Thursday 20 December 2012

Two cups of milk a day enough for kids


NEW YORK: Two cups of cow's milk per day may be enough for most kids to have the recommended amount of vitamin D in their blood while maintaining a healthy iron level, suggests a new study.

"One of the common questions I get from parents when their kids become toddlers is, ‘how much milk should they be drinking?' But we didn't have a good answer," said Dr. Jonathon Maguire, the study's lead author from Toronto's TARGet Kids! Collaboration.

One reason for the confusion, according to the researchers, is the American Academy of Pediatrics (AAP) recommends children between 2 and 8 years old drink two cups of milk per day, but in another guideline, the organization also says children need supplemental vitamin D if they drink less than four cups per day.

The researchers write in the journal Pediatrics that previous studies showed cow's milk increases the amount of vitamin D in a child's blood while also reducing iron levels. Iron, which the body can get from meats and beans, is important for developing brains and protecting against anemia.

Vitamin D, which is naturally produced in the body during sun exposure, helps the body absorb calcium and prevents the bone-softening disease rickets. People also get the vitamin by eating fortified foods, such as milk and fatty fish.

Maguire, a pediatrician at Toronto's St. Michael's Hospital, and his colleagues surveyed the parents of 1,311 children, who were between 2 and 5 years old and at pediatricians' offices in the Toronto area between December 2008 and December 2010. They also took blood samples from the children.

The researchers found one cup (250 milliliters) of milk was tied to a 5 nanomoles per liter (nmol/L) increase of vitamin D in the children's blood, and a small decrease in iron levels.

The Canadian Pediatric Society suggests children maintain a vitamin D level in their blood of at least 75 nmol/L. On average, the children were drinking just under two cups of milk per day, and were exceeding their recommended vitamin D level.

The researchers concluded that two glasses of cow's milk per day is enough to keep most kids at the suggested vitamin D levels while also maintaining a healthy amount of iron.

SUPPLEMENTS AND OTHER SOURCES

That's not a blanket suggestion for all children, however.

Maguire and his colleagues say darker skinned children may need 3 to 4 cups of milk per day during the winter, when their bodies produce less vitamin D naturally from sun exposure.

Maguire told Reuters Health that the findings seem consistent with previous recommendations.

"I don't think there is too much cause for concern. I think this is probably old news for some parents," he said.

Patsy Brannon, a professor of nutritional sciences at Cornell University in Ithaca, New York, said the finding of 2 cups of milk is consistent with the U.S. Department of Agriculture's recommendation for two and three year olds, but said older children need 2.5 cups.

Also, she points out, the U.S. Institutes of Medicine and AAP recommend a vitamin D level in children of at least 50 nmol/L, which is lower than the Canadian society's suggestion.

Currently, the AAP recommends infants, children and teens get 400 international units (IU) of vitamin D per day. The average cup of milk has about 100 IU of vitamin D.

Brannon recommends taking a daily vitamin D supplement to reach that recommendation, but adds that people can also get the vitamin from fortified cereals, grains and other foods.

"There are other sources of vitamin D in the diet besides what comes from milk. We have to be concerned about excessive milk consumption in this age group," she said. (Reuters)

Wednesday 19 December 2012

Men's cancer risk


Men look set to have a one in two chance of developing cancer in their lifetime, UK experts predict.
The increase to 50 out of 100, up from the current 44 in 100 chance, is largely down to people living longer - age is the biggest cancer risk factor, says Cancer Research UK.
The cancers set to increase the most in men within the next 15 years are bowel, prostate and skin (melanoma).
But more will survive cancer, thanks to better screening and treatments.
Medical advances mean cancer survival has already doubled in the past 40 years.

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And with more research, experts believe outcomes could continue to improve.
Projections
The team from the Wolfson Institute of Preventative Medicine at Queen Mary, University of London, and Cancer Research UK reached their figures by looking at past cancer incidence and mortality rates and projected population data for the UK.
They predict that by 2027 some 416,000 UK people are expected to be diagnosed with cancer compared with about 324,000 diagnosed in 2010.
For men, the figure will be more than 221,000, up from 164,000 in 2010.
And there will be more than 194,000 women diagnosed with cancer in 2027 compared with 160,000 in 2010 - which would mean a woman's lifetime odds of developing cancer would be 44 in 100, up from 40 in 100.
Dr Harpal Kumar of Cancer Research UK said the figures provided a glimpse into the future and what challenges lie ahead.
A pressing task is to find an effective way to screen for prostate cancer.
Not all cancer in the prostate is aggressive or life-threatening - some people live with the condition for a lifetime without any problems.
But doctors still have no reliable test that can spot which of these tumours are safe to leave alone.
Another challenge is getting men to turn up for cancer screening even when a good test for it does exist, says Alan White, chairman of the Men's Health Forum and professor of men's health at Leeds Metropolitan University.
For example, although men tend to be at greater risk of developing bowel cancer than women, relatively fewer men than women go for screening for this cancer, says Prof White.
"It's desperately important that men take up any opportunity to go for cancer screening that they can.
"Some men are fatalistic about cancer and screening. But screening does make a difference. If cancers are spotted earlier they are easier to treat.
"We also know that men who discuss screening with their doctor or their partner are more likely to take up the offer."
He said it was important for people to realise that there is a lot we can do ourselves to lower our own cancer risk, including limiting how much alcohol you drink, giving up smoking, getting enough exercise and eating a healthy diet.
Experts estimate that about four in every 10 cases of cancer could be avoided in this way.
In England, screening is available for bowel, breast and cervical (neck of the womb) cancer.
Men can also request medical tests (a prostate specific antigen blood test) if they are concerned about prostate cancer, although these checks are less than perfect.

Antibiotics 'ineffective for coughs'


Antibiotics are ineffective in treating patients with persistent coughs caused by mild chest infections, the Lancet journal reports.
About 2,000 patients across 12 European countries filled in an 'illness' diary.
The study found that the severity and duration of symptoms in patients treated with antibiotics were no different to those given a placebo.
But experts caution that if pneumonia is suspected, antibiotics should still be used due to the disease's severity.
Prof Paul Little from the University of Southampton, who led the research, said: "Using the antibiotic amoxicillin to treat respiratory infections in patients not suspected of having pneumonia is not likely to help and could be harmful.


"Overuse of antibiotics, dominated by primary care prescribing, particularly when they are ineffective, can lead to the development of resistance and have side effects like diarrhoea, rash and vomiting.
"Our results show that people get better on their own. But given that a small number of patients will benefit from antibiotics the challenge remains to identify these individuals."
Previous research into whether or not antibiotics are beneficial in the treatment of chest infections, where symptoms include shortness of breath, weakness, high fever, coughing and fatigue, have produced conflicting results- particularly in older people where chest infections can lead to further complications.
This study randomly divided patients into two groups - one received the antibiotic and the other was given a placebo, an inert treatment in the form of a sugar pill, three times a day for seven days.
The study found little difference in the severity and duration of symptoms reported between groups. This was also true for older patients - those aged 60 years or over - who made up nearly a third of the study.
And those taking antibiotics were reported to have more side effects including nausea, rash and diarrhoea than those given the placebo.
Drug resistance
Chest infections are one of the most common problems patients go to their GP about.
Dr Nick Hopkinson, a member of the British Lung Foundation, thought the study was helpful back-up when patients ask them for antibiotics.
He said: "Some patients with mild chest infections will ask for a prescription - this study can help GPs suggest it may not be the best thing for them.
"Most mild chest infections will settle by themselves with no need for antibiotics - as they are mainly caused by viruses. Those with mild infections are told to come back if symptoms don't get better.
"This study is encouraging and supports what GPs are already doing."
Overprescribing of antibiotics can lead to bacterial infection resistance.
Dr Michael Moore, from the Royal College of General Practitioners, who also co-authored the study, said: "It is important that GPs are clear when they should and should not prescribe antibiotics to patients to reduce the emergence of bacterial resistance in the community.
"This study backs the approach taken in the National Institute for Health and Clinical Excellence (NICE) guidelines that patients who present with acute lower respiratory tract infection where pneumonia is not suspected can be reassured by their GP that they will recover without antibiotics and that the illness is likely to last about three weeks in total whether or not they have a prescription."
The European study, which included Belgium, England, France and Germany, took place between November 2007 and April 2010.
It looked at 2,061 patients who had a persistent cough lasting more than 28 days and where a chest infection, like bronchitis, was suspected.
Those thought to have pneumonia were excluded from the study due to the severity of the disease if not treated promptly.
Participants completed a daily diary for the duration of their illness and rated the the severity of their symptoms including cough, shortness of breath, chest pain, and blocked or runny nose.

Some foods risk genetic colon cancer


Among people who have a genetic susceptibility to colon cancer, those whose diets are heavy in junk food have an even higher risk, according to a new study.

"These patients have this very high risk because of this (genetic) mutation they have, but it might be that they could reduce the number of (tumors) by having a more healthy lifestyle," said Akke Botma, the lead author of the study.

Botma's study is just the first to find a link between certain foods and a higher colon cancer risk in this group, and it can't prove that the diet is to blame.

All of the people in the study had Lynch syndrome, a genetic disorder that predisposes people to cancer at younger ages and that affects up to one in 660 people.

In Western countries, colorectal and endometrial cancers are the dominant cancers to turn up in people with the syndrome, while in Asia it's mostly stomach cancer, Botma said.

Up to 70 percent of people with Lynch syndrome will develop colon cancer. Among people without Lynch syndrome, such cancers are thought to be influenced by diet, particularly alcohol and red and processed meat, the authors note in their study, published in the journal Cancer.

Botma and her colleagues at Wageningen University in the Netherlands contacted 486 people with Lynch syndrome from a national database of families with inherited risks for cancer.

At the beginning of the study they surveyed the participants about what they ate, and they ranked each person on whether he ate low, medium or high amounts of foods within four dietary categories.

The food groups included one that was dominated by fruits, vegetables and whole grains; another that was high in meat and coffee; a third dietary group that resembled a Mediterranean diet - fish, leafy greens, pasta, sauces and wine; and a fourth group that was heavy on fried snacks, fast food and diet soda.

Botma and her colleagues found that, over 20 months of follow up, 56 of the participants -- or 12 percent -- screened positive for tumors in the colon, a precursor to cancer.

Of the four dietary groupings, only the junk food category showed any link with a different risk for developing colon tumors.

Of the 160 people who scored low on the junk food diet, 17 developed tumors, while 18 out of the 160 people who ate the most junk food developed tumors.

The numbers initially seemed similar, but after taking into account smoking and other risk factors, the researchers determined that those in the high junk food group were twice as likely to develop colon tumors.

HOW TO MANAGE RISKS?

"It's hard to say why" junk food is linked with a greater risk for these tumors, said Dr. Mala Pande, an instructor at the University of Texas MD Anderson Cancer Center in Houston who was not involved in the research.

She said some researchers have suggested that high fat might have something to do with it, but it's impossible to conclude that from this study.

Although the findings are too preliminary to be used in making dietary recommendations to people with Lynch Syndrome, the study was valuable in launching research into the possible role of certain foods on cancer risk, said Christopher Amos, a professor at the Geisel School of Medicine at Dartmouth College.

"People with Lynch Syndrome are at higher risk, and we'd really like to know how to manage their risks better," Amos, who was not part of the study, told Reuters Health.

Certain foods have been shown to be linked with different types of cancer, but many of those studies contradict each other and sow confusion. (Reuters)

Monday 17 December 2012

Shortage of critical care


The Paediatric Intensive Care Society and three other medical organisations say all 29 units in the UK are running close to capacity due to a surge in seasonal respiratory illness.
The Department of Health is expected to release additional money to help hospitals with winter pressures.
On Monday there were 10-20 unoccupied beds available.
During the previous week, there were days when virtually all of the beds were full - although doctors stress no child came to any harm as a result.
Services stretched
Medics say paediatric services are working hard to keep up with demand and are under "severe pressure".
Honorary secretary of the Paediatric Intensive Care Society (PICS) Peter Wilson said: "Although all trusts are really stretched we have had zero adverse outcomes, which is good news.

Malaria progress threatened


Recent gains in the fight against malaria could be reversed because funding has stalled, the World Health Organization (WHO) has said.
Its latest World Malaria Report says 1.1 million lives were saved in the past decade but that the expansion in funding from 2004-09 halted in 2010-12.
Less than half of the $5.1bn (£3.1bn) needed was spent last year.
The WHO's latest figures - for 2010 - show some 219 million people were infected, with 660,000 people dying.
'Precarious situation'
The WHO said in a statement that the plateau in funds meant "that millions of people living in highly endemic areas continue to lack access to effective malaria prevention, diagnostic testing, and treatment".
Its report said the supply of "life-saving commodities" - such as long-lasting insecticidal nets and indoor spraying programmes - had slowed.
The report said 50 countries were on track to meet targets for cutting malaria cases but that these countries only represented 3% of malaria cases.
Fourteen nations account for an estimated 80% of malaria deaths and Robert Newman, director of the WHO Global Malaria Programme in Geneva, said these high-burden countries were "in a precarious situation and most of them need urgent financial assistance".
Lead report author Richard Cibulskis said: "We need to make sure that we continue the investments in the control measures that we have.
"If we don't do that, malaria will bounce back. As soon as you take bed nets away, malaria will come back. If you stop indoor residual spraying, it will come back, and with a vengeance."

Sunday 16 December 2012

Magnetic tongue stud warning


Young people are being warned about the dangers of magnetic tongue studs, after reports of serious medical emergencies.
The head teacher of a school in Manchester has sent out an alert to parents and spoken to pupils.
The studs give the wearer the look of a tongue piercing but without a hole.
If accidentally swallowed, the magnets - designed to be worn either side of the tongue - can stick together, trapping parts of the intestine and leading to perforation of the bowel.
While magnetic facial studs can be bought online, schoolchildren are thought to be fashioning their own tongue versions using magnetic earrings and ball bearings from toy puzzles.
In his letter to parents, head teacher Kevin Hogan from St Matthew's Roman Catholic High School said: "We have spoken to all pupils about this matter and warned them of the potentially harmful consequences of swallowing these magnets.
"If your child has accidentally swallowed one or more of these balls you should seek medical advice immediately."
Dr Anil Thomas George and Dr Sandeep Motiwale, of Queen's Medical Centre in Nottingham, wrote a letter to medical journal the Lancet, asking doctors to advise parents of the dangers.
They said two young children in the East Midlands had been admitted to hospital for surgery to remove magnets that had been swallowed.
They wrote: "Parents need to be alerted to the potential risk of silent bowel perforation and fistulation from accidental ingestion of magnets in children.
"Accidental ingestion of magnetic foreign bodies, which was once rare, has become more common owing to the increasing availability of toys with magnetic elements.
"A solitary ingested magnet can pass through the gut spontaneously. However, ingestion of multiple magnets or a single magnet along with another metallic part can cause them to stick to each other with forces of up to 1,300G [gauss], compressing the intervening bowel and leading to subsequent fistulation and perforation."

Olympian lifespan 'possible for all


The longevity Olympians enjoy is within the reach of everyone, experts say.
Research published on the British Medical Journal (BMJ) website suggests athletes live 2.8 years longer on average than the average lifespan.
The research indicated those who took part in non-contact sports such as cycling, rowing and tennis enjoyed the longest life of all.
But the general population could have a similar "survival advantage" by doing a little more exercise, experts said.
The conclusion by two public health professors came after they reviewed two studies of Olympic athletes published by the BMJ website.
The studies looked at the lifespan and health of 25,000 athletes who competed in Games dating back to 1896.
Those taking part in contact sports such as boxing had the least advantage, while cyclists and rowers enjoyed the best health.
But the researchers also found those who played lower intensity sports such as golf enjoyed a boost.
'Public health failure'
Possible explanations put forward for the finding included genetic and lifestyle factors and the wealth and status that comes with sporting success.
However, the findings prompted public health experts Prof Adrian Bauman, from Australia's Sydney University, and Prof Steven Blair, from South Carolina University in the US, to suggest others could live as long as Olympic athletes.
The recommended level of physical activity for adults is 150 minutes of moderate to vigorous exercise each week.
Studies suggest people who manage that amount or more live for up to several years longer than those that do not.
Writing for the BMJ website, the professors said: "Although the evidence points to a small survival effect of being an Olympian, careful reflection suggests that similar health benefits and longevity could be achieved by all of us through regular physical activity.
"We could and should all award ourselves that personal gold medal."
But they said governments were still not doing enough to promote the benefits of physical activity, calling it a "public health failure".

Saturday 15 December 2012

Organic 'has no health benefits'



Organic food is no healthier than ordinary food, a large independent review has concluded.
There is little difference in nutritional value and no evidence of any extra health benefits from eating organic produce, UK researchers found.
The Food Standards Agency, which commissioned the report, said the findings would help people make an "informed choice".
But the Soil Association criticised the study and called for better research.
Researchers from the London School of Hygiene and Tropical Medicine looked at all the evidence on nutrition and health benefits from the past 50 years.


Among the 55 of 162 studies that were included in the final analysis, there were a small number of differences in nutrition between organic and conventionally produced food but not large enough to be of any public health relevance, said study leader Dr Alan Dangour.
Overall the report, which is published in the American Journal of Clinical Nutrition, found no differences in most nutrients in organically or conventionally grown crops, including in vitamin C, calcium, and iron.
The same was true for studies looking at meat, dairy and eggs.
Differences that were detected, for example in levels of nitrogen and phosphorus, were most likely to be due to differences in fertilizer use and ripeness at harvest and are unlikely to provide any health benefit, the report concluded.
m

Organic food



Eating organic food will not make you healthier, according to researchers at Stanford University, although it could cut your exposure to pesticides.
They looked at more than 200 studies of the content and associated health gains of organic and non-organic foods.
Overall, there was no discernible difference between the nutritional content, although the organic food was 30% less likely to contain pesticides.
Critics say the work is inconclusive and call for more studies.
The research, published in the journal Annals of Internal Medicine, looked at 17 studies comparing people who ate organic with those who did not and 223 studies that compared the levels of nutrients, bacteria, fungus or pesticides in various foods - including fruits, vegetables, grains, meats, milk and eggs.

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None of the human studies ran for longer than two years, making conclusions about long-term outcomes impossible. And all of the available evidence was relatively weak and highly variable - which the authors say is unsurprising because of all the different variables, like weather and soil type, involved.
Fruit and vegetables contained similar amounts of vitamins, and milk the same amount of protein and fat - although a few studies suggested organic milk contained more omega-3.
Organic foods did contain more nitrogen, but the researchers say this is probably due to differences in fertiliser use and ripeness at harvest and is unlikely to provide any health benefit.
Their findings support those of the UK's Food Standards Agency, which commissioned a review a few years ago into organic food claims.
Prof Alan Dangour, of the London School of Hygiene and Tropical Medicine, who carried out that work, said: "Consumers select organic foods for a variety of reasons, however this latest review identifies that at present there are no convincing differences between organic and conventional foods in nutrient content or health benefits.
"Hopefully this evidence will be useful to consumers."
Dr Crystal Smith-Spangler, the lead author of the latest review, said there were many reasons why people chose to eat organic, including animal welfare or environmental concerns.
"Some believe that organic food is always healthier and more nutritious. We were a little surprised that we didn't find that.
"There isn't much difference between organic and conventional foods, if you're an adult and making a decision based solely on your health."
But the Soil Association said the study was flawed.
"Studies that treat crop trials as if they were clinical trials of medicines, like this one, exaggerate the variation between studies, and drown out the real differences.
"A UK review paper, using the correct statistical analysis, has found that most of the differences in nutrient levels between organic and non-organic fruit and vegetables seen in this US study are actually highly significant."
A Department of Health spokeswoman said: "Evidence has not yet emerged that there are nutritional benefits from eating organically produced foods compared to conventionally produced foods. We will continue to review research on this subject."
READMORE:http://www.bbc.co.uk/news/health-19465692

Alcohol dependency



Alcohol-related health issues among baby boomers are on the rise. Daily drinking can start off as a social event but turn into dependency, addiction experts say. So when does social drinking become alcoholism?
In the festive season, with office parties, Christmas, and new year, there is opportunity aplenty for yet another tipple.
Since the 1950s, alcohol consumption in the UK has gradually increased. The NHS now spends more on alcohol-related illness among baby boomers than any other age group, with £825m spent on 55 to 74-year-olds in 2010-11 compared to £64m on under-24s.
Estimates also suggest about nine per cent of men and three per cent of women in the UK show signs of alcohol dependence.
But it is the functioning alcoholic that can slip under the radar - before their health issues are severe enough to need treatment.
Straight vodka
Dr John Marsden, an alcohol and drug dependency expert from King's College London, says a typical functioning alcoholic can manage to hold down a job despite having a "very severe drinking problem that they have been incubating over a very long period".
"Alcohol problems are difficult to understand because they do not occur overnight. They are hidden from view which makes functioning alcoholics a group we cannot easily help."
Rob C, who is 61, was one of them. At his worst he was drinking 1.5 litres of straight vodka per day.
"Then I began to suffer blackouts, losing whole days and not remembering anything."
He would be first to arrive at work, which made him able to set out his "drinks for the day with what looked like a bottle of mineral water".
"I would hide bottles around the office. You think nobody else knows, that it doesn't smell, that you're getting away with it. But of course they did notice."
Life saver
For several years, maintaining a full-time finance job, he drank increasingly more during the day.

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There was work, there was money and increasingly the motivation to alter ones mood quickly. Alcohol has been the drug of choice to do that”
Dr John MarsdenAddiction expert
What started as a social pastime nearly cost him his relationship. Now sober for eight years, looking back he says that even if a colleague had said something at the time, he would not have listened.
"I resented the changes at work and told myself I deserved a drink. I would buy wine at lunchtime and drink it from a polystyrene cup."
Wine turned to vodka for a "bigger kick" and lunchtime turned to morning through to night.
Early retirement on medical grounds made his addiction worse. It was only when his partner threatened to kick him out that he sought help with Alcoholics Anonymous, who he says saved his life.
Rob is not alone. In the last decade there has been a 63% increase in prescriptions for the treatment of alcohol dependency in England, as well as a 20% rise in deaths from liver disease.
Prof Sir Ian Gilmore, a liver specialist and chair of the Alcohol Health Alliance, believes the number of people dying from liver disease will keep rising.
The majority of people who have alcohol-related health problems are middle-aged, which Sir Ian says is a consequence of chronic alcohol misuse - many years of frequent heavy drinking, rather than binge drinking - a session of drinking large amounts of alcohol in a small space of time.
But he says that though there is a big overlap, it is important to remember not all heavy social drinkers are dependent on alcohol.
"Some people can control their drinking after work, others can't. If people are frequently drinking harmful levels of alcohol - over 50 units a week for men, 35 for women - most will end up suffering some form of physical, mental or social harm."
A lifetime's worth of drinking is catching up with baby boomers, says Emily Robinson from the Alcohol Concern.
The charity hopes that their campaign, Dry January, will help get people thinking about how much they drink, especially at home when units are harder to measure, and crucially, before they reach a stage where drinking is affecting their health.
"The issue of people drinking every day is worrying as it's a way of slipping into dependency, as you need to drink a little more each time to feel the same effects," she says.
Dr Marsden suggests the line between social drinking and dependency are clear. He says the first question that needs to be asked by clinicians or family members is: "Has anyone expressed concern to you about your drinking?"
This question assesses whether a person's behaviour has negatively impacted on someone close to them, he adds.
"If your alcohol consumption has caused a problem for someone else - I'm not rushing to label you an alcoholic but suggesting you need to take a closer look at your behaviour."
There is a clear reason the baby boomer generation is now most at risk from alcohol-related problems, argues Dr Marsden.
A hard-working generation led to an appetite for entertainment and relaxation.
"There was work, there was money and increasingly the motivation to alter one's mood quickly. Alcohol has been the drug of choice to do that."

'Action needed on vitamin D levels'




There is growing awareness about the importance of the "sunshine vitamin" - vitamin D - for health.
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.
Broken bones
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.

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In some countries, supplements are free for all”
A recent study in Australia revealed that a third of under-25% 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.
'Out of the shadows'
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.