side facing:
R65b: M1, k3, M1, k1 (8 stitches)
R66b: p
R67b: k6, M1, K1 (9 stitches)
R68b: p
R69b: M1, k6, M1, k1 (11 stitches)
R70b: p
R71b: k9, M1, k1 (12 stitches)
R72b: p
R73b: M1, k9, M1, k1 (14 stitches)
R74b: p
R75b: k12, M1, k1 (15 stitches)
R76b: p
R77b: M1, k12, M1, k1 (17 stitches)
R78b: p
R79b: k15, M1, k1 (18 stitches)
R80b: p
R81b: M1, k15, M1, k1 (20 stitches)
R82b: p
R83b: k
R84b: p
R85b: cast off, leaving only a small length of yarn to weave in when finishing.

Assembling your fish

Using the tail yarn left for finishing, join the sides of your fish together using mattress stitch (sewing from the middle of the fish towards the tail end), then sew across the base of the tail and join the other side of the fish to form a pocket.

On the wrong side of each flappy tail, sew in any lose ends so that they are hidden.

Next use a length of head colour yarn to join the remaining side of the fish together (from the middle towards the head. Next stuff your fish. Finally weave the remaining length of head colour in and out of the open end of the head and use it to pull the head end closed, just like a drawstring bag. Sew across the seem to close the sides of the head together. Lastly use the scrap of black thread to sew on eyes.

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