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Low Dietary Calcium May Be a Major Cause of Nutritional Rickets in Infants

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New research shows that some North American infants are not receiving enough dietary calcium and, as a result, are developing rickets - a disease usually attributed to a lack of vitamin D or insufficient exposure to sunlight - at a higher level than previously thought.

The new findings, published in the August issue of The Journal of Clinical Endocrinology & Metabolism, highlight the need to maintain a healthy diet for infants and children once breast feeding stops.

Thomas Carpenter and his colleagues studied the medical records of 43 children in New Haven, Connecticut with nutritional rickets. Eighty-six percent of the children were African American, Hispanic, or Middle Eastern descent. More than 93% of the children were breast fed, but 15% received vitamin D supplementation. Records also showed that 86% of the children with available food histories were weaned to diets with minimal dairy content. The average age of developing rickets was 20 months.

Researchers found that nearly 50% of the children had normal measures of vitamin D status, suggesting that the incidence of calcium deficiency rickets is much higher than previously thought among North American infants.

"Most people think of rickets as a disease of poor, third world countries. However, we are seeing that in North American communities, infants can develop rickets if they do not receive adequate levels of vitamin D or calcium," explained Carpenter. "Once breast feeding stops, even with attention to vitamin D, many infants do not have adequate intake of calcium."

He suggests that parents and pediatricians closely monitor the diet of infants and children to make sure that they are receiving an adequate amount of calcium as well as vitamin D.

"Recent trends indicate that the fluid intake of children, once predominantly milk, increasingly consists of soda and fruit juices. Since milk is an excellent source of calcium and vitamin D for children, this trend could be contributing to the high incidence of rickets," notes Carpenter. This article was prepared by Health & Medicine Week editors from staff and other reports.

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