According to Dame Sally Davies, Chief Medical Officer (CMO) for England, young children and some adults are not getting enough vitamin D. Not receiving enough of the vitamin can lead to health problems including rickets, broken bones, muscle weakness and infections including TB. Research last year suggested that a quarter of Britain's toddlers did not have enough vitamin D in their bloodstreams.
The survey in October by the “Feeding For Life Foundation” showed under-utilization of the nutrient. However the Department of Health pointed out there is no national data available on how much vitamin D children of this age have in their blood. The authors looked only at vitamin D obtained from dietary sources – such as oily fish, cereal and margarine – and not from exposure to sunlight. The foundation receives financial backing from the baby food firm Cow & Gate the Department of Health added.
Professor Mitch Blair, consultant pediatrician at Northwick Park hospital in London and the officer for health promotion at the Royal College of Pediatrics and Child Health, said he had seen a resurgence of rickets in the last two to three years. “The main reason is that the public aren't aware of the importance of vitamin D anymore,” he said. Public awareness has declined since schemes such as free cod liver oil and free vitamins given out at baby clinics ended, Blair said.
Dr Benjamin Jacobs, a consultant pediatrician at the Royal National Orthopedic hospital in London, said such programmes were stopped because they were deemed “unnecessary, possibly harmful”. In retrospect, he said, “that was a major mistake”. He told BBC Breakfast, “We see about one case of rickets a month in our hospital, but that's the very severe end of the disease. There are many other children who have less severe problems - muscle weakness, delay in walking, bone pains - and research indicates that in many parts of the country the majority of children have a low level of Vitamin D.”
The NHS tries to tackle the problem through its Healthy Start scheme, which gives mothers from poorer backgrounds vouchers to exchange for either fruit and vegetables or supplements. Ninety per cent of those eligible join the scheme, but only 5% end up collecting the tablets – although take-up is better for fruit and veg. Doctors such as Blair believe it is an overly complicated scheme, especially for those for whom English is not their first language, and that simplification is needed.
The guidelines say children and pregnant women should have 400 units a day of vitamin D, but that is far less than is recommended elsewhere. In America, experts have suggested 4,000 units.
Dame Sally Davies said, “We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear - low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.”
“Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme. It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups. The Department of Health has also asked the Scientific Advisory Committee on Nutrition to review the important issue of current dietary recommendations on vitamin D,” she added.