Posted Oct 9, 2011
LARGE numbers of children could be deficient in vitamin D and in danger of rickets because they aren’t exposed to enough sunlight, it is warned today.
It is thought the lure of computer games and cultural reasons are behind vitamin D deficiency, which could have long-term health consequences.
But increased awareness about sun protection measures is also thought to play a part.
At its worst, a lack of vitamin D can lead to rickets, a Victorian-era disease which has recently re-emerged in Cardiff and other cities across the UK.
There have been six new cases of the disease, which causes bone deformities, in the Welsh capital in the last two years.
Vitamin D is essential for bone health but deficiencies have also been linked to diabetes, multiple sclerosis, some forms of cancer and other immune system problems. The human body produces vitamin D when sunlight contacts skin – only up to 40% of our vitamin D requirement comes from food.
The Welsh Government is expected to decide later this year whether to roll out a programme to give all children under four and pregnant and breastfeeding women free vitamins in a bid to address the worrying deficiencies.
Helen Nicholls, the community dietetics service manager at Cardiff and Vale University Health Board, which runs the Cardiff Vitamins Pilot, said: “Paediatricians in the community are finding a lot of children have low vitamin D levels. It’s not just that there have been cases of rickets, it’s also this wider deficiency of vitamin D. “Childhood is when you lay down healthy bone and healthy bone density.
“Sunlight is the main source, but if you’re covering your skin for cultural reasons this will affect vitamin D production.
Also people with darker skins have a longer reaction time to produce vitamin D. “But we’re seeing the deficiency in the white population, which is probably about exposure to the sun and the UK climate.
“Many of the research papers talk about the fact children aren’t outside and that’s probably a combination of us, quite rightly, being sun aware and them not playing out as much as they used to.”
Dr Elspeth Webb, a reader in child health at Cardiff University, who works as a paediatrician in the city, told the BBC programme Eye on Wales: “We’re still seeing rickets in children in Cardiff in the 21st century, which a lot of people might be very shocked and surprised by, thinking of it as a Victorian illness. But no, it’s not.
“You get women living in certain communities that perhaps don’t go out much because of religious, cultural traditions.
“They’re covered up when they do.
They don’t get enough access to sunlight, so they get vitamin D deficient. “In every pregnancy, you use up vitamin D stores and if you’re not making enough to replenish them, you get more depleted. By your third or fourth child, that child is born without enough vitamin D. They’ll be presenting with rickets at about 18 months.” Previous research studies have suggested more than 50% of the UK’s adult population have insufficient levels of vitamin D and 16% have a severe deficiency during winter and spring.
And half of pregnant women from ethnic minorities in the UK have sub-optimal levels of vitamin D. The Scientific Advisory Commission on Nutrition is currently reviewing the recommendations about vitamin D and is undertaking a risk assessment of the vitamin D status of the UK population.
As part of the Cardiff Vitamins Pilot all pregnant and breastfeeding women and children under four are being offered a specially-formulated, free vitamin supplement, instead of just those on low incomes.
In the first year of the project, the number of children’s vitamins distributed, at a cost of pounds 1.75 per eight-week course, rose from 227 to 5,877.
And the number of women’s vitamins given out at a cost of 84p per course, also rose from 30 to 4,029.
The pilot has been funded until December.
Ms Nicholls added: “Nice [National Institute for Health and Clinical Excellence] has reviewed the evidence and recommended children have these supplements.
This project tries to ensure they reach the children that really need them through health visitors and midwives who are already in contact with these families.
“It’s a good use of resources.” A Welsh Government spokesman said: “Appropriate vitamin intake is essential for healthy growth and development in babies and toddlers and to maintain the health of pregnant women.
“The Welsh Government is currently considering the results of the pilot and the Health Minister will make an announcement on the future of the scheme in the autumn.”
SUNNY TIMES Cancer Research
UK’s SunSmart campaign advises that most people in the UK only need to spend a short amount of time in the sun to make enough vitamin D. It states: “Everyone can find a balance between enjoying the beneficial effects of the sun while not increasing their risk of skin cancer.
“Once a person makes enough vitamin D, any extra is turned into inactive substances. So heavy sun exposure that leads to tanning or burning does not improve vitamin D levels beyond a maximum threshold, but it can increase the risk of skin cancer.”
It is still advised to use sunscreen cream during long or heavy exposures.