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Vitamin d Rickets and Heart Disease

Parents to blame for rickets, say physicians

Are your kids glued to the television or the computer? Do they plug their little noses at the mere suggestion of drinking milk or eating seafood? Do you have them on a strict vegetarian diet? If so, they may be at risk for rickets. Not my kids you say? This long since forgotten disease not seen since World War I, which causes bones to soften and bow from a lack of vitamin D and calcium, has resurfaced among American children. Much to the surprise of physicians and parents, the disease has shown up in infants, toddlers and children in recent years. According to the Centers for Disease Control, 9 of every million babies age six months to 1 year were hospitalized for rickets in the 1990s. African-American babies had the highest incidence of rickets.

The cause is multifaceted including not enough exposure to sunshine and a lack of calcium and vitamin D fortified foods and beverages. According to two studies published the past few years in Pediatrics and the Journal of Pediatrics, the incidence of the growth-stunting disease may be caused by parents themselves. Both studies suggested that over-zealous parents feeding their children soft drinks or beverages that are not fortified with vitamin D, such as rice and soy-based drinks, may be one cause of rickets’ recurrence.

“Milk alternative beverages not containing appropriate quantities of protein or vitamins and minerals for toddlers should carry a warning label alerting parents to their inappropriateness for this age group,” said lead author of the Pediatrics study, Norman F. Carvalho, MD, a pediatrician at Children’s Healthcare of Atlanta in an interview with The National Dairy Council. Carvalho also believes that parents may be self-diagnosing milk allergies without guidance and confirmation from a physician.

Another cause of rickets is a lack of sunshine. Latch key kids and unsafe neighborhoods often force children to spend too much time indoors. As little as 15 minutes of sunshine per day is all it takes for the body to obtain substantial amounts of Vitamin D, but only at the right latitude. Northern climates may not produce enough sunshine to prompt the body to produce enough vitamin D.

This is of particular concern for African American children. Vitamin D is made by the skin when exposed to sunlight. African Americans, Middle Eastern and Asians do not absorb sunlight as easily. Another obstacle is too much sunscreen, which can prevent vitamin D production.

The problem isn’t just with children. The Centers for Disease Control says that nearly half of African American women lack enough vitamin D in their bloodstream in the winter and 30% in the summer. A study released this week by Archives of Internal Medicine says that three out of four Americans may not get enough Vitamin D. For adults, the health risks reach far beyond bone health, lack of vitamin D may also contribute to increased risk of heart disease and cancer.

Just how much vitamin D is needed? The National Institutes of Health aren’t sure yet what to suggest. Though pediatricians have stepped up and made recommendations without waiting for the NIH. Last year, the American Academy of Pediatrics (AAP) recommended intakes of 400 IU/day of vitamin D for infants, children and teens from foods or supplements. In addition, they recommend that pregnant women and lactating women to take vitamin D supplements at the advice of their physicians. Food sources of vitamin D include salmon, egg yolks, organ meats, fortified juices and some yogurt brands.