Roman Skeletons Show Vitamin D Deficiency in Children Was a Widespread Problem 2,000 Years Ago.

Vitamin D deficiency is not a new problem. A century ago rickets in children was rife due to crowded urban living and industrial pollution. However, a new study published today in the American Journal of Physical Anthropology reveals that it was already widespread as far back as Roman times.

The study, carried out by researchers from Historic England and McMaster University in Canada, looked at 2,787 human skeletons from 18 cemeteries across the Roman Empire (1st - 6th centuries AD), ranging from northern England to southern Spain. The findings of the study showed that vitamin D deficiency was not as bad in Roman times as it became in the Industrial Revolution in the 19th century, but it was still a significant problem. Among children, more than 1 in 20 showed evidence for rickets, with most cases in infants.

The results also revealed that, in general, rickets in children was more common in northern parts of the Roman Empire than in Mediterranean lands. Weaker sunshine at northern latitudes means it is less effective for vitamin D synthesis, but the high number of rickets cases in the very young suggests that infant care practices may also have been to blame. Colder conditions in northern areas may have meant people more often kept their babies indoors, away from direct natural light. Also, pregnant mothers may have been vitamin D deficient and passed this onto their babies.

Unlike in Victorian times, vitamin D deficiency in the Roman Empire was not more common in towns than in the countryside, according to the results of this study. The researchers concluded that this was because most Roman towns were fairly small by later standards and industrial pollution would not have been enough to obscure sunlight. However, there was one place in the study, a cemetery near Ostia in Italy that was an exception to this, showing a high number of skeletons with rickets. Ostia was a port on the River Tiber, not far from Rome. It was densely populated and many people lived in multi-storey apartment buildings.

Commenting on this, Megan Brickley of McMaster University, the principle investigator on the project, said: “Living in apartments with small windows, in blocks that were closely spaced around courtyards and narrow streets, may have meant that many children weren’t exposed to enough sunlight to prevent vitamin D deficiency”.

Simon Mays, a Human Skeletal Biologist at Historic England, said: “Our study shows that vitamin D deficiency is far from being a new problem – even 2,000 years ago people, especially babies, were at risk. Being indoors away from sunshine was probably a key factor. Infant care practices that were innocuous in a Mediterranean climate may have been enough to tip babies into vitamin D deficiency under cloudy northern skies.”

The role of Vitamin D

Vitamin D is vital to health – most vitamin D is made in the body when the skin is exposed to sunlight. Deficiency can lead to rickets in children, the main signs of which are skeletal deformity with bone pain or tenderness, and muscle weakness. It can also make them more vulnerable to infections.

Today, many people living in England have low vitamin D levels, linked to indoor lifestyles. According to National Institute for Clinical Excellence (NICE) guidance, surveys suggest that 8 to 24% of children (depending on age and gender) and around 1 in 5 adults may have low vitamin D status. This is not the same as being deficient in vitamin D which is more severe.

In 2012 all UK Health Departments recommended a daily vitamin D supplements for infants and young children aged 6 months to 5 years (unless fed instant formula which is fortified with vitamin D), and for all pregnant and breastfeeding women.