Article

Nutritional rickets among children in the United States: Review of cases reported between 1986 and 2003

Maternal Child Nutrition Branch, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 01/2005; 80(6 Suppl):1697S-705S.
Source: PubMed

ABSTRACT

Reports of hypovitaminosis D among adults in the United States have drawn attention to the vitamin D status of children. National data on hypovitaminosis D among children are not yet available. Reports from 2000 and 2001 of rickets among children living in North Carolina, Texas, Georgia, and the mid-Atlantic region, however, confirmed the presence of vitamin D deficiency among some US children and prompted new clinical guidelines to prevent its occurrence. We reviewed reports of nutritional rickets among US children <18 y of age that were published between 1986 and 2003. We identified 166 cases of rickets in 22 published studies. Patients were 4-54 mo of age, although in 17 studies the maximal age was <30 mo. Approximately 83% of children with rickets were described as African American or black, and 96% were breast-fed. Among children who were breast-fed, only 5% of records indicated vitamin D supplementation during breast-feeding. The American Academy of Pediatrics (AAP) recently recommended a minimal intake of 200 IU/d vitamin D for all infants, beginning in the first 2 mo of life. AAP recommends a vitamin D supplement for breast-fed infants who do not consume at least 500 mL of a vitamin D-fortified beverage. Given our finding of a disproportionate number of rickets cases among young, breast-fed, black children, we recommend that education regarding AAP guidelines emphasize the higher risk of rickets among these children. Education should also emphasize the importance of weaning children to a diet adequate in both vitamin D and calcium.

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Available from: Kelley Scanlon, Aug 02, 2014
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    • "Higher melanin concentrations in the stratum corneum interferes with vitamin D's synthesis in the stratum granulosum, and darker pigmentation filters between 50 to 95 percent of the sunlight that reaches the stratum granulosum (Jablonski, 2006, p. 80-81; Kaidbey et al., 1979, pp. 249 and 253; Loomis, 1967, p. 502; Weisberg et al, 2004, p. 1703S; Holick, 2007, p. 270). 7 Therefore, a complete explanation to address the stature differential between whites and blacks may be related to biology and vitamin D production. "

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    • "Higher melanin concentrations in the stratum corneum interferes with vitamin D's synthesis in the stratum granulosum, and darker pigmentation filters between 50 to 95 percent of the sunlight that reaches the stratum granulosum (Jablonski, 2006, p. 80-81; Kaidbey et al., 1979, pp. 249 and 253; Loomis, 1967, p. 502; Weisberg et al, 2004, p. 1703S; Holick, 2007, p. 270). 7 Therefore, a complete explanation to address the stature differential between whites and blacks may be related to biology and vitamin D production. "
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