Vitamin D deficiency rickets in developing countries

Karrar, Zein A.

doi:10.1080/02724936.1998.11833490

Cited by 24 publications

(9 citation statements)

References 20 publications

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“…Furthermore, in Kibera there may be specific cultural practices of protecting young children from illness, security risks or the 'evil eye' by keeping them inside. 20 Our study suggests possible seasonal variability related to the rainy season, which has been shown to contribute to the lack of sunlight exposure. 21 Clothing also has a significant impact on sun exposure.…”

Section: Discussionmentioning

confidence: 68%

Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

Edwards¹,

Thiongó²,

Bergh³

et al. 2014

public health action

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This study found that rickets is a common clinical presentation among children living in the informal settlement of Kibera and that there are likely multiple factors within that environment contributing to this condition. As rickets is a simply and inexpensively preventable non-communicable disease, we suggest that routine vitamin D supplementation be formally recommended by the World Health Organization for well-child care in Africa, especially in the contexts of informal settlements.

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Section: Discussionmentioning

confidence: 68%

Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

Edwards¹,

Thiongó²,

Bergh³

et al. 2014

public health action

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“…Infantile and toddler rickets remain a significant problem in the British Asian population, in less developed economies and in ethnic minorities in several developed economies. A common factor in these settings is late weaning to a lactovegetarian diet up to at least 2 years of age (Wilton, 1995;Karrar, 1998;Bloc et al 2000;Row, 2001;Shaw & Pal, 2002;Wharton & Bishop, 2003;Weisberg et al 2004).…”

Section: Discussionmentioning

confidence: 99%

Meat consumption reduces the risk of nutritional rickets and osteomalacia

et al. 2005

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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...

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“…As in other studies (6, 7) some of the patients had biochemical markers within the reference range ( Table 2). In particular, 1,25-dihydroxyvitamin D and serum calcium may be normal in less severe cases (6,12).…”

Section: Discussionmentioning

confidence: 99%

Children with nutritional rickets referred to hospitals in Copenhagen during a 10‐year period

2003

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Pedersen P, Michaelsen KF, Mølgaard C. Children with nutritional rickets referred to hospitals in Copenhagen during a 10-year period. Acta Paediatr 2003; 92: 87-90. Stockholm. ISSN 0803-5253 Aim: To describe the prevalence of nutritional rickets among children admitted to three large paediatric departments in the Copenhagen area during a 10 y period. Methods: Retrospective analysis of cases identified from the diagnosis registers fulfilling the diagnostic criteria for nutritional rickets. Results: Forty cases were identified, distributed in two distinct age groups: 0.5-4 y (n = 31) and 9-15 y (n = 9). All cases were immigrants, of whom 95% were born in Denmark. The main symptoms in the younger age group were bowed legs and clumsy walk, and in the peripubertal group were painful joints. Two children had generalized convulsions. None of the cases had received vitamin D supplementation. Conclusion:Nutritional rickets is still present among immigrants in Denmark, and it is likely that the prevalence of mild cases is high. Prevention through vitamin D supplementation is important, but requires a dedicated health education effort.

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Vitamin D deficiency rickets in developing countries

Cited by 24 publications

References 20 publications

Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya

Meat consumption reduces the risk of nutritional rickets and osteomalacia

Children with nutritional rickets referred to hospitals in Copenhagen during a 10‐year period

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