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Children wearing sunscreen, religious garments at the root of vitamin D deficiency, rise in rickets: U.K. doctor

Dr. Max Pemberton, The Daily Telegraph, National Post Wire Services |
For many years, parents have been protecting their children from the sun's harmful cancer-causing rays with sunscreen, but one U.K. doctor is suggesting they may also unwittingly be doing kids harm by blocking their bodies from absorbing much-needed vitamin D for bone development.

Most people associate rickets with Victorian urchins. Over the past half a century, the disease was virtually wiped out. But, because of a series of social and cultural shifts, it is making a comeback, with a five-fold rise in cases in the past 15 years in the U.K.

Last week, the chief medical officer for England, Dame Sally Davies, said every child should be given vitamins in order to tackle rickets. The idea was welcomed by the medical establishment, which perhaps thought that it had seen the last of the characteristic “bowing” legs associated with the condition, as the bones buckle under the weight of the upper body.

Summertime might not be the time to be worrying about taking a vitamin D supplement, but does that mean that you can let it fall off your radar entirely? Since our bodies naturally produce vitamin D through sun exposure, it follows that the brightest, most skin-bearing days of the year provide enough rays to reach our annual vitamin D peak.

But what if you’re not in the sun all that often, even in the summer? Whether because of long work hours, sunscreen use, religious beliefs, lousy weather, age or ethnicity, many Canadians simply aren’t able to meet their vitamin D needs naturally, even in this sun-bathed time of year.

Historically, the main cause of this was malnutrition. Rickets is, simply, a softening of the bones caused by a deficiency in vitamin D, calcium or phosphorus. All of these substances are needed in order to make bone, and when one or all are deficient, the bone cannot harden properly.

But the cases being seen today are almost entirely the result of a vitamin D deficiency due to a lack of sunlight: most of our vitamin D is made in our skin following sun exposure. For this reason, rickets was particularly prevalent in inner cities after the industrial revolution, because the smog and smoke that filled the air limited the amount of sun reaching people.

The current resurgence cannot be blamed on pollution. Public health campaigns have raised the issue of sunburn in children and the associated risk of skin cancer, meaning that children are now often covered up or slathered in sun block — so preventing sunlight from reacting with their skin to form vitamin D.

At the same time, children are increasingly sedentary and spend more time inside the house, watching TV and playing computer games. Parents are also more anxious about their children going out to play, fearful that they might be abducted by pedophiles. Wrapping our children in cotton wool has an unintended effect: once again, sunlight is not reaching their skin.

There are other social factors at play, too. Increasing immigration into Britain has meant there are more people living in the country whose skin is not adapted to our often-gloomy weather. This group is at increased risk of vitamin D deficiency, because the dark pigment in their skin acts as a stronger barrier to the ultraviolet rays that the skin needs to synthesize the vitamin. In countries where the sun’s rays are stronger or the days are longer, this is not a problem, but in the U.K. and Ireland it can lead to a serious deficiency.

Certain ethnic groups are at a greater risk of this because, for cultural or religious reasons, they cover up, limiting the amount of skin exposure. Indeed, all the cases I have seen of vitamin D deficiency have been in Asian women. But we are now faced with the possibility of medicating all children to combat this condition. Is this sensible?

The irony is that all this behaviour is driven by fear — fear that your children will be abducted; fear that they will get skin cancer; fear around the male gaze

We are letting children pop pills, rather than go out to play. And rather than trying to engage with and educate ethnic-minority groups about the importance of allowing their children to expose their skin to sunlight, we’re giving them a prescription and turning our backs.

While it’s a culturally sensitive issue, surely the problems associated with parents — mainly Muslim — who insist their children be covered up during gym class or, in some cases, wear a niqab or burka to and from school, need to be addressed.

The irony is that all this behaviour is driven by fear — fear that your children will be abducted; fear that they will get skin cancer; fear around the male gaze — and this has given birth to a very real, demonstrable threat: vitamin D deficiency.

I also note that only last week, Britain’s National Institute for Health and Care Excellence (Nice) warned of the increasing problem of childhood obesity, and encouraged parents to limit the amount of time youngsters spent watching television or playing computer games.

While there may well be a case for parents supplementing a child’s diet with vitamin pills, we must remember that the current worries over vitamin D deficiency are only a symptom of a bigger problem.


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