Life under cover causes health problems for NZers

By MARTIN JOHNSTON health reporter

Veil-wearing Muslim women are being warned about the risks of vitamin D deficiency from too little sun exposure.

"It is a big problem," said Auckland Public Health Service dietician Kate Sladden, who helped write a fact sheet on vitamin D deficiency.

"If you're not exposing your skin to the sun - and that's the main source of vitamin D - it's quite a big issue," she said yesterday.

The fact sheet says those at risk of being deficient include veil-wearing women and their children, all dark-skinned people, pensioners in rest homes and infants exclusively breast-fed beyond six months without sunlight exposure.

Vitamin D is vital to help the body absorb calcium and phosphorus, which are needed to build and maintain bone. A shortage of the vitamin can cause childhood rickets (called osteomalacia in adults), which is soft or deformed bones.

The body produces most of its own vitamin D in skin exposed to ultraviolet light. Dietary sources include oily fish such as salmon and tuna, egg yolk, meat from organs and muscles, and full-fat milk.

Vitamin D deficiency rickets was thought to be virtually eradicated from New Zealand by the 1960s, says Public Health's latest quarterly report.

But a 1998 study at Starship children's hospital found 18 patients aged 3 months to 3 years who had the condition. All were from dark-skinned ethnic groups and more than half were Indian.

Four had delayed walking and bowed legs, three had swollen wrists and/or ankles and four had suffered seizures.

Starship paediatrician Dr Cameron Grant, one of the researchers, said yesterday that the 1998 figures were unexceptional for the hospital.

"They represent a steady stream of children who continue to present with symptomatic vitamin D deficiency."

Ms Sladden said people who might receive too little sun should ask their GPs about taking a vitamin D supplement. She had worked with Muslim Somali women who were at risk of the deficiency.

"They were aware of the issue, but they had been doing it through glass, pulling the curtains back. That's not going to do it."

The fact sheet recommends that fair-skinned adults expose their face, hands and arms - or their legs and arms - to the sun for 10 to 15 minutes, two or three times a week. Dark-skinned adults need about twice as long.

Children of each skin-type need half as long as the adults.

The Cancer Society says that in daylight-saving months, most of this exposure should be before 11am and after 4pm, to avoid the high-risk hours for sunburn.