Meat consumption reduces the risk of nutritional rickets and osteomalacia

Abstract

Endogenous vitamin D deficiency (low serum 25(OH)D 3 ) is a necessary but insufficient requirement for the genesis of vitamin D-deficiency rickets and osteomalacia. The magnitude of the independent contributions of dietary factors to rachitic and osteomalacic risk remains uncertain. We reanalysed two weighed dietary surveys of sixty-two cases of rickets and osteomalacia and 113 normal women and children. The independent associations of four dietary variables (vitamin D, Ca, fibre and meat intakes) and daylight outdoor exposure with rachitic and osteomalacic relative risk were estimated by multivariate logistic regression. Meat and fibre intakes showed significant negative and positive associations respectively with rachitic and osteomalacic relative risk (RR; zero meat intake: RR 29·8 (95 % CI 4·96, 181), P,0·001; fibre intake: RR 1·53 (95 % CI 1·01, 2·32), P¼0·043). The negative association of meat intakes with rachitic and osteomalacic relative risk was curvilinear; relative risk did not fall further at meat intakes above 60 g daily. Daylight outdoor exposure showed a significant negative association with combined relative risk (RR 0·33 (95 % CI 0·17, 0·66), P,0·001). Operation of the meat and fibre risk factors was related to sex, age and dietary pattern (omnivore/lactovegetarian), mainly determined by religious affiliation. The mechanism by which meat reduces rachitic and osteomalacic risk is uncertain and appears independent of revised estimates of meat vitamin D content. The meat content of the omnivore Western diet may explain its high degree of protection against nutritional rickets and osteomalacia from infancy to old age in the presence of endogenous vitamin D deficiency. Nutritional rickets: Asian rickets: Rachitic risk factors: Osteomalacic risk factorsVitamin D-deficient rickets and osteomalacia (adult rickets) occur in settings in which limited skin exposure to UV radiation constrains the photochemical synthesis of cholecalciferol from an inactive precursor (7-dehydrocholesterol;Fraser, 1995). If the diet is largely unfortified, as in the UK, the contribution of dietary vitamin D to vitamin D status is small (Lawson, 1979). The contribution of other dietary factors to the risk of nutritional rickets and osteomalacia remains the subject of debate.The identification of nutritional rickets and osteomalacia in the Glasgow Asian community in 1962 provided an opportunity to reexamine the relative roles of limited exposure to UV radiation and dietary factors in their aetiology (Dunnigan et al. 1962). Neonatal, infantile, toddler and late rickets in Asian children, and osteomalacia in Asian women, were identified in this small Asian community, and subsequently in most centres of Asian population in the UK (Ford et al. 1972a(Ford et al. , 1973Holmes et al. 1973;Stamp et al. 1980;Iqbal et al. 1994).Multivariate analysis of a 7 d weighed case -control study of dietary intakes in eleven rachitic and fourteen normal Muslim omnivore school children indicated that high intakes of dietary fibre and phytate, mainly...

Dietary intakes of retinol, β-carotene, vitamin D and vitamin E in the European Prospective Investigation into Cancer and Nutrition cohort

“…Interestingly, a non-negligible and relatively consistent contribution across centres was observed for meats and meat products to overall vitamin D intake. In fact, this food group has recently been suggested to provide more vitamin D than believed previously and a recent study shows that rickets and osteomalacia can be prevented by higher meat consumption, related in part to its vitamin D content (Dunnigan et al, 2005). The vitamin D contribution of added fats was high in northern EPIC regions, likely because of the high consumption of marine oils.…”

Vitamin D deficiency among northern Native Peoples: a real or apparent problem?

“…But dietary causes are ubiquitous. Northern Natives eat much less meat now than in the past, and a high meat diet seems to reduce the risk of rickets independently of vitamin D intake (16). Modern diets also contain substances that react with calcium or phosphorus to form insoluble salts, thereby depleting the body's supply of usable calcium and phosphorus.…”

The vitamin D slant on allergy

“…The last problem seems to be manageable. Common rickets may not be viewed simply as vitamin D deficiency (103) as many other dietary factors like calcium, phytate, phosphate and fibers are as important as sun exposure (104–106). Current experience in an anthroposophic clinic at 48 ° latitude estimates the annual incidence of observing early rickets signs to be in the range of 1–500 untreated children (D. Hilgard 2004, personal communication) Risks may be further minimized by careful examination of study participants at regular intervals.…”