Nutritional rickets: Historic overview and plan for worldwide eradication

Abstract

Rickets was first described in great detail in the mid 17 th century and was affecting a great number of children in major European cities. The disease, however, existed already in the Roman times. The etiology of this disease remained enigmatic until the 1920s when two different mechanisms, lack of exposure to sunlight and lack of a dietary factor were finally solved by the discovery of vitamin D and its dual origin. Soon thereafter, the implementation of vitamin D supplementation for all infants and small children largely eliminated nutritional rickets in Europe and North America. It took nearly a century to elucidate the complex chemistry, metabolism, mode and spectrum of activity of the vitamin D endocrine system. Nutritional rickets, whether due to simple vitamin D or calcium deficiency or both, remains widely ravaging many infants and children around the world. Asian countries and the Middle East are mainly confronted with vitamin D deficiency whereas many African and some Asian countries face calcium deficiency rickets. Immigrants and refugees or in general people with a darker skin living in moderate climate zone are also confronted with this disease. There is great consensus how this disease could be prevented or cured. In collaboration with most international professional societies, we prepare a memorandum, in line with the successful battle against iodine deficiency disorders, to convince the World Health Organization and its member states to start an implementation program to eradicate nutritional rickets by 2030.

Controversies in Vitamin D: A Statement From the Third International Conference

“…Such a task force comprised of representatives from societies such as the International Society of Endocrinology, the International Federation of Musculoskeletal Research Societies, the Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology, as well as representatives from the vitamin D conference should prepare and present a plan to the WHO to eradicate rickets before 2030. (3) Vitamin D is produced by UVB light from the sun UVB light (wavelength of approximately 280 to 310 nm) opens the B ring of 7-dehydrocholesterol, the last step in the de novo synthesis of cholesterol, and generates previtamin D, which undergoes thermally induced isomerization into vitamin D 3 before being transferred into the circulation by binding to the serum vitamin D binding protein (DBP).…”

“…Nutritional rickets, caused by a simple vitamin D or calcium deficiency or both, still affects a significant number of infants and children worldwide. ( 3 ) Vitamin D‐deficiency rickets is cured by vitamin D administration. ( 3 ) There is consensus that infants and most children require approximately 400 IU (or 600 IU for older children) of vitamin D per day to prevent rickets because direct exposure to sunlight is often avoided and not recommended for the very young.…”

“…( 3 ) Vitamin D‐deficiency rickets is cured by vitamin D administration. ( 3 ) There is consensus that infants and most children require approximately 400 IU (or 600 IU for older children) of vitamin D per day to prevent rickets because direct exposure to sunlight is often avoided and not recommended for the very young. ( 4 ) However, such a supplementation policy is either not or not fully implemented in many countries.…”

Barriers towards Sun Exposure and Strategies to Overcome These Barriers in Female Indoor Workers with Insufficient Vitamin D: A Qualitative Approach

“…However, the significant health impact of low vitamin D status remains unclear. Although incidence of rickets and osteomalacia are increasing in certain places, these conditions remain relatively rare worldwide [ 3 , 4 ]. The clinical evidence of vitamin D deficiency and nonskeletal health is not yet validated [ 5 ].…”

Determination of Iodides from Groundwater and Surface Water using an Optimized Ion Chromatographic Method

“…Iodine is an essential element required for the synthesis of thyroid hormones. Unfortunately, about two billion people are facing iodine deficiency, which is responsible for multiple disorders [1] causing serious health problems mainly at infants and young children with long-term consequences [2]. On the other hand, excess iodine content in the human diet can severely affect the hormone synthesis activity leading to goiter and hypothyroidism diseases [3,4].…”