The key facts

  • According to the National Diet and Nutrition Survey, last year nearly 25% of adolescents aged 11–18 in the UK had vitamin D deficiency, especially girls and young women.
  • According to the National Diet and Nutrition Survey, last year almost 25% of adolescents aged 11–18 in the UK had a vitamin D deficiency, especially girls and young women.
  • Deficiency in young people is hard to recognise: symptoms include fatigue, bone and joint pain; in adults it leads to softening of the bones (osteomalacia).
  • The ACT NOW Vitamin D group is calling for raising the threshold for classifying deficiency; Professor Martin Hewison proposes studying mandatory food fortification, as in Canada and Sweden.
  • The ACT NOW Vitamin D group is calling for the threshold for classifying deficiency to be raised; Professor Martin Hewison suggests studying mandatory food fortification, as in Canada and Sweden.

Fainting without warning

Saskia Reeves-Priestley, a 23-year-old teacher, suddenly collapsed at work: she says she felt dizzy, nauseous, with a racing heartbeat and a hot flush. There were no warning signs — she played football four times a week and considered herself healthy. Tests later showed her vitamin D level was 'almost at zero'. This is reported by BBC News.

The scale of the problem

In the UK, low vitamin D levels are rising in some age groups — especially among girls and young women. According to the National Diet and Nutrition Survey, last year nearly a quarter of adolescents aged 11–18 were classified as deficient. Most vitamin D is produced by the skin under ultraviolet light; its production is reduced by lack of sun, covered clothing and sunscreen, and people with darker skin need stronger light to produce the same amount. Doctors do not offer a blood test for deficiency routinely, but prescribe a supplement if a patient considers themselves at risk.

'A silent disease'

Paediatric endocrinologist Suma Uday calls deficiency a 'silent disease': in infants it is linked to rickets, in adults to osteomalacia, softening of the bones. According to her, in young people and adults deficiency is hard to notice and can be missed or misdiagnosed; symptoms include fatigue and pain in the bones and joints. 'It literally silently eats away at the bones, making them soft and prone to fractures,' she says. The second case in the article is 21-year-old student Amaka Osu, who began experiencing tremors and vision loss while cooking in her student house in Liverpool; apart from fatigue she had no symptoms, and she never thought it could happen to her, even though her mother suffered from low vitamin D.

Doctors' calls and proposals for food fortification

Uday and other clinicians and scientists have formed the ACT NOW Vitamin D group, which is calling for raising the threshold at which a person is classified as deficient: in her view, this would 'catch' more people with low levels, give a more accurate picture of prevalence and allow earlier treatment. She warns of a 'lifelong deficiency' in women — in adolescence, then during pregnancy, which also affects the newborn: 'If this is not fixed from the very beginning, it will affect several generations.' Professor Martin Hewison of the University of Birmingham notes that 100 years after the discovery of vitamin D, 'rickets has not gone away', and suggests the government consider wider fortification of foods with vitamins at the point of production — as in Canada and Sweden, where mandatory policies are in place. In the UK, some products, such as breakfast cereals and spreads, are already fortified, but voluntarily. According to him, in winter people lose their vitamin D stores, and 'we may have to accept that for certain groups, taking supplements is routine.' Saskia now takes supplements regularly and has returned to the goal.

A young woman with long braids is sitting on the grass in a park on a sunny day. She is tilted slightly to her left, smiling gently toward the camera. She is wearing a cream top, jacket and trousers. Behind her is a paper bag with the word Hunger on it. In the background is a group of young people sitting on the grassImage source, Amaka Osu
Image caption,

Amaka Osu says she doesn't think many of her friends realise what the symptoms are

A young woman with dark hair tied back, wearing a black football shirt and shorts and padded white goalkeeper gloves is standing poised in the goal mouth. Her hands are out ready and her expression is completely fixed on the ball which is heading towards her.Image source, Liam Asman
Image caption,

Saskia Reeves-Priestley plays football four times a week - and had no previous symptoms

The young woman has long, blonde hair falling over her right shoulder. She is wearing a blue dress with thin straps and gold hoop earrings. She has tanned skin and blue eyes and is looking straight into the camera with a closed-mouth smile.Side-by-side photographs of Lucy facing the camera, with long dark hair, taken at different times.Ella Kipling, a young woman with long dark hair, smiles at the camera. She is wearing a long, white dress with black polkadots and is standing in front of a large park with old buildings in the background.