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Rickets’ comeback alarming

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Rickets, a bone-wrenching childhood condition that virtually disappeared from Canada more than a generation ago, is making an alarming comeback, warns the Canadian Paediatric Society.

Rickets, a bone-wrenching childhood condition that virtually disappeared from Canada more than a generation ago, is making an alarming comeback, warns the Canadian Paediatric Society.At least 84 children — a number described as the “tip of the iceberg” — have been diagnosed in the past two years with rickets, according to data released yesterday.Ironically, the upsurge in cases is due principally to two health-promoting measures: breastfeeding; and sun screen, which interferes with the formation of vitamin D. Rickets is caused by vitamin D deficiency and breast milk is rich in many nutrients, but not vitamin D. That is why it is recommended that all breastfed babies be given a daily supplement of vitamin D. Breastfeeding mothers should also take a vitamin D supplement.”Breast milk is indisputably, undeniably, unquestionably the best fluid source for infants, and we’re not disputing that,” said Leanne Ward, a pediatric endocrinologist at the Children’s Hospital of Eastern Ontario in Ottawa. “But children who are breastfed should take a supplement of 400 international units [IU] of vitamin D from birth until they start drinking milk.” (All milk sold in Canada is fortified with vitamin D.)Rickets is a serious disease in which children’s bones soften and break. Vitamin D regulates the body’s ability to use calcium, which is required for building bone, and without which the skeleton literally collapses. The first symptom of rickets is convulsions. Limb pain and broken bones are commonplace. Left untreated, rickets causes permanent skeletal damage.Dr. Ward said the 84 diagnosed cases are the “tip of the iceberg” and each case is a tragedy because the condition is easily preventable. The study, released yesterday at the Paediatric Society annual meeting in Montreal, revealed that rickets is seen principally in dark-skinned children, particularly black children and aboriginal children who live in the Far North. Dark skin blocks the absorption of vitamin D from the ultraviolet rays of the sun. The Canadian Paediatric Society recommends that children in the North take at least 800 IU of vitamin D daily in the winter.Charles Scriver, a biochemical geneticist at the Montreal Children’s Hospital who treated many children with the condition in the 1960s, said Canadians cannot afford to be complacent about rickets. “Some of you are asking: ‘Why all the fuss over 84 cases?’ Do you want to wait for the flood, or deal with this today?” he said.”Don’t you dare say: ‘It’s only 84 cases.’ This is entirely preventable. There shouldn’t be a single case,” Dr. Scriver said.While rickets is the most immediate result of vitamin D deficiency, there is increasing evidence that it contributes to other serious health conditions, such as cancer, diabetes and osteoporosis. One study suggested that vitamin D deficiency plays a role in 13 types of cancer and, if everyone consumed adequate amounts of the vitamin, there would be 3,000 fewer cases of cancer in Canada annually.The new research was restricted to children under six years of age, but Dr. Ward said vitamin D deficiency is a growing problem among adolescents, particularly those who consume soft drinks instead of milk. (Vitamin D can also be found in orange juice, wheat products and dark fish, such as salmon.)”I’m seeing patients in my bone-health clinic who have subclinical vitamin D deficiency,” she said. “There is real lack of milk ingestion underlying this problem.” (Source: The Globe Toronto, June 2004)


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Posted On: 19 June, 2004
Modified On: 7 December, 2013

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