If you think rickets is a thing of the past, think again. A condition caused by lack of vitamin D, affecting growing bones, rickets was widespread in 19th century Britain amongst the urban poor but died out in the early part of the last century. It is now appearing again, with several hundred cases of this preventable condition reported each year. In adults it is known as osteomalacia, characterised by bone pain and tenderness. Trends such as the tendency for children spend most of their time indoors, poor diet and over-enthusiastic use of sunscreen have been linked to low levels of vitamin D, which may be affecting a quarter of the UK population.
Chief Medical Officer for England Professor Dame Sally Davis said:
“A significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood…Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.”
The UK’s Chief Medical Officers have written to health professionals, urging them to use their routine contact with high-risk patients to raise their awareness of the advice on taking vitamin D supplements and warn them of the signs and symptoms of vitamin D deficiency.
Vitamin D is essential for the proper absorption of calcium from the gut, vital for the development of strong bones and teeth. Most Vitamin D is synthesised in the body by absorption of sunlight. It is also found in food such as eggs, butter and margarine, and oily fish such as tuna, herrings and salmon. Milk, juice and breakfast cereals may be fortified with vitamin D. It is difficult to get enough vitamin D from food alone.
Who is at risk of Vitamin D deficiency?
- All pregnant and breastfeeding women, especially teenagers and young women.
- Infants and young children under 5 years of age.
- Older people aged 65 years and over.
- People who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods.
- People who have darker skin, for example people of African, African-Caribbean and South Asian origin, because their bodies are not able to make as much vitamin D.
The Department of Health recommends:
- All pregnant and breastfeeding women should take a daily supplement containing 10μg of vitamin D, to ensure the mother’s requirements for vitamin D are met and to build adequate fetal stores for early infancy.
- All infants and young children aged 6 months to 5 years should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of 7-8.5 micrograms of vitamin D per day. Formula-fed infants will not need vitamin drops until they are receiving less than 500ml of infant formula a day, as these products are fortified with vitamin D. Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy.
- People aged 65 years and over and people who are not exposed to much sun should also take a daily supplement containing 10 micrograms of vitamin D.
Free supplements for some
People on lower incomes may be able to get free vitamin supplements through the Healthy Start scheme.This is a UK-wide statutory scheme providing vouchers for basic healthy foods and coupons for vitamin supplements to pregnant women and families with children under four years old in very low-income and disadvantaged families.
Time for this elf to leave her cave, get out into the sunshine and catch a fish for lunch.
Department of Health: Dangers of vitamin D deficiency highlighted http://www.dh.gov.uk/health/2012/02/vitamin-d/
Department of Health: Vitamin D – advice on supplements for at risk groups (PDF)http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132508.pdf
Healthy Start Scheme www.healthystart.nhs.uk