An uptick in rickets among children is warning of vitamin D deficiency
09/20/2019 / By Evangelyn Rodriguez
Rickets is a skeletal disorder caused by a deficiency of calcium, phosphate, and vitamin D — nutrients needed for the formation of healthy bones. As a result, children who suffer from rickets tend to have weak bones, abnormal growth, and problems with their skeletal structure. Recently, a rise in the number of rickets cases, especially among children from low-income families, has been reported. While poor nutrition may be a possible reason for this increase, a report published earlier this year in the Archives of Disease in Childhood revealed that another reason is the lack of required vitamin D among some commercially available supplements. This leaves children unable to receive the right amount of vitamin D they need. Researchers from the University of Southampton in England, therefore, urge parents and clinicians to be mindful of this, especially those who rely on these supplements to help children meet their daily nutritional requirement.
Rickets: Causes and symptoms
Rickets is not only an uncommon disease in the U.S.; it is also preventable. Infants and children, particularly those experiencing a growth spurt, are the ones who usually develop rickets. However, there are also cases of rickets among teenagers. In adults, the manifestation of this disease is known as osteomalacia.
The main defining feature of rickets is soft and weak bones that can easily bend and become abnormally shaped. Malnutrition and lack of adequate sun exposure are the most common contributors to this bone disease. But while vitamin D deficiency is widely associated with it, low intake of calcium and phosphate also plays a role in its development. Malabsorption syndrome — a group of disorders characterized by the inability of the intestines to efficiently absorb nutrients from food — is another cause of vitamin D deficiency which can lead to rickets.
Symptoms that appear in infants and children with rickets include:
- Abnormally shaped legs (e.g., bow-leggedness or knock knees)
- Abnormal or stunted growth
- Bones that easily fracture
- Delayed crawling and walking
- Irritability in infants
- Larger than normal bone ends, which cause swelling at the ankles, knees, and wrists
- Late closure of the fontanelle, the soft top portion of a baby’s head
- Late appearance of the first tooth
- Seizures (in babies only a few months old) due to low calcium levels
Getting the right amount of vitamin D
Health agencies around the world recommend a daily intake of 400 IU of vitamin D for children over the age of one. To determine whether commercially available supplements are enough to meet this requirement, English researchers surveyed 67 multivitamins and vitamin D supplements for children younger than 12 years old sold in nine U.K. supermarkets. They also surveyed health supplement retailers.
The researchers looked at data from the manufacturers’ websites and the information provided on the supplements’ packaging to determine the products’ vitamin D content. They found that only 25 to 36 percent of the multivitamins they were analyzing can provide more than 400 IU of vitamin D per day. Meanwhile, vitamin D supplements and those that were labeled “for healthy bones” had higher vitamin D content than the multivitamins. At least 57 percent can provide more than 400 IU of vitamin D per day. (Related: 7 Reasons why you should always get enough vitamin D.)
Based on these findings, the researchers concluded that while supplements that have the recommended 400 IU of vitamin D are available, parents should choose carefully to make sure their children receive the right amount. They also urged clinicians to take caution when recommending vitamin D supplements.
The most reliable source of vitamin D is sunlight. To ensure that children produce enough vitamin D in their skin, allow them at least 30 minutes of sun exposure every morning, preferably before 10 AM. They should also get vitamin D from the foods in their diet. Some good sources of vitamin D are seafood like salmon, sardines, oysters, and shrimp; egg yolks; mushrooms; and fortified products like whole-grain cereals and steel-cut rolled oats.
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