Reports are coming in that England’s doctors are seeing more cases of Vitamin D deficiency, with at least one expert describing the issue as a major problem.

I remember my father telling me how when he was a child in London in the 1930s he developed rickets, a softening of the bones due to lack of vitamin D. He was not alone. Rickets was widespread in England at the time, but by the 1950s the disease began to disappear because of supplements like cod-liver oil and the Clean Air Act of 1956, which got rid of the smog, allowing sunlight to fall on children’s skin.

Now it appears there may be a resurgence of the disease.

Dr Benjamin Jacobs of the Royal National Orthopaedic Hospital (RNOH) in Middlesex, told the BBC Breakfast programme that he and his colleagues were seeing about one severe case of rickets a month.

Jacobs, a consultant paediatrician and Director of Children’s Services in the Paediatric Unit at the RNOH, said the situation is a “major problem”.

While his unit sees one child a month with a severe case of rickets, there are many others with less severe problems associated with insufficient vitamin D, such as muscle weakness, delay in walking and bone pains.

He said “research indicates that in many parts of the country the majority of children have a low level of vitamin D”.

Jacobs said researchers were also investigating links between vitamin D deficiency and other diseases like heart disease and some cancers.

Another concern is that many medical professionals appear to be unaware of the problem, and they, together with many parents, don’t know that the government guidelines recommend that the under-fives and certain other groups, should take a daily supplement of vitamin D.

Dame Sally Davies, the chief medical officer for England, said she is going to be writing to health professionals about it.

She said the government’s current advice is that people at risk of not getting enough vitamin D, including the under-fives and pregnant women, should take daily supplements.

“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,” she told the BBC.

“Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” said Davies, adding that it was important to raise awareness and that she will be “contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups.”

Vitamin D is found in a few natural foods such as oily fish (sardines, salmon, mackerel, pilchards and tuna), and fortified foods, such as infant formula milk, margarine and some breakfast cereals.

But only about 10% of our vitamin D comes naturally from our diet: the rest can only be made by the action of sunlight on the skin. In the UK this is most likely to be in the summer time and only in the middle of the day when the sun is high in the sky.

The main source of vitamin D for much of the UK population, however, is supplements, bought either over the counter or on prescription.

Written by Catharine Paddock PhD