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But Professor Mitch Blair, from the Royal College of Paediatrics and Child Health, says more action is needed - potentially including fortifying more foods and even cutting the cost of the vitamin to make it more easily available,Vitamin D is an essential nutrient that contributes to healthy, strong bones and helps to control the amount of calcium in the blood.Unlike many other vitamins, getting your recommended daily amount of vitamin D is not that easy. The main source is sunlight; but with short days, long nights and limited sunlight even during the summer, it's not easy to get your fix that way. Vitamin D can be found in some foods such as oily fish, eggs and mushrooms - but only 10% of a person's recommended daily amount is found naturally in food. Put bluntly, eating more fish and getting out in the sun a bit more won't make much of a difference to your vitamin D levels.Unfortunately, there is limited national research on the true extent of vitamin D deficiency in the UK population.
But we do know that there has been a four-fold increase in admissions to hospital with rickets in the last 15 years and that some groups are more 'at risk' than others - namely children, pregnant women and certain ethnic minority groups. Pilot studies and regional monitoring suggests that vitamin D deficiency is likely to affect at least half the UK's white population, up to 90% of the multi-ethnic population and a quarter of all children living in Britain. A recent study in Australia revealed that a third of under-25s are vitamin D deficient - perhaps surprising in a country blessed with plenty of sunshine. Vitamin D deficiency has been linked to a range of debilitating diseases in children and adults - including diabetes, tuberculosis, multiple sclerosis and rickets, a bone disease associated with poor children in Victorian England. Lack of vitamin D is often cited as a contributory factor in broken bones and fractures, with obvious implications for some child protection cases. The National Institute of Clinical Excellence (NICE) recommends supplements for pregnant or breastfeeding women and their children from six months to four years.
The Chief Medical Officer recommends supplements for children up to the age of five and the government's Healthy Start programme provides vitamins free for people on income support.But we believe more needs to be done.Firstly, Vitamin D supplementation should be widely available at low-cost. In some countries, supplements are free for all. Whilst the Healthy Start programme of free supplements for low income families is a positive step, evidence suggest the vitamins are in short supply and uptake is low - with many eligible people unaware that they are available or of the need to take them.Secondly, we need to look at fortifying more foods with vitamin D. Currently, many brands of cereal and orange juice contain added vitamin D which helps boost daily intake. In the USA most milk is supplemented with vitamin D, which has helped reduce deficiency, particularly in children. The Scientific Advisory Committee on Nutrition is currently looking into this.We also need to make sure healthcare professionals - including GPs, paediatricians, doctors and nurses - know the signs and symptoms of vitamin D deficiency, but more importantly give appropriate advice to patients who are 'at risk' to prevent problems developing.
And it's important that the public are aware of the implications of vitamin D deficiency, where they can get supplements and how they can boost their intake.In addition, we need more research into the links between vitamin D deficiency and bone disease - and there must be better surveillance to monitor the prevalence and incidence of vitamin D deficiency across the population. Only by knowing the true extent of the problem can we develop the most appropriate preventions - and ensure that vitamin D is brought out of the shadows and into the sun.Cover up or protect your skin before it starts to turn red or burn We need vitamin D to help the body absorb calcium and phosphate from our diet. These minerals are important for healthy bones, teeth and muscles. A lack of vitamin D – known as vitamin D deficiency – can cause bones to become soft and weak, which can lead to bone deformities. In children, for example, a lack of vitamin D can lead to rickets. In adults, it can lead to osteomalacia, which causes bone pain and tenderness.
Our body creates vitamin D from direct sunlight on our skin when we are outdoors. From about late March/early April to the end of September, most people should be able to get all the vitamin D we need from sunlight. We also get some vitamin D from a small number of foods, including oily fish such as salmon, mackerel, herring and sardines, as well as red meat and eggs. Vitamin D is also added to all infant formula milk, as well as some breakfast cereals, fat spreads and non-dairy milk alternatives. The amounts added to these products can vary and may only be added in small amounts. Manufacturers must by law add vitamin D to infant formula milk. Most people can make enough vitamin D from being out in the sun daily for short periods with their forearms, hands or lower legs uncovered and without sunscreen from late March or early April to the end of September, especially from 11am to 3pm. It's not known exactly how much time is needed in the sun to make enough vitamin D to meet the body's requirements.
This is because there are a number of factors that can affect how vitamin D is made, such as your skin colour or how much skin you have exposed. But you should be careful not to burn in the sun, so take care to cover up, or protect your skin with sunscreen, before your skin starts to turn red or burn. People with dark skin, such as those of African, African-Caribbean or south Asian origin, will need to spend longer in the sun to produce the same amount of vitamin D as someone with lighter skin. How long it takes for your skin to go red or burn varies from person to person. Cancer Research UK has a useful tool where you can find out your skin type, to see when you might be at risk of burning. Your body can't make vitamin D if you are sitting indoors by a sunny window because ultraviolet B (UVB) rays (the ones your body needs to make vitamin D) can't get through the glass. The longer you stay in the sun, especially for prolonged periods without sun protection, the greater your risk of skin cancer.
If you plan to be out in the sun for long, cover up with suitable clothing, wrap-around sunglasses, seeking shade and applying at least SPF15 sunscreen. In the UK, sunlight doesn't contain enough UVB radiation in winter (October to early March) for our skin to be able to make vitamin D. During these months, we rely on getting our vitamin D from food sources (including fortified foods) and supplements. Using sunbeds is not a recommended way of making vitamin D. Children aged under six months should be kept out of direct strong sunlight. From March to October in the UK, children should: To ensure they get enough vitamin D, babies and children aged under five years should be given vitamin D supplements even if they do get out in the sun. Find out about vitamin D supplements for children. Some groups of the population are at greater risk of not getting enough vitamin D, and the Department of Health recommends that these people should take daily vitamin D supplements, to make sure they get enough.
For the rest of the population, everyone over the age of five years (including pregnant and breastfeeding women) is advised to consider taking a daily supplement containing 10 micrograms (mcg) of vitamin D. But the majority of people aged five years and above will probably get enough vitamin D from sunlight in the summer (late March/early April to the end of September), so you might choose not to take a vitamin D supplement during these months. Find out more about who should take vitamin D supplements and how much to take. You can get vitamin supplements containing vitamin D free of charge if you are pregnant or breastfeeding, or have a child under four years of age and qualify for the Healthy Start scheme. You can also buy single vitamin supplements or vitamin drops containing vitamin D for babies and young children at most pharmacies and larger supermarkets. Speak to your pharmacist, GP or health visitor if you are unsure whether you need to take a vitamin D supplement or don't know what supplements to take.
If you choose to take vitamin D supplements, 10mcg a day will be enough for most people. People who take supplements are advised not to take more than 100mcg of vitamin D a day, as it could be harmful (100 micrograms is equal to 0.1 milligrams). This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11-17 years. Children aged one to 10 years should not have more than 50mcg a day. Babies under 12 months should not have more than 25mcg a day. Some people have medical conditions that mean they may not be able to take as much vitamin D safely. If in doubt, you should talk to your doctor. The amount of vitamin D contained in supplements is sometimes expressed in international units (IU) where 40 IU is equal to one microgram (1µg) of vitamin D. There is no risk of your body making too much vitamin D from sun exposure, but always remember to cover up or protect your skin before the time it takes you to start turning red or burn.